Equity, diversity and inclusion in clinical simulation healthcare education and training: An integrative review

Abstract

Patient profiles have changed from shifting demographics, globalization and immigration. Such changes highlight the need to educate and train healthcare trainees and healthcare providers (HCPs) on the provision of person-centred care through an equity, diversity and inclusion (EDI) approach. Simulation pedagogy has the potential to be a useful and impactful teaching and learning approach for EDI. The purpose of this review was to explore and summarize the current literature on the level of integration and state of EDI in clinical simulation within healthcare education, curricula and training. An integrative literature review was conducted using Whittemore and Knafl’s (2005) method. Studies that met the selection criteria were assessed using the Johns Hopkins Nursing Evidence-Based Practice Model. A total of 64 studies were included in the review. Five themes emerged from EDI incorporation in clinical simulation education and training for HCPs and healthcare trainees: (1) increase in self-awareness; (2) enhanced communication; (3) enhanced insight and knowledge; (4) strengthened EDI-related self-efficacy; and (5) increase in EDI-related competence and skills. Clinical simulation provides opportunities for EDI integration in healthcare education. Several implications were identified: (1) employing a more systematic process for EDI integration in healthcare education and programs; (2) developing a digital repository of EDI-focused clinical scenarios; (3) co-creating EDI-focused clinical simulations with persons of diverse background; (4) the importance of maintaining a safe learning environment for all involved persons – learners, staff, faculty and standardized/simulated patients in the EDI simulations; and (5) the need for more robust and rigorous research to advance the science of clinical simulation.