Table 3 Individual and organisational factors, barriers and expedient factors expressed in the interviews with faculty before the simulation training period started

High workload on the base

The facilitator and the crew members have to be flexible

Accept variation on workload. Plan less training in high seasons and more training in quiet periods

Pilots are used to frequent simulation of technical skills, and it can be a challenge to involve them in the medical treatment of patients

Involve the pilot in the development of the scenarios

Clear learning objectives for each crew member

Pilots are the leader of the crew and can decide that other things should be trained

Participants who have a passive role in the training, may lose interest

The physician might be the most motivated for training

Focus on both medical, non-technical and technical skills

The physician is afraid to be tested in their role as a medical expert their knowledge and skills will be exposed to the crew

Some pilots will feel exposed. It is expected that they know where things are

You see that the pilot is asked to fetch things, and you will have questions, they have never dared to ask. They ask about the treatment, CRM challenges and other issues that have not been discussed openly before

My own calendar is full

To involve another instructor

An advantage to have two facilitators, because they can share the workload. A secondary benefit is that they can try both the role of the facilitator and course participant

The distance to the base is long

Train either before or after being on call myself

Only one instructor on the base

Facilitation by distance solutions

Create a facilitator network; a buddy to contact and discuss with would help, could be from another base

High personal expectations

It can be difficult to get started

Be more enthusiastic in the beginning, and then, later, it will be easier for the facilitator

Lack of routine in/habit of conducting training

Participate in a 3-day instructor course

It will be easier when you have more routine

Exchange or visit a facilitator on another base, see how others do it. In addition, you discover the culture at other bases

Logistical challenge to get the technical things ready

Manage to structure the debriefing

Contact other facilitators that can guide you

Continuous development with the help of other more skilled facilitators from other bases to ensure that I learn from my mistakes. To help me develop my competence

Participate in training myself

Learning from being a facilitator

The facilitator learns from conducting simulations; they see different solutions and hear reflections. You discover how your colleagues work and you learn a lot from seeing how they solve the tasks

Learning from colleagues is a benefit—we have to talk more about medical skills in the group on the base. The CRM aspect can also be useful

Some leaders might be sceptical and do not fully support it

My leaders are very positive—they fully support me and have sent mail stating that simulation is planned and to be seen as equal to other training activities

Competition with daily missions

In the weekly plan, the facilitator should be free to run the training at least once a week

Another simulation project is running already

We have to find a way so both projects can run

If there is maintenance on the helicopter, the crew can still train

Payment of the facilitators

The project is financed for one year

At the end of the project, the payment will stop

If the crew members see the training as a positive, a learning experience, they will ask for training after the project has ended