Why does a student performance change in a new environment?
I've been looking at how and why students behave differently in simulation when they are in a 'fold away ambulance'.
We use a video debriefing system and wifi monitor (iSimulate) to control the clinical / physiological features of the actor, (Occasionally a fellow student) , but we are seeing changes in performance linked to the clinical setting.
As soon as the students and their patient are closed away inside the space - the atmosphere appears to change... the students seem more attentive and focussed, and we seem to be better able to review their actual performance.
I think there are a number of reasons...
- They can't see their Tutors or Peers- for verbal or visual support - we deliberately close the students away in the fold away ambulance - so that they feel the responsibility of patient care in an ambulance setting.
- The environment enhances the visual cues - making the simulation more challenging and realistic in the mind of the student.
- The space is smaller than the classroom setting - maybe this is intimidating to "newby paramedics"
- 'Environment shapes behaviour' has become a fascination...
I know I have some GREAT peers here on linkedin - Patricia Benner included.. and many of you are specialists in the sim-world, so can I please ask what you think causes the change...
We even see a difference in student performance if we leave the rear ambulance doors open! (Not a positive one!)
Lead for Anaesthetics and Resuscitation Independent Hospital Guildford Clinical ODP/ Former Resuscitation Officer / Simulation Based Education specialist.
8 年I have to say with increase in availability of immersive environments it breeds necessity. I always struggled delivering ALS courses in conference rooms amid table and chairs when clinical areas could be used at possibly a fraction of the cost. The clinical area added context , maybe not the case in point for yourself as prehospital medicine has no environmental framework (setting) that is constant. A house, a car park, a field or a busy supermarket are all potential workspaces for the first responders be them medical or paramedical. In addition to the environment other factors may assist immersion Do they wear uniforms or own clothes? The action of donning surgical scrubs, paramedic uniform or simply placing stethoscope around ones neck displays role and projects purpose and professionalism. Those trained or in training may unknowingly make distinction between I am at work or at leisure by doning and or removing uniform or work apparatus. I endeavour to "realise" simulation as far as possible a lesson learned from a piece of feedback post session stating "our defibrillatior would normally be on the other side of the room" I am now fastidious about getting it right, photographing difficult airway trolleys, removing equipment and placing exactly what would be available. While in a safe,stocked and sanitised sim environment this "hybrid simulation" is as close as you get to "in situ" sim without the service disruption / upheaval. A great fan of the new work David I am still really keen to come and see.
President of VES, LLC - VRpatients, Chairman of Ferno Group, Chairman of ATSR, Ltd - ACETECH,
8 年Justin Wand
Academic Paramedic Practitioner
8 年James Graveson
Senior Staff Development Officer
8 年Hi Dave, Thanks for sharing this interesting observation. I agree with your thoughts and those comments already made. I am also interested in the link between instructor engagement encouraging student engagement. I wounder if the rear door being left open or closed and the change in behavior may be a subtle example of this. When we make efforts to do our utmost to reduce the reality gap we may also be sending a message that we are engaged and that these efforts are important...
Offshore Medic/SSU
8 年Very interesting angle to look at training David. I think that there will be a number of factors involved, most of which you have covered. It would be very interesting to look at this in more depth. Maybe get a university involved, just a thought Ann??