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Title: The power of simulation: a large-scale narrative analysis of learners' experiences.
Austin Authors: Bearman, Margaret;Greenhill, Jennene;Nestel, Debra 
Affiliation: Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Centre for Research in Assessment and Digital Learning, Deakin University, Geelong, Victoria, Australia
Rural Clinical School, Flinders University, Renmark, South Australia, Australia
Monash Institute for Health and Clinical Education, Monash University, Clayton, Victoria, Australia
Issue Date: 2019 2018-10-18
Publication information: Medical education 2019; 53(4): 369-379
Abstract: Simulation-based education (SBE) includes a broad spectrum of simulation activities, which are individually well researched. An extensive literature reports on SBE methods, topics and modalities, but there are limited studies investigating how simulation as a holistic phenomenon promotes learning. This study seeks to identify the ways in which health professionals narrate powerful SBE experiences and through this to understand in what ways SBE may influence learning. Three hundred and twenty-seven narratives about powerful learning through SBE were gathered from participants' online reflections from a national faculty development programme in SBE. Narrative and thematic analyses were conducted on included texts, using 'transformative learning theory' as a sensitising notion. Narratives were categorised into the following categories: progress (267/327 = 81%); transformation (25/327 = 8%); practice (27/328 = 8%); and humiliation (8/327 = 2%). Recurrent features across narrative categories were as follows: early experiences in training; dramatic scenarios; developing appreciation of SBE; highly emotional experiences; things that 'went wrong'; and ongoing reflection. Themes regarding mechanisms that supported learning were as follows: verisimilitude; feedback, debriefing and facilitation; observation of self and others; repetition of activities; and role-playing the patient. The results generally support the notion that SBE is experienced as a holistic phenomenon, rather than separate modalities. The narrative categories, recurrent features and learning themes tended to work across all simulation modalities, with the exception of 'being in the patient's shoes' being supported by role-play in particular. Although powerful experiences were not necessarily transformative ones, they often occurred at formative stages of training. There was a strong sense that things going wrong in simulation scenarios (and the associated emotions and reflection) were a key part of learning. This underlines SBE's potential role in helping learners see fallibility as part of professional practice.
DOI: 10.1111/medu.13747
ORCID: 0000-0002-6862-9871
PubMed URL: 30334299
Type: Journal Article
Appears in Collections:Journal articles

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