Supporting Transitions in Medical Career Pathways: the Role of Simulation-Based Education
Have you checked out the Advances in Simulation journal yet? Great news it’s free for everyone online thanks to the folks at SESAM! Just finished reviewing “Supporting transitions in medical career pathways: the role of simulation-based education” by Jennifer Cleland et al., and found it very useful for us all to consider!
About Advances in Simulation Journal
Advances in Simulation provides a forum to share scholarly practice to advance the use of simulation in the context of health and social care. Advances in Simulation publishes articles that cover all science and social science disciplines, all health and social care professions and multi- and inter-professional studies. The journal includes articles relevant to simulation that include the study of health care practice, human factors, psychology, sociology, anthropology, communication, teamwork, human performance, education, learning technology, economics, biomedical engineering, anatomy, physiology, pharmacology, therapeutics, scientific computation, simulation modelling, population studies, theatre, craft, program evaluation and more.
Transitions, or periods of change, in medical career pathways can be challenging episodes, requiring the transitioning clinician to take on new roles and responsibilities, adapt to new cultural dynamics, change behaviour patterns, and successfully manage uncertainty. These intensive learning periods present risks to patient safety. Simulation-based education (SBE) is a pedagogic approach that allows clinicians to practise their technical and non-technical skills in a safe environment to increase preparedness for practice. In this commentary, we present the potential uses, strengths, and limitations of SBE for supporting transitions across medical career pathways, discussing educational utility, outcome and process evaluation, and cost and value, and introduce a new perspective on considering the gains from SBE. We provide case-study examples of the application of SBE to illustrate these points and stimulate discussion.
Increasing doctors’ preparedness to perform the skills and behaviours required to fulfil the responsibilities of any new role is important for patient safety, service efficiency, and individual psychological well-being. Whilst true mastery of a role cannot be achieved until one is immersed within the workplace itself , the literature indicates that we can go some way to preparing individuals for the technical and non-technical elements of any new role, and indeed the associated psychological challenges, through the judicious and imaginative use of SBE. In this paper, we have provided an overview of some of the key factors associated with planning and evaluating SBE for transitions.
We have also highlighted a number of areas for future research in SBE to support medical career transitions. These include the development of understanding around the practical factors to be considered when designing SBE, ranging from the delivery of feedback and the incorporation of longer term outcome measures to analysis of the cost-effectiveness of the approach being undertaken, as well as the socio-cultural influences on learning in simulated settings. We urge those working in SBE research to consider how best to identify and evaluate concrete specific outcomes of SBE for this purpose. There remains the need for further investigation into the use of SBE to support the transition from medical student to junior doctor, but we urge those working in this area to not neglect examining the use of SBE to support later medical career transitions where “learners” are working with less supervision and increasing responsibility yet where (largely non-technical) issues pertinent to patient safety remain apparent.