The power of simulation: a large-scale narrative analysis of learners' experiences

Bearman, Margaret, Greenhill, Jennene and Nestel, Debra 2019, The power of simulation: a large-scale narrative analysis of learners' experiences, Medical education, vol. 53, no. 4, pp. 369-379, doi: 10.1111/medu.13747.

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Title The power of simulation: a large-scale narrative analysis of learners' experiences
Author(s) Bearman, MargaretORCID iD for Bearman, Margaret
Greenhill, Jennene
Nestel, Debra
Journal name Medical education
Volume number 53
Issue number 4
Start page 369
End page 379
Total pages 11
Publisher John Wiley & Sons
Place of publication Chichester, Eng.
Publication date 2019-04
ISSN 1365-2923
Keyword(s) simulation
simulation-based education (SBE)
holistic phenomenon
health professionals
Social Sciences
Science & Technology
Life Sciences & Biomedicine
Education, Scientific Disciplines
Health Care Sciences & Services
Education & Educational Research
Summary CONTEXT: Simulation-based education (SBE) includes a broad spectrum of simulation activities, which are individually well researched. An extensive literature reports on SBE methods, topics and modalities, but there are limited studies investigating how simulation as a holistic phenomenon promotes learning. This study seeks to identify the ways in which health professionals narrate powerful SBE experiences and through this to understand in what ways SBE may influence learning. METHODS: Three hundred and twenty-seven narratives about powerful learning through SBE were gathered from participants' online reflections from a national faculty development programme in SBE. Narrative and thematic analyses were conducted on included texts, using 'transformative learning theory' as a sensitising notion. RESULTS: Narratives were categorised into the following categories: progress (267/327 = 81%); transformation (25/327 = 8%); practice (27/328 = 8%); and humiliation (8/327 = 2%). Recurrent features across narrative categories were as follows: early experiences in training; dramatic scenarios; developing appreciation of SBE; highly emotional experiences; things that 'went wrong'; and ongoing reflection. Themes regarding mechanisms that supported learning were as follows: verisimilitude; feedback, debriefing and facilitation; observation of self and others; repetition of activities; and role-playing the patient. CONCLUSIONS: The results generally support the notion that SBE is experienced as a holistic phenomenon, rather than separate modalities. The narrative categories, recurrent features and learning themes tended to work across all simulation modalities, with the exception of 'being in the patient's shoes' being supported by role-play in particular. Although powerful experiences were not necessarily transformative ones, they often occurred at formative stages of training. There was a strong sense that things going wrong in simulation scenarios (and the associated emotions and reflection) were a key part of learning. This underlines SBE's potential role in helping learners see fallibility as part of professional practice.
Language eng
DOI 10.1111/medu.13747
Field of Research 130103 Higher Education
130209 Medicine, Nursing and Health Curriculum and Pedagogy
13 Education
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
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