The following is a joint blog post from Team 5: Christina Jones, Eunice Leung, Tala Mami, Kerry Sharples, and Lorne Strachan.
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The learning technology our team collectively took part in was a virtual healthcare simulation provided by Centennial College, Ryerson University, and George Brown College. The goal of this blog post is to take you on a journey of our simulation experiences and highlight our key learnings.
Each team member was responsible for completing a module of the experience individually before coming together as a team to discuss the findings. There were five modules offered: Emergency Room, Mental Health, Orthopedic Rehabilitation, Pediatrics, and Perinatal, with additional sub-modules depending on which experience the team member chose. Materials in each e-module provided participants with clear learning objectives, theoretical base, readings, resources, and a content summary. This prepared learners for the module simulation experience by providing an opportunity to answer reflective questions, conduct a self-assessment, and participate in an opinion poll related to each module. The simulation was designed to enable an interactive and experiential learning opportunity to explore clinical knowledge and skills. Materials were provided to allow the participant to interact with building confidence within the simulated environment.
Elements That Benefited Our Experience
The steps were easy to navigate and the use of video to replicate the hospital environment provided a realistic and relatable visual experience. A structured approach starting with a narration of each module, then interacting with the simulation allowed the participant to view which therapeutic approaches should be taken, additional information was then provided to supplement the learning modules. Lastly what the team described as the most rewarding learning experience was the post-simulation evaluation (scorecard). The scorecard debriefs offered detailed feedback and further resources to the participant including the appropriate measures to be taken grounded in clinical understanding. An empathetic approach and insight into the importance of communication were key learning objectives. The debrief had the option of a printable PDF, which allows the participant to review their scenarios adding to a well-rounded learning experience that can be later reflected upon.
Drawbacks That Were Observed
The fidelity or realism of the simulation provided a low degree of similarity between training and operational situations. The team discussed the fidelity detracted from the experience as the benefits afforded by debriefing and analyzing the collaborative experience would be enhanced by a more realistic representation. The live-action simulation with text-based responses was a little underwhelming and the simulation provided limited options to explore key skills leading the participant to predetermined conclusions. It lacked an immersive quality by limiting the path of the learner experience. Because the experience allowed limited predetermined responses, only a moderate degree of similarity between the training and operational situation was present, which would not effectively predict real-life situations.
Within each scenario, only one diagnosis/procedure/issue was presented, and the team felt a more well-rounded experience with multiple diagnoses would have been preferred. The questions asked seemed to be relevant to the objectives set for the participant, however, they seemed quite preliminary in their scope. Due to limited options to explore the key competencies and being coupled with unfamiliarity in a clinical environment, the simulation lacked confidence-building attributes. As a participant, the simulation was quite lackluster, and, in the end, the Virtual Healthcare Experience felt more like a proof-of-concept or example of how video could be used to create a scenario-based learning event and not a simulation. The currency of simulation was also not readily discernible which brings uncertainty regarding how relevant the material is considering the rate of change in healthcare.
Each team member gained knowledge from the virtual learning experience based on the learning objectives outlined in the module. The team believed the criteria were met for a valid learning experience. With the continual evolution and advancement in healthcare, content should be reviewed periodically and updated as necessary. Through our shared experience, collective research and discussions, our team concludes that functionality, interaction, authenticity, and source credibility are all vital elements/considerations needed for optimal learning purposes within educational based simulation environments. Even though the team would not feel confident applying what we learned in practice, we felt we learned and retained valuable information, appreciating the values of what the simulation afforded. The true value is evident in the interaction with the simulated environment and reflection of debriefing. Aredes, Campbell & Fonseca (2018) note that a facilitator’s knowledge of how to maximize each context is likely more important than the platform itself.
Reference
Aredes, N. D., Campbell, S. H., & Fonseca, L. M. (2018). Virtual gaming in nursing education. In R. M. Gordon & F. McGonigle (Eds.), Virtual simulation in nursing education (pp.143-158). New York, NY: Springer Publishing Company.
Centennial College, Ryerson University, and George Brown College. Virtual Healthcare Experience. (2015). Retrieved from https://de.ryerson.ca/games/nursing/hospital/index.html
Feinstein, A. H., & Cannon, H. M. (2002). Constructs of simulation evaluation. https://doi.org/10.1177/1046878102238606
May 20, 2020 at 9:15 pm
I am quite enthralled about your team’s topic, in that Air Traffic Controllers use simulation as one of the main methods of teaching. Combined within an augmented-virtual type simulation world, air traffic control students are constantly evaluated based on a plethora of categories. As Feinstein and Cannon (2202) elude to, it is difficult to create a uniformed taxonomy of simulation evaluation. This may just be due to the complexity and diverse usable states simulation affords learning institutions. In air traffic control, we are constantly re-evaluating our methods and practices to how we evaluate simulation. Feinstein and Cannon (2002) also touch on the fidelity of simulation use, or realism for lack of better term – their research allowed them to see that high fidelity did not necessarily translate into better learning experiences for students…in some cases the opposite was true. Are there tangible insights to Feinstein and Cannon’s research compilation? Of course, I believe their greatest insight to actual educators who use simulation is to ensure the simulation is validated effectively. An air traffic control instructor may create a simulation believing it to be the best simulation created on planet earth, however, once actually conducted with students, the simulation may not be an effective representation as to the real environment or the simulation may not effectively help the student learn about a particular skill/topic. Whatever the case may be, validation from multiple areas (external/internal etc…) is critical into making an effective simulation that is equally an effective learning tool. Thanks for you post.
