RESUMEN
Introduction: As the global population ages, healthcare providers must prepare for the complexities associated with caring for older adults, defined according to the WHO, as being over the age of 60. Simulation-based education in healthcare allows caregivers to practice and master skills and competencies associated with care of older adults. Simulated patients/participants (SP), well people trained to portray other individuals, are an effective choice when training behavioural skills (eg, communication). When working with older SPs, it is important to recognise unique considerations and requirements related to physiological changes, in physical, cognitive and sensory systems associated with normal ageing. Method: SP educators from two different countries, with diverse backgrounds and contexts, collaborated through an iterative, consensus-based process to create a framework for working with older SPs. Results: A practical three-phase framework with specific strategies was developed that synthesised elements of best practices related to simulation methodology with relevant clinical evidence. Discussion: Effective collaboration with older SPs is achievable through investing resources in preparing, training and ensuring their well-being. Through faculty development of healthcare simulation educators, we can ensure that older SPs and simulation communities have the right tools and support to safely and effectively contribute to simulation-based education.
RESUMEN
BACKGROUND: Simulated patients (SPs), defined as being over 65 years old, are valuable partners in the training of health professionals related to the care of our aging population. Many senior SPs have been long-time members of SP programs. As SPs age, shifts in their abilities may be observed that, in turn, can affect the overall quality and effectiveness of their participation. It can be challenging and distressing for both the SP educator and the SP to acknowledge these changes and to respond in a compassionate, respectful, and ethical manner that ensures the safe and effective delivery of a simulation for all stakeholders. SP educators are looking for guidance. The aim of this study was to ask SPs from two countries (Switzerland and Canada) to identify the benefits and challenges of working as SPs as they age and to offer strategies to SP educators to accommodate and facilitate their participation. METHOD: A qualitative thematic analysis research design was implemented to address the study aims. A semi-structured approach with a topic guide was used to individually interview 16 SPs (9 in Switzerland; 7 in Canada). Researchers iteratively compared their results until consensus was reached in terms of identifying the themes and subthemes. RESULTS: Three main themes, with corresponding subthemes, were identified: giving and receiving value as senior SPs, recognizing challenges when working as a senior SP, and fostering meaningful involvement for senior SPs. Meaningful involvement focused on creating a sense of security, adapting to changing abilities, acknowledging contributions, and providing opportunities to stay connected to the program. CONCLUSION: This study illustrates the importance of SP educators working with SPs to co-create a safe and effective work environment. Studies like this can serve as a model to provide practical strategies. Through this study, we have learned from senior SPs how we can best support them in their important work.
RESUMEN
BACKGROUND: Professional behaviors, tacitly understood by Canadian-trained physicians, are difficult to teach and often create practice barriers for IMGs. The purpose of this design research study was to develop a Web-based program simulating Canadian medical literacy and culture, and to evaluate strategies of scaffolding individual knowledge building. METHOD: Study 1 (N = 20) examined usability and pedagogic design. Studies 2 (N = 39) and 3 (N = 33) examined case participation patterns. RESULTS: Model design was validated in Study 1. Studies 2 and 3 demonstrated high levels of participation, on unprompted third tries, on knowledge tests. Recursive patterns were strongest on Reflective Exercises. Five strategies scaffolded knowledge building: (1) video simulations, (2) contextualized resources, (3) concurrent feedback, (4) Reflective Exercises, and (5) commentaries prompting "reflection on reflection." CONCLUSIONS: Scaffolded design supports complex knowledge building. These findings are concurrent with educational research on the importance of recursion and revision of knowledge for improvable and relational understanding.
