By: Victoria Brazil (@SocraticEM)
Clinician educators are increasingly expected to embrace equity, diversity and inclusion (EDI) principles into their educational design and delivery, including in simulation-based education (SBE). Despite growing literature on the topic, there remains a dearth of practical guidance for simulation faculty on how to enact EDI principles in their practice. This risks confusion for faculty and learners, and potential harm if problematic values or behaviours are unaddressed.
Mutch and colleagues have risen to the task of helping to fil that gap in their recent publication – Equity, diversity and inclusion in simulation-based education: constructing a developmental framework for medical educators, recently published in Advances in Simulation. The authors offer us some practical guidance on EDI, and their study is also a masterclass in qualitative research methods. The article is part of the Advances in Sim Special Collection of articles on the role of simulation in Equity, Diversity, Accessibility and Inclusion.
The authors remind us that EDI is ‘there’ in simulation, irrespective of scenario design, intent, or whether we feel equipped to address it. E.g. how people of different ages/ genders/ racial backgrounds are portrayed, who is and isn’t included in simulation activities, and the power dynamics and hierarchies in debrief rooms. As Eve Purdy reminds us in a previous ICEnet post, simulation is a moment of cultural compression – “where ideologies about healthcare professions can be reinforced, and values and beliefs can be transmitted to learners with intensity”
The developmental framework proposed is composed of ten ‘developmental areas’ (not competencies), and Table 4 of the article is reproduced here.
The framework is adapted from the Hordijk et al.’s framework for medical teachers’ competencies to teach ethnic and cultural diversity. The methods by which the framework was developed shows us how to derive scholarly outcomes from our work in educational practice. Using a constructivist approach, the authors interviewed 10 simulation educators (faculty) from NHS Lothian in Scotland, who were involved in SBE for junior doctors. These educators had been asked to engage in in a 4 month period of EDI focused group reflections with other faculty members after simulation sessions. These conversations were structured using the ‘sim EDI tool’ (already profiled here on Icenet blog). Thematic analysis was conducted on the data obtained from the interviews, and these results used to produce the framework. In addition to the developmental framework outcome, the article provides illustrative quotes from the study participants that pick up on the fears and lack of competence felt by faculty.
I think this article offers us some granular language and concepts that are helpful for simulation educators seeking to be thoughtful about EDI in their practice. The authors show us that self and group reflection by faculty is an important element of seeking to make progress on EDI issues.
References
- Mutch, J., Golden, S., Purdy, E. et al. Equity, diversity and inclusion in simulation-based education: constructing a developmental framework for medical educators. Adv Simul 9, 20 (2024). https://doi.org/10.1186/s41077-024-00292-5
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