PAXsims is pleased to present a selection of recently-published articles on simulation and serious gaming. We will start doing this regularly, in addition to our periodic “simulation and gaming miscellany” updates. Some of these may not address peacebuilding, conflict, or development issues at all, but have been included because of the broader perspective they offer on games-based education or analysis.
Articles may be gated/paywalled and not accessible without institutional access to the publication.
Simulation Exercises (SimEx) are an established tool in defence and allied security sectors, applied extensively in health security initiatives under national or international legislative requirements, particularly the International Health Regulations (2005). There is, however, a paucity of information on SimEx application to test the functionality of health systems alongside emergency preparedness, response and recovery. Given the important implications health services resilience has for the protection and improvement of human life, this scoping review was undertaken to determine how the publicly available body of existing global SimEx materials considers health systems, together with health security functions in the event of disruptive emergencies.
The global review identified 668 articles from literature and 73 products from institutional sources. Relevant screening identified 51 materials suitable to examine from a health system lens using the six health system building blocks as per the WHO Health System Framework. Eight materials were identified for further examination of their ability to test health system functionality from a resilience perspective.
SimEx are an effective approach used extensively within health security and emergency response sectors but is not yet adequately used to test health system resilience. Currently available SimEx materials lack an integrated health system perspective and have a limited focus on the quality of services delivered within the context of response to a public health emergency. The materials do not focus on the ability of systems to effectively maintain core services during response.
Without adjustment of the scope and focus, currently available SimEx materials do not have the capacity to test health systems to support the development of resilient health systems. Dedicated SimEx materials are urgently needed to fill this gap and harness their potential as an operational tool to contribute to improvements in health systems. They can act as effective global goods to allow testing of different functional aspects of health systems and service delivery alongside emergency preparedness and response.
The work was conducted within the scope of the Tackling Deadly Diseases in Africa Programme, funded by the UK Department for International Development, which seeks to strengthen collaboration between the health system and health security clusters to promote health security and build resilient health systems.
Virginia C. Muckler, Christine Thomas, “Exploring Suspension of Disbelief Among Graduate and Undergraduate Nursing Students,” Clinical Simulation in Nursing 35 (2019).
The nature and process of suspending disbelief is complex, subjective, and has not been well researched in clinical simulation.
A descriptive phenomenological approach with semistructured interviews explored student experiences of suspending disbelief during simulation-based learning.
Among the 18 (69%) graduate students and 8 (31%) undergraduate students, three themes emerged from participant narratives including (1) frame of mind, (2) environment, and (3) tempo. Subthemes of frame of mind included cognitive focus, apprehension, and confidence.
Understanding nursing students’ lived experiences of suspending disbelief can enhance the educator’s ability to design and facilitate effective simulation, student development, and suspension of disbelief.
- Suspension of disbelief is complex, subjective, and underresearched.
- Frame of mind or mindset influences suspension of disbelief.
- Cognitive focus, apprehension, and confidence affect suspension of disbelief.
- Functional equipment enhances the environment and suspension of disbelief.
- Scenario progression without interruption promotes suspension of disbelief.
Louis P. Halamek, Robert Cady, and Michael Sterling, “Using briefing, simulation and debriefing to improve human and system performance,” Seminars in Perinatology (prepublication 2019).
Safety, effectiveness and efficiency are keys to performance in all high-risk industries; healthcare is no exception, and neonatal-perinatal medicine is one of the highest risk subspecialties within healthcare. Briefing, simulation and debriefing are methods used by professionals in high-risk industries to reduce the overall risk to life and enhance the safety of the human beings involved in receiving and delivering the services provided by those industries. Although relatively new to neonatal-perinatal medicine, briefing, simulation and debriefing are being practiced with increasing frequency and have become embedded in training exercises such as the Neonatal Resuscitation Program (NRP) of the American Academy of Pediatrics (AAP). This chapter will define these terms and offer examples as to how they are used in high-risk activities including neonatal-perinatal medicine.
Sundeep Kaur Varaich, “Effectiveness of Simulation in Addressing Stigma,” PhD dissrtation, University of Northern Colorado, May 2019.
Mental health stigma hinders quality nursing care. The aim of this quasi- experimental study was to test if simulation was effective for addressing stigma in nursing education and evaluating student attitudes towards psychiatric conditions. A sample of eight-nine undergraduate nursing students were assigned to a control or treatment group and participated in either a chronic health challenge scenario or a mental health scenario to test the effectiveness of using a mental health simulation to address stigmatizing attitudes. Day’s Mental Illness Stigma Scale was used as the data collection tool for the post-test to measure students’ stigmatizing perceptions in relation to their assigned scenario. This scale was completed by the students immediately after the simulation and approximately three months after participating in the simulation scenario to evaluate change in perceptions. Analysis of mean scores revealed that students participating in the mental health scenario demonstrated more stigmatizing attitudes overall except related to the subscale for anxiety toward mental illness, for which the control group showed more stigmatizing attitudes. These findings indicate a need for further research into the use of simulation as an educational approach and the possibility of modifying this approach for effectively addressing mental health stigma.
(Emphasis added–this research shows a simulation experience potentially causing undesirable learning outcomes.)