The transfusion of blood and blood products is a complex, multi-professional task which is liable... more The transfusion of blood and blood products is a complex, multi-professional task which is liable to errors at any point in the journey from donor to recipient. The serious hazards of transfusion (SHOT) scheme has documented reports which consistently demonstrate that the administration of the incorrect blood component is a major cause of morbidity and mortality in the United Kingdom. Training programmes which focus on different stages of safe effective blood transfusion are currently available but none involve practice in the workplace setting. This paper shares the design, implementation and subsequent evaluation of a simulated ward exercise, which was developed in partnership with the Scottish National Blood Transfusion Service (SNBTS), NHS Tayside and the University of Dundee Medical School to reinforce learning in a workplace context. The exercise was evaluated from a number of different perspectives. The exercise demonstrated that it is an effective method of reinforcing safe transfusion practice in a non-threatening realistic workplace environment. Costs in terms of time, finance and staff numbers may however preclude large scale implementation in practice.
From simulation to reality Shibboleths of incompetence Development of a clinical skills bus: maki... more From simulation to reality Shibboleths of incompetence Development of a clinical skills bus: making simulation mobile "See one, do one, teach one!"-the uphill struggle for clinical skills acquisition
Highlights Medicines reconciliation reduces medication errors and potential for patient harm. ... more Highlights Medicines reconciliation reduces medication errors and potential for patient harm. Pharmacist role is currently limited in medicines reconciliation in Kuwait hospitals. Several barriers hinder pharmacist-provision of medicines reconciliation. There is lack of policy to support pharmacist role in medicines reconciliation. Policy reform is needed to support pharmacist in providing patient care services.
British Journal of Clinical Pharmacology, Nov 20, 2013
The aim of the study was to explore and compare junior doctors' perceptions of their self-efficac... more The aim of the study was to explore and compare junior doctors' perceptions of their self-efficacy in prescribing, their prescribing errors and the possible causes of those errors. METHODS A cross-sectional questionnaire study was distributed to foundation doctors throughout Scotland, based on Bandura's Social Cognitive Theory and Human Error Theory (HET).
There have been a number of drivers for the use of simulation in healthcare education for the NHS... more There have been a number of drivers for the use of simulation in healthcare education for the NHS workforce. The development of an accessible and efficient national approach to its implementation has been challenging. An action research approach was used to develop a national strategy using several data inputs. From sampling across practitioners and territorial health boards geographical and professional groups, access was the main challenge to the use of simulation. Four priority areas were identified, which formed the basis of the national strategy Partnership for Care, which included a mobile unit, a managed educational network, a programme board and an alliance of stakeholders.
Non-technical skills (NTS) are gaining increasing prominence within the field of emergency medici... more Non-technical skills (NTS) are gaining increasing prominence within the field of emergency medicine. Situational awareness (SA), one key component of NTS, is a key skill for emergency physicians (EPs) during initial training and throughout their career. Furthermore, the majority of frameworks used to evaluate clinical performance incorporate SA as one key component. This review seeks to define and explore the concept of SA within the context of emergency medicine. We describe SA at an individual, team and departmental level. Development of this ability enables EPs to function effectively within the challenging environment of the emergency department (ED). Enhancing our understanding of SA may develop the cognitive process that underpins our clinical performance. We propose a model for consideration to support evaluation and training of SA within the ED, linking the model to the novice expert continuum.
Abstract Background: There are a number of approaches to teaching high-risk clinical skills, such... more Abstract Background: There are a number of approaches to teaching high-risk clinical skills, such as a large bore chest drain insertion, although effectiveness is limited and realism is only achieved at great expense. Summary of work: In response to a training needs' analysis of practitioners in remote and rural areas in Scotland, training in chest drains was identified as an urgent priority need. Subsequently, the Clinical Skills Managed Educational Network (CSMEN) developed an evidence-based multi-professional clinical skills pack. This e-learning resource encompasses all aspects of chest drain management, both pre and in-hospital. The pack and an interactive workshop is used to deliver 'blended' chest drain training on a mobile clinical skills unit. Evaluation confirms that the chest drain training is a valuable resource and has been widely used to deliver skills training in remote and rural areas. Feedback from all professional groups is positive. Conclusions: Developing shared national resources, with standardised workshops taught in local contexts via a mobile skills unit is one approach to the challenges associated with delivering high-risk clinical skills education.
