A pilot study exploring how facilitators support healthcare learners during simulation-based scenarios to achieve the learning outcomes

Background:
A significant body of work has been surrounding simulation design, pre-briefing, debriefing, and evaluation within healthcare simulation that has informed several frameworks and national guidelines [1]. The 2021 INACSL Standards of Best Practice Facilitation direct the facilitator to deliver cues to redirect learners during the scenario to achieve the learning outcomes within the scenario [1]. Cue is the term used to describe additional information provided by the facilitator to the learners about the patient to achieve the learning outcomes [1]. Cueing examples include providing additional blood results or changing a vital sign [1]. The facilitator chooses cues based on their learners’ perception within the scenario [1]. There is no guidance on the types of cues used or when and how to use them. Interestingly no other strategies are suggested to support learners. This research is exploring how simulation facilitators working with undergraduate nursing students can support learning through simulation at a university in England using a descriptive case study [2]. A case study will reveal current practices from the perspectives of facilitators and learners within a scenario. The research questions (RQ) to be addressed are: How do facilitators support student nurses in simulation-based scenarios? What support do student nurses require from facilitators in simulation-based scenarios to aid their learning?

Methods:
A small number of student nurses and facilitators have been interviewed via semi-structured interviews to describe the current situation. The pilot study has been granted Ethical Approval by the Institution (HREC 4853). The interviews have been recorded and transcribed using MS Teams and are being analyzed using Thematic Analysis (TA). TA is one method to analyze qualitative data using the transcripts and field notes documented during the semi-structured interviews for the pilot study. Data from the study is coded and categorized using TA. Codes will be found and identified that suggest themes to answer the two RQ. Braun and Clarke [3] suggest that TA is a method with a clear set of procedures to identify themes and patterns about specific RQs. This approach was chosen as it is not linked to a specific method.

Conclusion:
Preliminary findings suggest there is a mismatch between what learners and facilitators need for support through the scenario phase. Facilitators appear to intervene based on their perceptions of what they see with no pre-determined approach.

References
1. Persico L, Belle A, DiGregorio H, Wilson-Keates B, Shelton C. Healthcare simulation standards of best practiceTM facilitation. Clinical Simulation in Nursing. 2021;58:22–26. DOI: 10.1016/j.ecns.2021.08.010.

2. Yin R. Case Study Research and Applications, 6th Edn, London, SAGE. 2018

3. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006;3(2):77–101.