As part of LRNT526, Inquiry into Contemporary Issues in Learning Technology, our team decided to investigate the application of simulations as educational technology in educational contexts. After participating in a Virtual Healthcare experience  (De.ryerson, n.d.) and attending five different modules; Mental Health, Medical-Surgical, Maternal & Child, and Pediatrics, we reviewed the associated literature and collectively approached this learning event with a critical inquiry lens. Our group decided to focus on three main areas (1) The importance of debriefing of a simulated learning event (2) The application of simulations embedded within a learning experience (3) The evaluation of a simulation’s effectiveness. My critical personal inquiry in this course will be examining simulations from a Universal Design for Learning (UDL) lens.Â
Simulation as educational technology aims to imitate reality to facilitate learning in a safe and secure environment, often immersive in nature, to evoke or replicate substantial aspects of the real world in a fully interactive manner (Lateef, 2010). Simulations align with the Schank—Learning by Doing model as they can assist a goal-based scenario learning. Merrill (2002) postulated that “GBS [goal-based scenario] is a learn-by-doing simulation in which students pursue a goal by practicing target skills and using relevant content knowledge to help them achieve their goal” (Merrill, 2002, p.56). The technical (hard) design of simulations is variable depending on the degree that they match reality. Accordingly, simulations techniques can have low and high fidelity (Cant & Cooper,2009). However, the human factor should also contribute to the variability of simulations design. From a critical approach towards educational technology, the human factor allows us to investigate how individual learning technologies (simulations in this case) fit into wider socio-technical systems and networks (Selwyn, 2010). Dron (2014) also emphasized the role of humans in the process of learning by describing the process of learning as a “richly dynamic, interconnected, and human system in which we are at once the actors and the acted-upon” (Dron, 2014, p.261). How can we utilize UDL to act upon our role as humans in the learning process?
Introducing UDL to the instructional practices in the simulation’s design supports the human role in the learning process. The Center for Applied Special Technology, Inc. (CAST), an educational research organization, introduced UDL in its earliest form nearly 35 years ago and explained that the concept of UDL in education considers three distinct elements; multiple means of representation, action and expression, and engagement. (CAST, 2018). The UDL guidelines aim to improve and optimize teaching and learning for individuals based on scientific insights (CAST, 2018). Therefore, embedding inclusive pedagogical practices within course design and delivery support the increased diversity of the student population. My efforts in my critical personal inquiry will be to answer some if not all of the questions: How can UDL be applied in simulation debriefing to facilitate and enhance learning? Simulations as immersive environments afford applications that were previously limited to the real event, what can be brought to the learning environment if we apply UDL guidelines in the simulation design? Lastly, how does UDL affect the effectiveness of the simulations as educational technology?
Have you had any experience in simulations in an educational context? If yes, have you applied UDL guidelines? How?Â
References
CAST (2018). Universal Design for Learning Guidelines version 2.2. Retrieved from http://udlguidelines.cast.org
De.ryerson. (n.d.). Virtual Healthcare Experience. Retrieved from https://de.ryerson.ca/games/nursing/hospital/index.html
Dron, J. (2014). Chapter 9: Innovation and Change: Changing how we Change. In Zawacki-Richter, O. & Anderson, T. (Eds.), Online distance education: Towards a research agenda. Athabasca, AB: AU Press. doi: https://doi.org/10.15215/aupress/9781927356623.01
Lateef, F. (2010). Simulation-based learning: Just like the real thing. Journal of Emergencies, Trauma and Shock, 3(4), 348.