Prescribing medicines is one of the most common interventions in health care, so even a small per... more Prescribing medicines is one of the most common interventions in health care, so even a small percentage of prescribing errors can affect many patients. Many of these errors are prevented by the intervention of pharmacists. Research has identified gaps in medical education and training that contribute to these errors. More effective learning opportunities for prescribing at undergraduate level will help to improve the preparation of junior doctors for their role. Traditionally, doctors have acquired their prescribing skills through an apprenticeship model. Given the complexity of current health care and increasing polypharmacy, a more systematic approach to safe prescribing is required. The pharmacist can have a key role in education and the practice of safe prescribing. Final-year students at the University of Dundee Medical School are invited to undertake sessions to rehearse safe prescribing practices using an objective structured clinical examination (OSCE) format. This helps to recreate the time pressures of practice with a focus on the elements of safe prescribing for patients. On a simulated ward, students rehearse six situations that represent the basis of commonly reported prescribing errors. Each scenario has four prescribing related tasks, one of which is feedback from a pharmacist. An evaluation of this approach and students' self-reported learning indicated that it was a useful way of enhancing awareness of errors and of increasing confidence. The pharmacist can have a key role in education and the practice of safe prescribing IMPLICATIONS: There are several benefits for students in having pharmacists design and facilitate the OSCE clinical scenarios, which include the immediate learning of accurate prescribing as well as the advisory role that the pharmacists play.
International Journal of Clinical Pharmacy, Sep 28, 2019
Background There has been a worldwide exponential rise in simulation use in health professions ed... more Background There has been a worldwide exponential rise in simulation use in health professions education. Most of the evidence about simulation-based education (SBE) comes from Western educational systems. Little is known about simulation use in the education and training of pharmacy students and pharmacists in the Middle Eastern countries. Objective To explore pharmacists' experiences, perceptions and attitudes toward simulation use for learning clinical skills in Kuwait. Setting Different governmental hospitals across the State of Kuwait. Method This was an exploratory descriptive study of pharmacists' perceptions about SBE. A mixed-method research design was employed whereby 110 hospital pharmacists participated in focus groups and completed self-administered surveys. The focus group interviews were audio-recorded, transcribed verbatim and analysed using framework analysis. Descriptive statistics were used to describe characteristics of study participants and survey findings. Main outcome measure Pharmacists' experiences, perceptions and attitudes toward SBE. Results A total of 110 pharmacists participated in the focus groups, of whom 88 completed the survey (80% response rate). The focus groups revealed that pharmacists had different experiences in relation to simulation use which included learning, assessment, and less frequently reported in their training as practitioners. They identified many benefits of simulation such as enhancing knowledge retention and allowing learners practice and rehearse clinical skills in safe environments. Participants' perceived barriers to simulation use in pharmacy students' training included the need for qualified faculty and simulated patients, time constrains to incorporate simulation in faculty teaching and reluctance of learners/educators to use simulation. Most participants expressed positive attitudes toward simulation and welcomed its integration in pharmacy students' learning. In response to survey, 26.1% of pharmacists reported having no prior experience in the use of simulation. The top reported barriers to using simulation for learning were time constrains (22.7%) and the need for qualified faculty (6.8%). Conclusion Pharmacists in Kuwait have diverse experiences regarding simulation use for learning. They expressed positive attitudes toward simulation use for learning clinical skills. Efforts are needed to standardize and expand simulation use in the education and training of pharmacy students, trainees and practitioners to equip them with the clinical skills essential for pharmacy practice.
Surgeon-journal of The Royal Colleges of Surgeons of Edinburgh and Ireland, Aug 1, 2003
The aim of this study was to obtain consensus amongst consultant surgeons on the attributes of a ... more The aim of this study was to obtain consensus amongst consultant surgeons on the attributes of a good surgical trainer that can be used to inform continuing professional development programmes for trainers. good trainer attributes were generated from an intensive qualitative study using a participative inquiry process with consultant general surgeons and specialist registrars in the Tayside region. These good trainer attributes were then used as the basis of a modified Delphi study; the early rounds of the Delphi simultaneously sought participants' views concerning stated attributes and sought to generate new attributes. A final Delphi questionnaire was sent to all 180 consultant general surgeons in Scotland to identify consensus. The first two rounds of the Delphi process produced 45 attributes covering seven themes: interest in training, trainer as a team member, communication, receptiveness to trainee needs, trainer as a role model, reflection on practice and clinical and operative competence. The final survey identified significant consensus among surgeons. Clinical and operative competence achieved the highest consensus with 89.2% of surgeons believing it to be an essential attribute. The results indicate that there is consensus on the seven themes identified as essential for a trainer in general surgery. The recognition of the importance by trainers of non-surgical trainer attributes in the changed training structure is encouraging. Surgeons' level of awareness of their roles as a trainer will help inform the level and direction of trainer training and support required as part of a flexible and continuing developmental process.