Feinstein, A. H., & Cannon, H. M. (2002). Constructs of simulation evaluation. https://doi.org/10.1177/1046878102238606
May 29, 2020 at 12:50 pm
Hi Mark,
Thanks so much for sharing your thoughts! There are so many approaches and layers to simulations. As much as we want simulations to help properly prepare learners for the real world, there will always be experiences that they will have to learn while on the job. While working with my team on this project, it became clearer to me that learning should be a dynamic approach. We cannot depend on one particular learning method (i.e. simulations) to fully educate/train people. I think that designing learning experiences using a differentiated approach will create more holistic outcomes.
Cheers,
Eunice
May 21, 2020 at 7:31 pm
The idea behind simulated environments has always intrigued me. There are certain skills that student cannot learn in a true environment without risk to themselves or others. The medical field is a prime example of one of those environments. I woke with an allied health program and we run simulation labs in every semester of the program. The purpose of these simulation labs is to create environments for the students to learn with mannequins before they perform the procedures on live patients. Much better to practice on the mannequin and have something go wrong than on a person!
These labs are held in face-to-face environments. As the COVID-19 pandemic hit there was a lot of conversation around how to move these labs to digital environments. Fortunately, the time of year was such that the students had learned the skills and had moved into practising what they had learned. Your presentation regarding your learning event gave a possible solution. I can understand your concern with the scenario only having one outcome leading to a less than ideal experience. Something that I have observed with simulation training is that there needs to be multiple scenarios with various outcomes. After listening to your presentation, I wonder if digital simulation is not where it needs to be to be considered educational for post-secondary. Perhaps, at this time, its best place is for career exploration. It can give individuals a sense of the career before applying to a program at a post secondary.
I wonder what we can do to help simulation training get to where it needs to be for post-secondary education. Is the solution as simple as creating more scenarios? Or will it require a change in thinking surrounding simulation training?
Thank you for your thoughts and presentation.
May 29, 2020 at 4:15 pm
Hi Kathy,
Thanks for stopping by reading the blog! The healthcare simulation that my group members and I experienced had good aspects to it, but also lacked in certain areas. I know that there varying formats and interpretations of simulations that are currently available.
You’ve asked some good questions regarding the use of simulations in post-secondary education. I think that it would be interesting to see how this technology can be used in other educational environments. However, I believe that one of the reasons we don’t see simulations as widespread because it often requires more money and resources to develop and produce. As for some of the questions you posed, I don’t think it’s as simple as creating more scenarios to create a more credible and enriching experience. Like you had mentioned, it’s more of a shift in thinking surrounding simulation training. Maybe it’s more than asking ourselves what we can do to make simulations better, but instead how we can better incorporate the use of this technology in learning experiences. Through our group work, we discovered the value and richness that came from debriefing our experiences. Through those interaction and deep conversations, we were able to piece together a more comprehensive analysis when examining simulations.
Cheers,
Eunice
May 25, 2020 at 11:33 am
A very thoughtful exploration of simulations in learning. It seems both Mark and Kathy agree with Team 5 that (a) simulations can be very important where learning critical skills must be practised in low-risk environments (you don’t want to hear an air traffic controller or brain surgeon go “oops” in real life) and (b) it is very difficult to recreate a full range of realistic possible options, choices and repercussions in a simulation that could be found in reality. In terms of critical inquiry, simulations are often oversold on the basis of high fidelity in the visual and audio aspects when in fact the psychological fidelity is often the key component, and it doesn’t require the same types of fidelity. Kathy asks, “I wonder what we can do to help simulation training get to where it needs to be for post-secondary education. Is the solution as simple as creating more scenarios? Or will it require a change in thinking surrounding simulation training?” The challenges to this question are manifold, including the cost of simulation development and the associated equipment, the difficulty in creating a sufficiently rich and deep environment that takes into account many of the unexpected things that happen in real life including human behaviour and responses under stress, the cost of commercial products, the skills of faculty and media departments required to deliver and debrief simulations…and it goes on and on. In the case of such simulations as air traffic control that Mark works in, the work environment is relatively straightforward to simulate, e.g. radio transmissions, radar screens and other such equipment, although the interpersonal dynamics in the tower and the cockpits can be much more complex to reproduce. On the helpful side, many such simulations can be “replayed” from previous recorded events and debriefed at critical learning moments (which the instructor needs to be able to identify as well as observe from among the learners). In the end, as noted by Team 5, “The true value is evident in the interaction with the simulated environment and reflection of debriefing.”
Complex indeed!
May 29, 2020 at 4:29 pm
Hi Irwin,
Thanks for sharing your insights. I agree with your sentiments that simulation can be a complex technology with many different challenges. As you also mentioned, this simulations are often costly to develop and produce, which is why it is predominately used in specific industries for educational and training purposes. Now that I’ve learned a little bit more about simulations, it will be interesting to see how it will evolve in the next few years. Will this technology eventually become more accessible to the masses? Will software become widely available so that anyone can learn how to build simulation experiences just like we do with e-Learning modules?
Cheers,
Eunice