Simulation-based training for increasing health service board members' effectiveness: a cluster randomised controlled trial

Nicholas Faulkner, Breanna Wright, Alyse Lennox, Marie Bismark, Jane Boag, Sophie Boffa, Bruce Waxman, Janet Watson-Kruse, Geoff Paine, Peter Bragge

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Objectives There is a paucity of research on how to improve the functioning of health service boards, despite their importance in influencing patient care. We examined the impact of simulation-based training on health service board members' perceptions of their skills in communicating during board meetings and of board meeting processes. Design Prospective, cluster randomised controlled trial. Setting Health service boards in Victoria, Australia. Participants Twelve boards were randomised, and pre- and post-intervention data were collected and analysed from 57 members of these boards. Interventions Boards were randomly allocated to either a treatment condition in which they received a 2-hour simulation-based training session or to a wait list control condition. Primary and secondary outcome measures Primary outcome variables were board members' perceptions regarding: (1) their skill and confidence in communicating during board meetings and (2) processes at their board meetings. Measures were collected in the intervention group before and 3 months post-training and compared with a wait list control group. Results Skills and confidence in communicating during board meetings was higher after training (control marginal mean=5.11, intervention marginal mean=5.42, mean difference=0.31, 90% CI (-0.03 to 0.66), one-sided p=0.068, d=0.40). Board meeting processes were also improved after training (control marginal mean=4.97, intervention marginal mean=5.37, mean difference=0.40, 90% CI (0.14 to 0.65), one-sided p=0.005, d=0.54). Conclusions Simulation-based training appeared to improve board members' skills and confidence, and perceptions of board meeting processes. A larger scale trial is needed to examine possible impacts on patient outcomes. Trial registration Open Science Framework:; Pre-results.

Original languageEnglish
Article numbere034994
Number of pages8
JournalBMJ Open
Issue number12
Publication statusPublished - 13 Dec 2020


  • education & training (see medical education & training)
  • health policy
  • organisation of health services
  • quality in health care

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