The practice placement setting offers opportunities and challenges for engaging students in high-... more The practice placement setting offers opportunities and challenges for engaging students in high-quality interprofessional learning. The Fife Interprofessional Clinical Skills Model for Education was established to develop structured interprofessional learning opportunities for students during their clinical attachments in NHS Fife. This short report describes the delivery and evaluation of the model, which was piloted with students from the nursing, medicine and allied health professions. Scheduled workshops were delivered within primary and secondary care locations. The learning activities involved exploring and comparing their professional identities, discussing roles and responsibilities within the healthcare team and practicing nontechnical clinical skills. Students who participated in the workshops reported that they developed a better understanding of each other's roles and responsibilities and also identified that this would be transferable knowledge to their future practice. Exploring the student experience has assisted in developing relevant and accessible interprofessional learning opportunities within the practice placement setting.
This study has emphasised the complex nature of prescribing errors, and the wide range of error-p... more This study has emphasised the complex nature of prescribing errors, and the wide range of error-producing conditions within hospitals including the work environment, team, task, individual and patient. Further work is now needed to develop and assess interventions that address these possible causes in order to reduce prescribing error rates.
Simulation-based education has been a key development in health care education, providing a safe ... more Simulation-based education has been a key development in health care education, providing a safe learner-centred educational environment. It is a valuable tool, giving learners the opportunity to develop their knowledge and skills, engage in deliberate practice, think about team processes and develop non-technical skills. Simulation-based education allows learners to work towards curriculum competencies in a safe environment where mistakes are expected with no detrimental impact on patient care. This is thought to have an impact on patient safety in the clinical environment when learners take these skills forward into clinical practice. As technology has evolved, it has increasingly been incorporated into simulation-based education. Faculty can use audio-visual technology for remote observation of learners within the simulated environment, allowing faculty the option of video-assisted debriefs. These facilitated debriefs are key to supporting learners to get the greatest benefit from simulation-based education. They allow learners to gain knowledge of their practice and reflect on events guided by facilitators. This style of learner-centred debriefing focuses on the collaborative process between learners and facilitators, with facilitators supporting learners to derive meaning from their experiences. In Lanarkshire, audio-visual technology has been used in simulation-based education since 2010. Faculty use instructor-driven simulators within scenarios, while observing learners in the simulated environment through the audio-visual system. We developed a new immersive simulation course focusing on interprofessional clinical reasoning. The interprofessional team consisted of a medical student, nursing student, pre-registration pharmacist, physiotherapy student and occupational therapy student in their final or penultimate year of study. The simulation was set within an acute medical receiving ward, followed by a facilitated team debrief for learners (Figure 1). While piloting this course, the audio-visual technology failed. This left faculty unable to observe learners during the simulation. Faculty were concerned how they would debrief safely and effectively if they were unaware how learners had performed through observing. Learners were oblivious to the technical issues while immersed within the simulated environment, and this was only disclosed during the debrief. Facilitators became aware of how the simulation had unfolded when learners recounted events as part of the debrief. When facilitators disclosed that they had been unable to see or hear anything, learners laughed and appeared to relax. The apparent pressure they felt, due to being watched, evaporated. Their response appeared to play a part in post simulation decompression, reducing the learner–facilitator power imbalance. This disclosure supported everyone in creating a psychologically safe team which the facilitators became integrated into. The learners observed the discomfort and vulnerability in experienced faculty, perhaps mirroring their own experience within the simulation. There was a sense of everyone reflecting and learning from the experience together, with learners feeling they could truly guide their debrief. Facilitators were enabling reflection through actively modelling their own reflective process. Given that the establishment of psychological safety is essential for successful teams, should we actively consider how this is established in a post simulation debrief? Furthermore, this is a reminder that learning is something learners do themselves and facilitators should recognise the need to step back and allow this to happen.
Leadership development of medical trainees has come to the fore in recent years alongside a chang... more Leadership development of medical trainees has come to the fore in recent years alongside a changing workplace and workforce. Historically leadership theory favours an individualistic approach. However, current social psychological theory proposes that social identity (SI) makes leadership possible through shared understanding and championing of group goals and visions.Current leadership development practices and research tends to focus on individual competence and training despite espousing shared leadership.
