Simulation Scholarship

Aligned to the NHS Lothian Simulation Strategy, this programme of scholarship explores various approaches to simulation-based education, emphasising mastery learning, EDI, growth mindset, and innovative techniques like shadowbox simulation. Simulation-Based Mastery Learning (SBML) is highlighted for its success in both large-scale and specialised training, such as PPE use for infectious diseases. The importance of fostering a growth mindset explored through interactive methods like tabletop games. Finally, the adaptation of the shadowbox technique, both in virtual simulations and for end-of-life care training, demonstrates its potential to teach complex communication skills and advocate for patient care in healthcare settings.

 
 

Mastery Skills Pathway

An enhanced approach to simulation-based mastery learning: optimising the educational impact of a novel, National Postgraduate Medical Boot Camp

(link to An enhanced approach to simulation-based mastery learning: optimising the educational impact of a novel, National Postgraduate Medical Boot Camp | Advances in Simulation | Full Text (biomedcentral.com)

The enhanced simulation-based mastery learning (SBML) programme, incorporating pre-learning (online materials) and peer learning (peer-assisted practice and observation), was successfully scaled within a national simulation programme. Feedback from 50 participants showed high satisfaction with both the pre-learning and peer learning components, highlighting the value of peer-assisted practice for equipment familiarisation and skill rehearsal, and peer observation for comparing performances and learning from mistakes. This enhancement allows SBML to be applied more effectively on a national scale.

The PATH to PPE Mastery - Programme for Assessment and Training in HCID (High Consequence Infectious Diseases) PPE (Personal Protective Equipment) Mastery

(Link to The PATH to PPE Mastery - Programme for Assessment and Training in HCID (High Consequence Infectious Diseases) PPE (Personal Protective Equipment), Mastery - PMC (nih.gov)

This study investigates the effectiveness of a modified Simulation-Based Mastery Learning (SBML) programme for training healthcare workers (HCW's) in the safe use of Personal Protective Equipment (PPE) for High Consequence Infectious Diseases (HCID's). The programme involved both asynchronous and synchronous learning components, and all participants who completed it achieved mastery. The results suggest that modified SBML improves preparedness and can be an effective method for training HCW's in HCID PPE use.

 
 

EDI in Simulation Based Education

Equity, diversity and inclusion in simulation-based education: constructing a developmental framework for medical educators

(link to Equity, diversity and inclusion in simulation-based education: constructing a developmental framework for medical educators | Advances in Simulation | Full Text (biomedcentral.com)

This study explores how a competency framework for teaching ethnic and cultural diversity can be adapted for simulation educators in the context of equity, diversity, and inclusion (EDI). The researchers engaged simulation faculty in discussions around EDI, using these insights to modify the existing framework and develop a new "Developmental Framework for Simulation Educators in EDI" with 10 key areas for faculty growth. The framework aims to guide simulation teams in incorporating EDI principles into programme design, delivery, and debriefing.

 

Growth Mindset Development

From safety net to trampoline: elevating learning with growth mindset in healthcare simulation

(link to From safety net to trampoline: elevating learning with growth mindset in healthcare simulation | Advances in Simulation | Full Text (biomedcentral.com)

The Implicit Theory of Mindset distinguishes between a fixed mindset, where individuals see their abilities as static, and a growth mindset, where abilities are viewed as adaptable through effort and learning. In simulation-based learning, encouraging a growth mindset can enhance psychological safety by helping participants see errors as a natural part of the learning process. The authors propose that simulation educators explicitly introduce the concept of a growth mindset in pre-briefing sessions or through pre-reading materials to foster a more positive and effective learning environment.

Growing a growth mindset: A tabletop simulation board game

(link to Growing a growth mindset: a tabletop simulation board game | Request PDF (researchgate.net)

This article discusses the development of a Tabletop Simulation Board Game (TSBG) designed to teach oncology Specialty Trainees the concept and practical application of a growth mindset. The game simulates an oncology trainee's on-call shift, allowing participants to adopt either a fixed or growth mindset in response to various challenges. The evaluation showed that participants found the game engaging and gained a deeper understanding of mindset theory, which they linked to their own training experiences. The game-based simulation approach proved effective, and the model is adaptable to other clinical settings for further trainee education.

Mindset dynamics in clinical learning environments: Unravelling the Goldilocks paradox

(link to: TO BE ADDED)

This study explores factors influencing the adoption of a growth versus fixed mindset in medical trainees, aiming to improve resilience and mental health outcomes. Using a tabletop simulation game followed by a debrief, 16 participants identified factors promoting a growth mindset, such as passion, collaboration, and role modelling, while burnout and competition promoted a fixed mindset. The "Goldilocks paradox" emerged, where factors like grit and previous success influenced mindset positively when balanced, but negatively when in excess. The findings suggest strategies to optimise the clinical learning environment for promoting a growth mindset in trainees.

Podcast: Sowing the Seeds - How can doctors grow a growth mindset? 

(link to: /show/clinical-conversations/sowing-the-seeds-how-can-doctors-grow-a-growth-mindset-12-feb-2024/)

In this episode, two members of the MED team chat about growth mindset. They talk about what growth and fixed mindsets are, and why thinking about your mindset is critical to successful learning and development as doctors. They discuss practical tips on ways to influence your mindset and the mindset of others around you, including effective ways to seek and give feedback and the power of role-modelling that failure is not only normal but an essential part of growth as a doctor.

 
 

Shadowbox Simulation

Virtual simulation of communication skills challenges using a shadowbox technique

(link to TO BE ADDED)

This article discusses the adaptation of the shadowbox video-based simulation technique for online distance education during a week-long Infectious Diseases elective in Edinburgh due to COVID-19 restrictions. The scenario, based on a real-life patient case, focused on taking a challenging travel history, with learners engaging in decision-making at key points and reflecting on the expert's actions. Feedback from participants rated the session highly, emphasising key takeaways like building rapport for sensitive questions, with suggestions to extend the session for further discussion. The method has potential for broader application in healthcare education.

Using an adapted shadowbox technique to teach healthcare staff how to manage a patient with end-of-life care needs - A blueprint for educators

(link to: 7 Using an adapted Shadowbox technique to teach healthcare staff how to manage a patient with end-of-life care needs- A blueprint for educators | BMJ Supportive & Palliative Care

This study adapted the shadowbox technique, originally used for training emergency personnel, to teach junior clinical staff how to advocate for palliative care patients. Three videos were created based on key palliative care scenarios, with a voice-over explaining expert actions as best practice. This flexible educational tool allows learners to reflect on their own approaches before receiving expert guidance, addressing the need for palliative care education in a time-constrained environment.