‘How can we help the students learn?’ A grounded theory study of simulated participants as educators

Abstract

Purpose

Despite the demonstrated value of simulated participant (SP) feedback, we are only beginning to understand how to optimize SPs’ feedback practices for communication skills and strengthen their role as educators. SPs portray roles and engage in feedback practices to support simulated-based learning for communication skills training. SPs come to their role with diverse experiences, knowledge, and training, such as (a) professional actors, (b) lay people, and (c) health professions educators. This study explored what factors influenced SPs’ role as educators, including their preparation, training, and approach to role portrayal and feedback practices and how these aspects were influenced by SPs’ backgrounds.

Methods

Using grounded theory methodology, we collected and analysed data iteratively from 16 semi-structured in-depth interviews. We identified key concepts, using constant comparison and by exploring how concepts were related , to develop a conceptual model of SPs as educators.

Results

The SP role as educator was shaped by several interrelated dualities which spanned both the SP and learner roles and contributed to the identity formation of both SP and learner: (a) building competence (SP competence as educator and learner competence as healthcare professional), (b) engaging in reflective practice (SPs prompting learner reflection and SPs reflecting on their own role), and (c) establishing a safe space (SP needing to feel safe in their role to create safety to support learner engagement). SPs’ backgrounds influenced how they learned to portray roles and how they engaged in feedback practices, both in-action, through in-role prompts and cues, and on-action, through post-scenario feedback discussions.

Conclusion

Our conceptual model about SPs as educators informs SP selection and training. Further, this model enables practical suggestions for SP educators and faculty who involve SPs in teaching. Enhanced feedback practices have the potential to improve learning from simulated encounters.

Keywords:

• Communication skills
• simulation
• health professions education
• identity
• feedback practices

Acknowledgements

The authors would like to thank the simulated participants, from acting, non-acting, and faculty backgrounds who gave their time to contribute to this study and continue to give their time to support simulation based education.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Simulated participant: A person trained to portray a role, which can be a patient, family member, healthcare professional, or other professional, for the purpose of enacting a simulated scenario.

Psychological safety: A feeling by participants that they can contribute authentically without the risk of ridicule or humiliation for their ideas, contributions, questions, or mistakes.

Additional information

Funding

This work was supported by the Irish Higher Education Authority Innovation and Transformation Programme under grant agreement 19032A01. RCSI SIM is a CAE Healthcare Centre of Excellence and receives unrestricted funding to support its educational and research activities.

Notes on contributors

Clare Sullivan

Clare Sullivan, BE, MSc, is a Researcher and Senior Simulation Technician with responsibility for SP education at RCSI University of Medicine and Health Sciences, Dublin Ireland.

Andrea Jane Doyle

Andrea Jane Doyle, BSc(Hons), PGDip MedPhys, PhD, PGDip MedEd, is a Senior Post-Doctoral Researcher at RCSI University of Medicine and Health Sciences, Dublin Ireland.

Michelle O’Toole

Michelle O’Toole, BSc, MA, PGDip EMS, PGDip HPE, is a Researcher at RCSI University of Medicine and Health Sciences, Dublin, Ireland.

Claire Mulhall

Claire Mulhall, BA, DMS, PhD, is a Research Programme Manager at RCSI University of Medicine and Health Sciences, Dublin Ireland.

Nancy McNaughton

Nancy McNaughton, MEd, PhD, is a Scientist with the Wilson Centre for Research in Education and Assistant Professor with the Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

Walter Eppich

Walter Eppich, MD, PhD, is the Professor of Simulation Education and Research at RCSI University of Medicine and Health Sciences, Dublin Ireland.