The transfusion of blood and blood products is a complex, multi-professional task which is liable... more The transfusion of blood and blood products is a complex, multi-professional task which is liable to errors at any point in the journey from donor to recipient. The serious hazards of transfusion (SHOT) scheme has documented reports which consistently demonstrate that the administration of the incorrect blood component is a major cause of morbidity and mortality in the United Kingdom. Training programmes which focus on different stages of safe effective blood transfusion are currently available but none involve practice in the workplace setting. This paper shares the design, implementation and subsequent evaluation of a simulated ward exercise, which was developed in partnership with the Scottish National Blood Transfusion Service (SNBTS), NHS Tayside and the University of Dundee Medical School to reinforce learning in a workplace context. The exercise was evaluated from a number of different perspectives. The exercise demonstrated that it is an effective method of reinforcing safe transfusion practice in a non-threatening realistic workplace environment. Costs in terms of time, finance and staff numbers may however preclude large scale implementation in practice.
From simulation to reality Shibboleths of incompetence Development of a clinical skills bus: maki... more From simulation to reality Shibboleths of incompetence Development of a clinical skills bus: making simulation mobile "See one, do one, teach one!"-the uphill struggle for clinical skills acquisition
Highlights Medicines reconciliation reduces medication errors and potential for patient harm. ... more Highlights Medicines reconciliation reduces medication errors and potential for patient harm. Pharmacist role is currently limited in medicines reconciliation in Kuwait hospitals. Several barriers hinder pharmacist-provision of medicines reconciliation. There is lack of policy to support pharmacist role in medicines reconciliation. Policy reform is needed to support pharmacist in providing patient care services.
British Journal of Clinical Pharmacology, Nov 20, 2013
The aim of the study was to explore and compare junior doctors' perceptions of their self-efficac... more The aim of the study was to explore and compare junior doctors' perceptions of their self-efficacy in prescribing, their prescribing errors and the possible causes of those errors. METHODS A cross-sectional questionnaire study was distributed to foundation doctors throughout Scotland, based on Bandura's Social Cognitive Theory and Human Error Theory (HET).
There have been a number of drivers for the use of simulation in healthcare education for the NHS... more There have been a number of drivers for the use of simulation in healthcare education for the NHS workforce. The development of an accessible and efficient national approach to its implementation has been challenging. An action research approach was used to develop a national strategy using several data inputs. From sampling across practitioners and territorial health boards geographical and professional groups, access was the main challenge to the use of simulation. Four priority areas were identified, which formed the basis of the national strategy Partnership for Care, which included a mobile unit, a managed educational network, a programme board and an alliance of stakeholders.
Non-technical skills (NTS) are gaining increasing prominence within the field of emergency medici... more Non-technical skills (NTS) are gaining increasing prominence within the field of emergency medicine. Situational awareness (SA), one key component of NTS, is a key skill for emergency physicians (EPs) during initial training and throughout their career. Furthermore, the majority of frameworks used to evaluate clinical performance incorporate SA as one key component. This review seeks to define and explore the concept of SA within the context of emergency medicine. We describe SA at an individual, team and departmental level. Development of this ability enables EPs to function effectively within the challenging environment of the emergency department (ED). Enhancing our understanding of SA may develop the cognitive process that underpins our clinical performance. We propose a model for consideration to support evaluation and training of SA within the ED, linking the model to the novice expert continuum.
Abstract Background: There are a number of approaches to teaching high-risk clinical skills, such... more Abstract Background: There are a number of approaches to teaching high-risk clinical skills, such as a large bore chest drain insertion, although effectiveness is limited and realism is only achieved at great expense. Summary of work: In response to a training needs' analysis of practitioners in remote and rural areas in Scotland, training in chest drains was identified as an urgent priority need. Subsequently, the Clinical Skills Managed Educational Network (CSMEN) developed an evidence-based multi-professional clinical skills pack. This e-learning resource encompasses all aspects of chest drain management, both pre and in-hospital. The pack and an interactive workshop is used to deliver 'blended' chest drain training on a mobile clinical skills unit. Evaluation confirms that the chest drain training is a valuable resource and has been widely used to deliver skills training in remote and rural areas. Feedback from all professional groups is positive. Conclusions: Developing shared national resources, with standardised workshops taught in local contexts via a mobile skills unit is one approach to the challenges associated with delivering high-risk clinical skills education.
