Fantasies of medical reality: An observational study of simulation-based medical education

Pelletier, Caroline; Kneebone, Roger

doi:10.1057/pcs.2015.50

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…Tun, Alinier, Tang, and Kneebone (2015) argue that the notion of fidelity is manufacture driven and related purely to the equipment used rather than the design or experience. Pelletier and Kneebone (2016) state that fidelity has a different meaning for different professions. Where a high-functioning, but ultimately plastic mannequin may work well for performing certain procedures (Blood Pressure, Heart Rate, Taking bloods, etc.)…”

Section: Discussionmentioning

confidence: 99%

A Systematic Scoping Review and Textual Narrative Synthesis of Undergraduate Pediatric Nursing Simulations: What, Why, and How?

Essex

Malamateniou

Narramore

et al. 2021

Clinical Simulation in Nursing

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Section: Discussionmentioning

confidence: 99%

A Systematic Scoping Review and Textual Narrative Synthesis of Undergraduate Pediatric Nursing Simulations: What, Why, and How?

Essex

Malamateniou

Narramore

et al. 2021

Clinical Simulation in Nursing

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“…By protecting against actual harm, simulation offers new design freedoms. Simulation-based encounters can be exploratory, experimental, fluid and even ludic, complementing the ‘medical’ applications of simulation and repositioning the locus of control away from clinicians [ 36 – 38 ]. Seen as an active process, simulation becomes a means of communication between people who do not have access to one another’s originary worlds.…”

Section: Introductionmentioning

confidence: 99%

Simulation reframed

Kneebone

2016

Adv Simul

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BackgroundSimulation is firmly established as a mainstay of clinical education, and extensive research has demonstrated its value. Current practice uses inanimate simulators (with a range of complexity, sophistication and cost) to address the patient ‘as body’ and trained actors or lay people (Simulated Patients) to address the patient ‘as person’. These approaches are often separate.Healthcare simulation to date has been largely for the training and assessment of clinical ‘insiders’, simulating current practices. A close coupling with the clinical world restricts access to the facilities and practices of simulation, often excluding patients, families and publics. Yet such perspectives are an essential component of clinical practice.Main bodyThis paper argues that simulation offers opportunities to move outside a clinical ‘insider’ frame and create connections with other individuals and groups. Simulation becomes a bridge between experts whose worlds do not usually intersect, inviting an exchange of insights around embodied practices—the ‘doing’ of medicine—without jeopardising the safety of actual patients.Healthcare practice and education take place within a clinical frame that often conceals parallels with other domains of expert practice. Valuable insights emerge by viewing clinical practice not only as the application of medical science but also as performance and craftsmanship.Such connections require a redefinition of simulation. Its essence is not expensive elaborate facilities. Developments such as hybrid, distributed and sequential simulation offer examples of how simulation can combine ‘patient as body’ with ‘patient as person’ at relatively low cost, democratising simulation and exerting traction beyond the clinical sphere.The essence of simulation is a purposeful design, based on an active process of selection from an originary world, abstraction of what is criterial and re-presentation in another setting for a particular purpose or audience. This may be done within traditional simulation centres, or outside in local communities, public spaces or arts and performance venues.ConclusionsSimulation has established a central role in clinical education but usually focuses on learning to do things as they are already done. Imaginatively designed, simulation offers untapped potential for deep engagement with patients, publics and experts outside medicine.

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“…If we draw on this rhetoric to examine field data generated in an ethnographic study of London-based simulation centers (Pelletier and Kneebone 2015, 2016a, 2016b, we see phenomena that are rarely commented upon in the literature on medical simulation. These include the relish with which parts were played and the pleasure taken in acting 'out of character' at work.…”

mentioning

confidence: 99%

Exploration: Wigs, Brown Sauce and Theatrical Dames—Clinical Simulation as Play

Pelletier¹,

Kneebone

2019

The Power of Play in Higher Education

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Walking into the store cupboard, just off the A&E ward, I see a pile of arms in a box. Two luxuriant scalps lay across a closed hospital laptop. Flaccid faces peak out of a drawer. Some brown liquid with a couple of blood-red specks is splattered across the base of a stainless-steel kidney dish. That store cupboard is where a London hospital's simulation centre keeps its theatrical apparel (see Figure 1). This is brought out whenever there is a simulationbased medical education course, together with the toiletry bags of make-up and sacks of costumes. The doctors and nurses who work in the simulation centre dress up the mannequin to appear as a young man who has just had a motorbike accident; or an elderly lady unsteady on her feet; or a young woman with acute pain in her belly-the appearance of each character, as in countless episodes of ER or Holby City, provoking the summary telling of a backstory, the unfolding of a storyline structured around bodily trauma, and narrative crisis resolved in the saving of a life. The doctors and nurses also wear costumes, to enact the parts of the anxious relative, the elated drunk, or the cocksure orthopedic surgeon.

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Fantasies of medical reality: An observational study of simulation-based medical education

Cited by 7 publications

References 22 publications

A Systematic Scoping Review and Textual Narrative Synthesis of Undergraduate Pediatric Nursing Simulations: What, Why, and How?

A Systematic Scoping Review and Textual Narrative Synthesis of Undergraduate Pediatric Nursing Simulations: What, Why, and How?

Simulation reframed

Exploration: Wigs, Brown Sauce and Theatrical Dames—Clinical Simulation as Play

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