Early general and specialty medical education fellowships were developed to augment teaching skills, create communities of educators, and develop educational leaders at a time of growing interest in medical education scholarship [2]. Similarly, health services research fellowships, sponsored by groups like the Robert Wood Johnson Foundation, also offered academic, methodologic, and leadership training in order to help selected clinicians better understand nonmedical disciplines essential to health care. Today, the rapidly increasing interest in simulation [7, 8] has driven a new demand for specialty leaders. These individuals need the training to lead, develop, teach, and evaluate the kind of simulation-based initiatives which promise wide-ranging impact on health care quality and safety. While medical students and residents interested in staying in academia increasingly view simulation as a viable career pathway, they need a support infrastructure to develop and sustain education-based careers. Fellowship work can help trainees efficiently acquire needed skills by providing an intensive period of time, focus, and support.

Most current simulation fellowships are focused on physician trainees who have just completed residency training. These individuals are more likely to have experienced simulation in their prior training but typically have limited training in the theory, style, administration, and science of simulation-based education. Potential fellows can identify a range of focus areas during a simulation fellowship, including clinical teaching, medical education research, leadership and administration, and biomechanical engineering. Some institutions have chosen to combine medical education and simulation fellowships into a unified whole, complementing those shared competencies (i.e., teaching methodology, competency assessment, curriculum development, program evaluation, organizational structure, and educational scholarship) with more simulation-specific skills like technology-enhanced case development, scenario implementation, and debriefing strategies.

The primary goal of simulation fellowship programs is to create experts and leaders in the field of healthcare simulation by providing dedicated experience and mentored training in simulation-based medical education. A sample list of objectives is listed in Table 42.2.

Other objectives are at the discretion of the fellowship director and fellow, such as those focusing on specific projects tailored to the fellows’ goals and the local environment. Fellowship program objectives should adapt with changing institutional or fellow needs.

The strategies employed for any fellowship should reflect the local environment in terms of objectives, resources, and faculty. It is more efficient to make use of existing courses and infrastructure, such as master’s degree coursework or certificate programs, and established faculty development workshops. It is helpful if the simulation fellows can join an existing cohort of research and education trainees in other disciplines to learn from one another, share research ideas, and participate in collective “works-in-progress” presentation and feedback sessions.

Educational strategies should map to the objectives of the program. The sample objectives from Table 42.2 are recounted below with example strategies matched to each item:

The implementation of a fellowship program will be driven by the local environment and resources. This section will be a general discussion of simulation fellowship program implementation, with framework adapted from Kern’s curricular development model [6], including a discussion of resources, support, administration, barriers, and introduction of the curriculum.

While not required for the academic training component of the fellowship, clinicians need a venue to maintain their clinical skill during the fellowship period. This clinical component complements the simulation fellowship work and is typically arranged in collaboration with the relevant clinical department of the base institution. However, some fellows may arrange clinical work independently, as long as it fits within the structure and time demands of the fellowship curriculum. Under special arrangement, some fellows, particularly international research physicians, will be eligible only for nonclinical fellowship experience.

Resources required for any fellowship program revolve around discussion of applicants, faculty, time, facilities, and funding considerations.