Long-Term Effect of Large-Scale Simulation Curation and Participation

Abstract

Context Previous research has found simulation with debriefing to be helpful in developing self-confidence, improving clinical competence, identifying knowledge deficits, and implementing knowledge into practice in the short term. However, the long-term implications of simulation curation and participation are unknown. Objective The purpose of this study was to evaluate the long-term effect of large-scale simulation curation and participation as part of an advanced-practice athletic training course. Design Qualitative phenomenological approach. Setting Video-conferencing software. Patients or Other Participants From among 60 potential participants, 11 individuals participated in a long-term, follow-up interview to explore their recollections, perceptions, and subsequent experiences from curating and participation in large-scale simulation. Main Outcome Measures Deidentified transcripts were checked for accuracy and sent for member checking. Subsequently, a 3-person data analysis team used several sequenced rounds of review, aligned with consensual qualitative research, to the analyze data. Trustworthiness was established with member checking, multianalyst triangulation, and auditing. Results Three domains emerged from the data: emotional reaction, improvements to practice, and the value of debriefing. When the emotional reaction domain was described, learners focused on the reality, overload, and need to maintain composure of the encounter. Within their clinical practice, improvements were made primarily regarding mindset, teaching, collaboration, emergency planning, and triage. Finally, learners noted the value of debriefing as humbling, a time for realized deficiency, and a time of emotional decompression. Conclusions Simulation-based learning in advanced-practice clinicians leads to perceived increase in skills such as intra- and interpersonal skills and emotional readiness. Long-term effects of simulation demonstrated that learners could translate these skills into clinical practice even 2 to 3 years post experience. Finally, the use of debriefing is a critical component to both the learner's skill acquisition and translation of knowledge in all simulation-based experiences.