Merrill, M. D. (2002). First principles of instruction. Educational Technology Research and Development, 50(3), 43-59. Retrieved from https://doi-org.ezproxy.royalroads.ca/10.1007/BF02505024
Selwyn, N. (2010). Looking beyond learning: notes towards the critical study of educational technology. Journal of Computer Assisted Learning, 26(1), 65-73. doi:10.1111/j.1365-2729.2009.00338.x
Attribution
April 23, 2020 at 10:01 am
Thanks for sharing your UDL research interests concerning simulations Tala, I find this fascinating; both the educational technologies potential for developing student competencies and how this experience can be augmented to support diverse learning needs using UDL. My institution has patient simulators in the nursing labs, which are designed to replicate a variety of healthcare environments, including acute care, medical-surgical, obstetrics and pediatrics. The simulators have many functions allowing for clinical skills practice and evaluation using customized case studies. Instructors can provide a voice to these simulators from a sound booth, adding a level of authenticity to the simulated scenarios. I have been present in many meetings where the design of the simulators from a student learning perspective has been discussed, at length, and there are ongoing efforts to incorporate accessibility levellers such as diverse speech software (languages) and sound and light indicators; as well as processes for post reflection and discourse, and charting patient care. Incorporations of UDL principles can support learners in these simulated scenarios and can be beneficial to students; nevertheless, I wonder how this will translate in practicum situations where scenarios are no longer mock, and the added human complexities come into play? Will UDL, in theory, translate into improved practice and care approaches in real life?
I am looking forward to what you discover, Tala!
April 23, 2020 at 9:19 pm
Hi Lisa,
Thank you so much for sharing your experience with simulations in nursing labs. I love how you pointed out that “instructors can provide a voice to these simulators from a sound booth, adding a level of authenticity to the simulated scenarios”. I was looking at the INACSL Standards of Best Practice for Simulation (https://www.inacsl.org/inacsl-standards-of-best-practice-simulation/). They actually have a whole section that specifically addresses the facilitation process in simulations. Facilitation methods depend on the levels of the participants, where instructors should take into consideration the cultural and individual differences that affect participants’ knowledge, skills, attitudes, and behaviours. UDL incorporation can help instructors with this complex task. But, As you said in situations where scenarios are not mock, it is even more challenging to facilitate such scenarios. High fidelity simulation is able to provide participants with a learning environment in which they develop non-technical skills, that are safe and controlled and participants would be able to make and correct mistakes without the fear of compromising patient safety. Examining how UDL would help with such “human complexities” in such scenarios is differently something I’m looking forward to exploring!
April 23, 2020 at 11:39 am
Tala the idea of humanizing simulation learning experiences with UDL in mind is an interesting one, and the focus on debriefing is particularly germane to simulation learning, as you point out. Lisa points out an important aspect of debriefing which is formative, designed to keep improving the simulation technology, learning design and overall experience; i.e. learning how to improve the simulation. Another function is the pedagogical one, which is to elicit, encourage reflection and application of learning on the part of the learner post-simulation. You might choose either type of debriefing, or both, for your study and its focus on UDL. An interesting and unique topic.
April 23, 2020 at 9:30 pm
Thank you for your feedback, Irwin.
Do you know what I like the most about this course? The flexibility in directing your focus and interest as you explore the literature. I’m still not sure what type of debriefing I will choose for this assignment, as you said in one of our collaborate sessions, examining the literature can be like reading a story. I am close to reaching the plot 🙂 Looking forward to continuing my learning journey and seeing how the ending would look like!
Cheers,
Tala
April 23, 2020 at 5:35 pm
Tala,
Thanks for sharing your ideas about simulation learning and UDL. I think that simulation learning will become more and more valuable in this age of social distancing. I recently created a learning event about story meetings: how to pitch a news story, and how to run an effective story meeting. The course is conducted in situ, in story meetings in news rooms. But now that story meetings are mostly done online, I am wondering if there is an opportunity to modify the course into a simulation learning event. Story meetings are organic and interactive, and the may be too complex to create a simulation. Perhaps a gameification of a story meeting, with a series of possible answers to guide the learners. In any case, it’s a fascinating topic. Good luck.
April 23, 2020 at 9:41 pm
Thank you Jeff for taking the time to comment on my post.
This is such an interesting idea to add a simulation approach to a story meeting. I totally understand how applying a narrative/story context provides a mechanism for learning and maintaining participants’ engagement!
I don’t want to share details about our team’s presentation before presenting, but now that you have mentioned storyboards, I must tell you that we will be addressing them during our presentation. If you’re free, please join us, we might spark an idea 🙂 Our presentation will be on May 13th, 1:00 pm (PST). We will be more than happy to have you present with us!
Good luck to you too!