Prescribing medicines is one of the most common interventions in health care, so even a small per... more Prescribing medicines is one of the most common interventions in health care, so even a small percentage of prescribing errors can affect many patients. Many of these errors are prevented by the intervention of pharmacists. Research has identified gaps in medical education and training that contribute to these errors. More effective learning opportunities for prescribing at undergraduate level will help to improve the preparation of junior doctors for their role. Traditionally, doctors have acquired their prescribing skills through an apprenticeship model. Given the complexity of current health care and increasing polypharmacy, a more systematic approach to safe prescribing is required. The pharmacist can have a key role in education and the practice of safe prescribing. Final-year students at the University of Dundee Medical School are invited to undertake sessions to rehearse safe prescribing practices using an objective structured clinical examination (OSCE) format. This helps to recreate the time pressures of practice with a focus on the elements of safe prescribing for patients. On a simulated ward, students rehearse six situations that represent the basis of commonly reported prescribing errors. Each scenario has four prescribing related tasks, one of which is feedback from a pharmacist. An evaluation of this approach and students' self-reported learning indicated that it was a useful way of enhancing awareness of errors and of increasing confidence. The pharmacist can have a key role in education and the practice of safe prescribing IMPLICATIONS: There are several benefits for students in having pharmacists design and facilitate the OSCE clinical scenarios, which include the immediate learning of accurate prescribing as well as the advisory role that the pharmacists play.
International Journal of Clinical Pharmacy, Sep 28, 2019
Background There has been a worldwide exponential rise in simulation use in health professions ed... more Background There has been a worldwide exponential rise in simulation use in health professions education. Most of the evidence about simulation-based education (SBE) comes from Western educational systems. Little is known about simulation use in the education and training of pharmacy students and pharmacists in the Middle Eastern countries. Objective To explore pharmacists' experiences, perceptions and attitudes toward simulation use for learning clinical skills in Kuwait. Setting Different governmental hospitals across the State of Kuwait. Method This was an exploratory descriptive study of pharmacists' perceptions about SBE. A mixed-method research design was employed whereby 110 hospital pharmacists participated in focus groups and completed self-administered surveys. The focus group interviews were audio-recorded, transcribed verbatim and analysed using framework analysis. Descriptive statistics were used to describe characteristics of study participants and survey findings. Main outcome measure Pharmacists' experiences, perceptions and attitudes toward SBE. Results A total of 110 pharmacists participated in the focus groups, of whom 88 completed the survey (80% response rate). The focus groups revealed that pharmacists had different experiences in relation to simulation use which included learning, assessment, and less frequently reported in their training as practitioners. They identified many benefits of simulation such as enhancing knowledge retention and allowing learners practice and rehearse clinical skills in safe environments. Participants' perceived barriers to simulation use in pharmacy students' training included the need for qualified faculty and simulated patients, time constrains to incorporate simulation in faculty teaching and reluctance of learners/educators to use simulation. Most participants expressed positive attitudes toward simulation and welcomed its integration in pharmacy students' learning. In response to survey, 26.1% of pharmacists reported having no prior experience in the use of simulation. The top reported barriers to using simulation for learning were time constrains (22.7%) and the need for qualified faculty (6.8%). Conclusion Pharmacists in Kuwait have diverse experiences regarding simulation use for learning. They expressed positive attitudes toward simulation use for learning clinical skills. Efforts are needed to standardize and expand simulation use in the education and training of pharmacy students, trainees and practitioners to equip them with the clinical skills essential for pharmacy practice.
Surgeon-journal of The Royal Colleges of Surgeons of Edinburgh and Ireland, Aug 1, 2003
The aim of this study was to obtain consensus amongst consultant surgeons on the attributes of a ... more The aim of this study was to obtain consensus amongst consultant surgeons on the attributes of a good surgical trainer that can be used to inform continuing professional development programmes for trainers. good trainer attributes were generated from an intensive qualitative study using a participative inquiry process with consultant general surgeons and specialist registrars in the Tayside region. These good trainer attributes were then used as the basis of a modified Delphi study; the early rounds of the Delphi simultaneously sought participants' views concerning stated attributes and sought to generate new attributes. A final Delphi questionnaire was sent to all 180 consultant general surgeons in Scotland to identify consensus. The first two rounds of the Delphi process produced 45 attributes covering seven themes: interest in training, trainer as a team member, communication, receptiveness to trainee needs, trainer as a role model, reflection on practice and clinical and operative competence. The final survey identified significant consensus among surgeons. Clinical and operative competence achieved the highest consensus with 89.2% of surgeons believing it to be an essential attribute. The results indicate that there is consensus on the seven themes identified as essential for a trainer in general surgery. The recognition of the importance by trainers of non-surgical trainer attributes in the changed training structure is encouraging. Surgeons' level of awareness of their roles as a trainer will help inform the level and direction of trainer training and support required as part of a flexible and continuing developmental process.
