Reducing practice shock with Simulation-Based Learning Methods in Healthcare Vocational Education

Introduction: The Danish Healthcare system is challenged by pressures facing healthcare vocational educations (HVE) due to recruitment problems and increasing dropout rates. Often HVE students describe a lack of coherence between theory and practice, resulting in practice shock when they meet reality. These experiences may be rooted in a suboptimal capacity to reflect on practice, transfer knowledge to action competences, and communicate with patients. The didactical learning methods used so far do not adequately embrace these challenges. The application of simulations-based learning methods (SBLM) in HVE may be key to creating greater coherence between theory and practice since SBLM create realistic learning situations, offer safe places for experimental learning, and train communication and reflection skills. This kind of reflective practice-based learning may be particularly beneficial for HVE learners. Few studies have explored how SBLM can be used in HVE. This project explores how to develop and complete a “How to use and facilitate SBLM” program aimed at improving teachers’ didactic professionalism, sharpening facilitator’s role and attributes, and developing a number of scenarios for use in HVE.
Instructional and assessment methods: Evidence-based SBLM are applied in this program during a period of 8 days. The program will be implemented in three HVE institutions in Denmark from January 2019 to May 2020. In total, 150 teachers are expected to complete the program. Following the program implies that teachers will design and test scenarios based on a relevant HVE curriculum; they will also receive feedback on their role as facilitators and on the process of facilitation. To underpin the realism of the scenarios, actors will be employed to perform roles. The program concludes with a practice exam, where teachers’ reflections on completed scenarios and debriefings are assessed. The program is expected to produce 75-100 scenarios for use in the future curriculum of the HVE.
Program evaluation: Three approaches will be used for program evaluation. Firstly, teachers will answer a survey focusing on their experiences with SBLM and their didactic practice before entering the program; this survey will be repeated 4 weeks after they conclude participation. Secondly, teachers will be invited to give a qualitative evaluation of the program immediately after participating in the program. Finally, their outcome will be assessed using methods to evaluate behavioral change over time. Preliminary findings from the first two courses show that teachers are strongly motivated to experiment and to develop scenarios for use in HVE. So far, 25 scenarios are available for use.
Implications: Findings from this project are expected to provide insight into the use of SBLM in HVE and will thereby introduce the simulation concept in a novel setting. Furthermore, the findings may have significant implications for our understanding of how we may strengthen coherence between theory and practice in HVE.