In the clinical healthcare environment, difficult emotions can be viewed as bad. Safe clinical environments are not possible without difficult emotions aired and repaired through effective communication and emotional intelligence. Workplace cultures within the clinical healthcare environment are to avoid and ignore difficult emotions. Healthcare simulation is an ideal educational environment for clinical healthcare staff to be able to explore emotional, communication, team and clinical care based challenges. This article by Erin Carn-Bennett, RN, MSN will explore the important yet risky work that clinical simulation staff do and why self and team based care is so important for clinical simulation program sustainability.
Healthcare Simulation is a Space to Practice with Difficult Emotions
Difficult emotions between colleagues or with patients are often not addressed in clinical care. This can lead to poor clinical outcomes, team breakdown, workplace culture issues and complaints about clinical care teams performances. Learning objectives in clinical simulation scenarios are often focused on these challenges so that participants can have experiential learning of such difficulties. The facilitation of clinical simulation is often emotional and psychologically risky work. This requires a lot of attention to detail of the participant’s learning experience for the best intended results.
The process to ensure a psychologically safe learning environment can often require hypervigilance on the healthcare simulation educators behalf in order to maintain psychological safety and minimise risk or impact of participant clinical simulation trauma. The process of this can be incredibly taxing on clinical simulation staff particularly in high risk training or with crammed schedules that don’t allow time for self and team based care and recalibration. As healthcare simulation educators there can be great damage done to clinical simulation participants in a psychologically unsafe learning environment. There is so much pressure if conscious of this to show up as a best version consistently in every clinical simulation experience.
Trust as a Healthcare Simulation Educator Matters
Due to current healthcare workplace challenges there has never been a more important time to care for both the frame of mind of healthcare simulation educators and the protection of a psychologically safe educational space in healthcare simulation. Trust in healthcare simulation educators such as the sense of trust in themselves, their clinical simulation program team members and also between educator and participant is essential. Healthcare simulation educators must aim to prioritise and partake in self and team based care on a regular basis to ensure sustainability of a psychologically safe learning environment.
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If healthcare simulation education is delivered to a high standard, clinical simulation educators are able to provide participants with an environment that is psychologically safe and founded in trust for all parties. The skillset often required for educators to be able to create this learning environment requires healthcare simulation educators to turn up emotionally stable, grounded and able to connect with their participants on a deep level in order to provide both profound and career altering educational experiences is full of pressure to perform.
Healthcare simulation is founded in communicative and relational experiences between clinical simulation educators and participants. Many emotions can come to the surface in a healthcare simulation experience. Safety for all involved means that a depth to learning can occur for both the educator and participant through transparency at all points and continued evaluation and adjustments based on responses. This can be very taxing for healthcare simulation educators.
Healthcare simulation participants can turn up to their clinical simulation scenario with a variety of emotional baggage that clinical simulation staff have to manage and potentially address within the scenario or course. Much experience acquired as a clinical simulation educator is to become comfortable with others discomfort. Recognition of challenged emotions in clinical simulation participants is important, however often no action is required by faculty members.
Implicit trust in clinical simulation participants as adults to be able to reflect on their clinical performance is important. The adult learner will reflect and in general is far more hard on themselves than a faculty member would be. Trust in the adult learner, the learning experience and their reflection of this, is essential. Yet this is often far more difficult to achieve than anticipated. This can cause distress and over thinking spirals for clinical simulation educators at the weight of responsibility carried to keep learners as safe as possible.
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Assumptions around why participants have acted in a particular manner in healthcare simulation, should be avoided. These behaviors can be enquired about in the debrief with curiosity and good judgement. Although clarity may not be obtained, deep emotional intelligence is required by clinical simulation educators as to when to ask these questions of participants and when to trust in the adult learners’ reflection abilities either within the debrief or in the time which follows.
Healthcare Simulation Educators Can Be Culture Change Agents
Healthcare simulation staff are in a unique position to be able to challenge workplace culture between colleagues. Often clinical simulation debriefs can be a space for clinical staff to raise and reflect on the challenges faced in their day to day clinical work. This also can be incredibly difficult information for healthcare simulation educators to hear and to carry.
There can be a heavy weight carried to want to fix these challenges for clinical simulation participants. However, there are ways in which clinical simulation educators can assist that are meaningful such as guidance to resources, assistance to place safety reports or encouragement to participants to alter behaviors or even to escalate concerns. Trust in the strength of clinical simulation participants and maintenance of professional boundaries will assist healthcare simulation educators to maintain their own personal safety.
Debrief of the debrief for healthcare simulation staff is important and is considered self and team based care. Reflection time for clinical simulation staff after debriefs is incredibly important and in a best case scenario should not be a rushed process. Ideally, pre allocate time for clinical simulation staff to debrief after each education session or course. An intentional reflective practice allows more junior team members to receive guidance from more experienced team members and also for others to receive feedback on their performances. Just as reflection in debrief is powerful for clinical simulation participants, reflection can be equally important for healthcare simulation faculty. Reflection guides people to consider actions and what would be done differently next time.
In this article, the concept of self care for healthcare simulation educators has been discussed. Healthcare simulation educators are under a lot of pressure to provide a psychologically safe learning environment and to turn up grounded and regulated everyday. Self and team based care is essential for healthcare simulation educators to be able to show up and continue to change cultures and inspire change for clinical healthcare environments.
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Reference:
- Drake, Gareth DClinPsy; Drewek, Katherine BMBS. “I Hate Sim!”—Using Psychotherapeutic Concepts to Help Educators Attend to Challenging States of Mind During Simulation Prebriefs. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare 19(6):p e147-e153, December 2024. | DOI: 10.1097/SIH.0000000000000781