The practice placement setting offers opportunities and challenges for engaging students in high-... more The practice placement setting offers opportunities and challenges for engaging students in high-quality interprofessional learning. The Fife Interprofessional Clinical Skills Model for Education was established to develop structured interprofessional learning opportunities for students during their clinical attachments in NHS Fife. This short report describes the delivery and evaluation of the model, which was piloted with students from the nursing, medicine and allied health professions. Scheduled workshops were delivered within primary and secondary care locations. The learning activities involved exploring and comparing their professional identities, discussing roles and responsibilities within the healthcare team and practicing nontechnical clinical skills. Students who participated in the workshops reported that they developed a better understanding of each other's roles and responsibilities and also identified that this would be transferable knowledge to their future practice. Exploring the student experience has assisted in developing relevant and accessible interprofessional learning opportunities within the practice placement setting.
This study has emphasised the complex nature of prescribing errors, and the wide range of error-p... more This study has emphasised the complex nature of prescribing errors, and the wide range of error-producing conditions within hospitals including the work environment, team, task, individual and patient. Further work is now needed to develop and assess interventions that address these possible causes in order to reduce prescribing error rates.
Simulation-based education has been a key development in health care education, providing a safe ... more Simulation-based education has been a key development in health care education, providing a safe learner-centred educational environment. It is a valuable tool, giving learners the opportunity to develop their knowledge and skills, engage in deliberate practice, think about team processes and develop non-technical skills. Simulation-based education allows learners to work towards curriculum competencies in a safe environment where mistakes are expected with no detrimental impact on patient care. This is thought to have an impact on patient safety in the clinical environment when learners take these skills forward into clinical practice. As technology has evolved, it has increasingly been incorporated into simulation-based education. Faculty can use audio-visual technology for remote observation of learners within the simulated environment, allowing faculty the option of video-assisted debriefs. These facilitated debriefs are key to supporting learners to get the greatest benefit from simulation-based education. They allow learners to gain knowledge of their practice and reflect on events guided by facilitators. This style of learner-centred debriefing focuses on the collaborative process between learners and facilitators, with facilitators supporting learners to derive meaning from their experiences. In Lanarkshire, audio-visual technology has been used in simulation-based education since 2010. Faculty use instructor-driven simulators within scenarios, while observing learners in the simulated environment through the audio-visual system. We developed a new immersive simulation course focusing on interprofessional clinical reasoning. The interprofessional team consisted of a medical student, nursing student, pre-registration pharmacist, physiotherapy student and occupational therapy student in their final or penultimate year of study. The simulation was set within an acute medical receiving ward, followed by a facilitated team debrief for learners (Figure 1). While piloting this course, the audio-visual technology failed. This left faculty unable to observe learners during the simulation. Faculty were concerned how they would debrief safely and effectively if they were unaware how learners had performed through observing. Learners were oblivious to the technical issues while immersed within the simulated environment, and this was only disclosed during the debrief. Facilitators became aware of how the simulation had unfolded when learners recounted events as part of the debrief. When facilitators disclosed that they had been unable to see or hear anything, learners laughed and appeared to relax. The apparent pressure they felt, due to being watched, evaporated. Their response appeared to play a part in post simulation decompression, reducing the learner–facilitator power imbalance. This disclosure supported everyone in creating a psychologically safe team which the facilitators became integrated into. The learners observed the discomfort and vulnerability in experienced faculty, perhaps mirroring their own experience within the simulation. There was a sense of everyone reflecting and learning from the experience together, with learners feeling they could truly guide their debrief. Facilitators were enabling reflection through actively modelling their own reflective process. Given that the establishment of psychological safety is essential for successful teams, should we actively consider how this is established in a post simulation debrief? Furthermore, this is a reminder that learning is something learners do themselves and facilitators should recognise the need to step back and allow this to happen.
Leadership development of medical trainees has come to the fore in recent years alongside a chang... more Leadership development of medical trainees has come to the fore in recent years alongside a changing workplace and workforce. Historically leadership theory favours an individualistic approach. However, current social psychological theory proposes that social identity (SI) makes leadership possible through shared understanding and championing of group goals and visions.Current leadership development practices and research tends to focus on individual competence and training despite espousing shared leadership.
Uploads
Papers by Jean Ker