Simulation-based education: deceiving learners with good intent

Abstract

The level of performance of every clinician and of the overall multiprofessional team relies on the skills and expertise they have individually and collectively acquired through education, training, self-directed learning, and reflection. Simulation-based education (SBE) is playing an increasingly important role in that respect, and it is sometimes said that it is an art to facilitate. Many explanations can justify this assertion. Although there is generally an emphasis on making everything as realistic or “high-fidelity” as possible, it is often futile and this is where the art of simulation comes into play with an element of modulation of realism linked to the intended learning objectives. The atmosphere created by the educators; how the learners are made to engage and interact; how physical, technical, and contextual elements are simulated or represented; and what type of technology is used need to be appropriately adapted to contribute to the immersiveness of any SBE activity. Although it inevitably carries a negative connotation, some form of “deception” is more commonly used than one may think for the benefit of learners during SBE. High levels of realism are sometimes achieved by making learners believe something works or reacts as would be expected in real life, whereas it is achieved in a totally different manner. Learners do not need to know, see, or understand these “tricks of the trade”, shortcuts, or artistic or technological aspects, and this can be considered a form of benevolent deception. Similarly, information may be withheld to recreate a realistic situation and push learners to demonstrate specific learning outcomes, but it needs to be practised with caution and be justifiable. These forms of “positive” deception are part of most SBE activities and are used to help learners bridge the reality gap so they can suspend disbelief more easily, exercise critical thinking, and treat the simulation more realistically without damaging the trust they place in their educators. This article will discuss how aspects of SBE activities are often manipulated, modified, or hidden from learners to facilitate the learning experience and present a simulation fidelity model encompassing the environmental, patient, semantical, and phenomenal dimensions.

Students' experience and perceived value of a clinical simulation centre

“…The importance of support and an effective pre-briefing and debriefing process facilitated by trained staff was discussed by Sawyer et al (2016), So et al (2019) and Alinier and Oriot (2022), and demonstrated by Alshammari et al (2018) in their study of Asian nursing students. The present study supports this in relation to the IR, which students perceived as an ineffective learning environment when JPP Manuscript -V.1.0 suitable faculty staff are not present.…”

“…Practising alone and within groups is important everyone learns differently, but the availability of a lecturer who can provide both a structured pre-brief and immediate debrief that facilitates guided reflection has a positive impact on the level of support perceived by students, as well as on their safety (Lane and Mitchell, 2013;Alinier and Heinrichs, 2019;Zhang et al, 2020;Schertzer and Waseem, 2021;Alinier and Oriot, 2022). Furthermore, it limits the likelihood of negative learning, where students develop misconceptions and poor practice when transitioning theory into practice.…”

“…For paramedics, the importance of simulation as part of the greater learning environment is recognised nationally by both their professional body (College of Paramedics, 2017) and regulator (Health and Care Professions Council, 2017). All this has led to higher education institutions and healthcare trusts investing a lot of time and money into the development of simulation facilities, with the aim of increasing students' exposure to experiential learning and providing staff with the capability to enhance these opportunities (Kunst et al, 2017;Alinier and Heinrichs, 2019;Senvisky et al, 2021;Alinier and Oriot, 2022). Galvanised through the emergence of affordable technologies, simulation centres have become more prevalent in these organisations (Alinier and Newton, 2013;Power et al, 2013).…”

Identifying the Challenges of Simulating the Hospital Emergency Department in the Event of Emergencies and Providing Effective Solutions: A Qualitative Study

“…Therefore, 1 of the general goals of organizations should be to strengthen the employee management system, develop the capabilities of employees, and satisfy health care. 13 According to the study of Arbon et al in Australia, 80% of nurses who volunteered for emergency care had no previous experience in emergency situations. This study about providing care based on nurses' experiences showed that nurses working in the emergency department could play an important role in emergency nursing and perform measures such as triage and life-saving intervention.…”

“…Access to data and information exchange should be such that individuals can timely access data in emergencies to circumvent strict security walls and access policies. 13,14 Most of the participants stated that a suitable infrastructure had to be used for an educational software. The software must have appropriate and attractive graphics and animation, be available to everyone, and before that it must be analyzed by a suitable scenario.…”