The cultural considerations related to learning in simulation

Recently, the area of cultural considerations in relation to learners – and faculty – has been featuring in writings, conference presentations, and discussions. All of us are aware of the diversity of cultures within student cohorts across Australian universities. This requires all of us to become more attuned to the differing expectations of learners, from both academic and student perspectives. We love students to engage in Socratic dialogue, that is, to discuss, explore differing opinions and sometimes challenge what is written or said. This can be quite an adjustment for some students to participate in small group work within tutorials, and group assignments – popular approaches to broaden thinking and understanding.

So what about in simulation? How might we best foster exploring new knowledge and understanding about practice? For students with differing cultural backgrounds, should we assign simulation roles differently? I’m sure this is already done implicitly, but it’s worth thinking about how best to approach this and whether we should have more  dialogue about such considerations in our simulation practices. One way to inform if our ‘natural tendencies’ are on point, is to gain student feedback about what they gained from participating in simulations, and how. For instance, in my own research, students who were deemed ‘international’ preferred to be an observer of the simulation first off rather than participating in an active role. This way they could build their own schema of professional behaviours – what to say, where to stand, how to respond – so their upcoming portrayal of the nurse role was ‘as expected’.

Let’s now fast track to the simulation debriefing session where the expectation of contributing to feedback in the spoken word can be daunting, for many students actually. Explicit  directions (stated verbally by the instructor or through using a rubric) of what learners should focus on while observing simulations provides more structure when facilitating the debrief. Grouping observers into pairs or 3’s allows for more intimate time to talk as they watch the unfolding action. One person can be nominated to provide verbal feedback, which may on one hand take the pressure off others to ‘speak up’ while also allowing group members’ opinions to be added to the mix.

Why am I raising these points that some of you have realised already? If you incorporate some of these strategies already in your simulation delivery, tell us how they work for you. If you haven’t given much thought to the points I raise, take a look at the emerging literature on the topic, and talk with your colleagues – and students – about some strategies. And of course I’d be happy to take this line of conversation further. Post a response …