WHY the Simulation Culture Organizational Readiness Survey (SCORS) was Developed

The Simulation Organizational Readiness Survey (SCORS) was developed to assist administrators in evaluating institutional and program readiness for simulation integration. Around the world, simulators sit unused on beds, in closets, and often still in their boxes. This is costly to the organization because it ties up valuable fiscal resources, there is poor or absent uptake of simulation, a failure to link course and program outcomes, and creates a disservice to learners who are not exposed to effective evidence-based teaching practices.

Failure to ensure organizational readiness and lack of strategic planning prior to purchase of simulation equipment is often a verbalized cause of why the equipment is unused or under-used. Historically, point-of-use simulationists self-educate, learn from conference presenters and by reading journals. No matter their excitement, ideas, or attempts to integrate, they do not have decision-making power or budgetary control.

As a result of this, we decided to create a tool that will assist organizational leadership to better understand the necessary components to address PRIOR to purchasing simulation equipment, with the goal of increasing effective and efficient integration of simulation into the academic or organizational education curriculum.

Leighton et al. SCORS(1).mp4

HOW the Simulation Culture Organizational Readiness Survey (SCORS) was Developed

These reports, standards, and guidelines were used to create the SCORS:

The SCORS has 38 items in 4 subscales, answered using a 5-point Likert scale


  • Defined Need & Support for Change (9 items)
  • Readiness for Culture Change (11 items)
  • Time, Personnel & Resource Readiness (12 items)
  • Sustainability Practices (4 items)
  • Current Readiness & Progress (2 items)

Reliability and Validity of the SCORS

Sample: 103 healthcare educators (52% 4-year institutions, 24% community college, hospitals 7%, graduate programs 3% and other 14%)

Expert Panel

Six expert simulationists with graduate degrees and a minimum of 5 years experience with simulation-based education completed the content validity tasks necessary to establish validity of the tool.

Content validity indexes for each survey item ranged from .67 - 1.00. Two items had a CVI of .50. Feedback was incorporated and wording changes were made. All items were retained in the survey.

Internal Consistency of SCORS Subscales

Using the SCORS

The SCORS is designed for evaluation of organizational readiness for integration of simulation. While most respondents were nurses, the sample included academic and clinical educators and leaders. The SCORS can be completed by individuals, but there may be more value in completing the survey as a team. This provides the opportunity for input from leadership as well as the front-line simulatonists. Because oftentimes, everyone is not on the same page, meaningful conversations can occur that will increase understanding of the requirements for successful simulation integration.


The SCORS Guidebook: A Companion for Completing the Simulation Culture Organizational Readiness Survey was created to provide additional guidance in how to complete the SCORS. All persons completing the tool should be familiar with the information contained in this Guidebook. It is available for download if you decide to consider use of the tool.


The SCORS is useful for evaluating an organization's readiness to begin or improve simulation integration in their program (academic or clinical). Results can be used to:

    1. Identify areas of strengths and weaknesses that may impact successful integration of simulation
    2. Prioritize areas that require improvement
    3. Guide budgeting needs related to simulation


The scoring criteria for the SCORS is embedded in the Guidebook. Consider prioritizing results according to subscales of highest need and those areas that can quickly be improved.

Click HERE to obtain your copy of the Simulation Culture Organizational Readiness Survey (SCORS) and Guidebook.


For additional detail regarding the development and psychometric analysis of the SCORS:

Leighton, K., Foisy-Doll, C., & Gilbert, G. E. (2018). Development and psychometric evaluation of the Simulation Culture Organizational Readiness Survey (SCORS). Nurse Educator, 43(5), 251-255. doi: 10.1097/NNE.0000000000000504

Agency for Healthcare Research and Quality. (2015). Readiness assessment. Retrieved from

Melnyk, B. M., & Fineout-Overholt, E. (Eds.). (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Patillo, R. E., Hewett, B., McCarthy, M. D., & Molinari, D. (2010). Capacity building for simulation sustainability. Clinical Simulation in Nursing, 6(5), e185-e191. doi: 10.1016/j.ecns.2009.08.008

Taplay, K., Jack, S. M., Baxter, P., Martin, E. K. (2014). Organizational culture shapes the adoption and incorporation of simulation into nursing curricula: A grounded theory study. Nursing Research & Practice, Article ID 197591. doi:10.1155/2014/197591

Webpage suggested citation:

Leighton, K. (2018). Simulation Culture Organizational Readiness Survey. Retrieved from