Tala
April 29, 2020 at 12:33 pm
Hi Tala,
You pose some interesting, thought provoking questions regarding the compatibility of simulation learning with UDL guidelines and how can this style of learning be improved through the use of UDL’s design concepts. I found the idea of UDL and debriefing in simulation-based learning very interesting as I believe there exists an excellent pairing of need and facilitation.
The importance of debriefing post simulation stems from the recognition of the need to allow participants the opportunity to reconcile and reflect on the activity that has just been completed. Or as Fanning and Gaba suggest, the debrief is to guide participants through the emotional processing of their experience ( 2007 ).
The UDL guidelines provide ample opportunity for both parties, the moderator and participant, to express themselves in a unique way that is most comfortable to them. This is very much encompassing the principles of empathetic design that we examined in LRNT524 allowing for the creation of systems or processes that include consideration of end user context (Mattelmäki, Vaajakallio, & Koskinen, 2014).
UDL guidelines offer excellent guideposts for the development of a debriefing model that will enable all levels of understanding to express their understandings and experiences from a simulation learning event (“UDL: The UDL Guidelines,” n.d.). The provision for multiple means of expression and engagement enable participants a wide array of modalities with which to express themselves while also allowing for the moderator plenty of latitude with which to conduct an inquiry.
This is a very timely subject with the current movement towards online teaching and learning which may drive the development and inclusion of simulation learning into mainstream education.
Thank you for introducing me to this resource.
It is an excellent reference with which to inform a lesson plan and assessment matrix.
Owen
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References
Fanning, R. M., & Gaba, D. M. (2007). The Role of Debriefing in Simulation-Based Learning. Simulation in Healthcare, 2(2), 115–125. https://doi.org/10.1097/SIH.0b013e3180315539
Mattelmäki, T., Vaajakallio, K., & Koskinen, I. (2014). What Happened to Empathic Design? Design Issues, 30(1), 67–77. https://doi.org/10.1162/DESI_a_00249
UDL: The UDL Guidelines. (n.d.). Retrieved April 29, 2020, from http://udlguidelines.cast.org/?utm_medium=web&utm_campaign=none&utm_source=cast-about-udl
April 29, 2020 at 9:42 pm
Hi Owen,
Thank you for taking the time to comment on my blog and also for sharing these interesting resources!
You talked about an important aspect of debriefing in simulation-based learning; fostering learners’ emotional processing simulation experience. Another example of supporting the emotional states of individual learners is confidentiality. Supportive and respectful learning environments strategies support the emotional state for participants. For example, Zigmont, Kappus, & Sudikoff (2011) explained how supporting performance confidentiality in simulation-based learning is extremely important. Unlike instructor-based learning, in some cases in simulations, a learner’s performance can be observed by the whole group. How can you maintain confidentiality in such cases to create support, rapport but also trust sot that the learning experience will not compromise learners’ emotional state?
Zigmont, Kappus, & Sudikoff (2011) introduced six strategies to address confidentiality in simulation-based learning:
“(1) define the goals (ie, assessment or learning) for participants before the course; (2) introduce all facilitators and participants (3) outline expectations for the course, including ground rules for participating in the scenarios and post-simulation debriefing; (4) prepare a confidentiality agreement to protect individual performance and issues raised during group discussions; (5) provide an orientation to the manikins and the simulation environment; and (6) disclose how videos are secured and archived” (Zigmont, Kappus, & Sudikoff,2011. P.49).
I believe establishing such strategies that address the emotional well-being of learners aligns with UDL principles. Establishing a psychologically safe environment with a commitment to respect learners and concern for their psychological safety is as important as catering for their cognitive load in simulation-based learning design (Palaganas, Fey, & Simon, 2016).
References
Palaganas, J. C., Fey, M., & Simon, R. (2016). Structured Debriefing in Simulation-Based Education. AACN Advanced Critical Care, 27(1), 78–85. doi.org/10.4037/aacnacc2016328
Zigmont, J. J., Kappus, L. J., & Sudikoff, S. N. (2011, April). Theoretical foundations of learning through simulation. In Seminars in perinatology (Vol. 35, No. 2, pp. 47-51). WB Saunders.