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Simulated death enhances learner attitudes regarding simulation
  1. Chang H Park1,
  2. Douglas Wetmore2,
  3. Daniel Katz1,
  4. Samuel DeMaria1,
  5. Adam I Levine1,
  6. Andrew T Goldberg1
  1. 1Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  2. 2Department of Anesthesiology, Hospital for Special Surgery, New York City, New York, USA
  1. Correspondence to Dr Chang H Park, Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai New York City, New York 10029, USA; chang.park{at}mssm.edu

Abstract

Introduction Despite the widespread use of simulated death in healthcare education, some view it as a controversial learning tool due to potential psychological harm. Others believe that allowing death during simulation enhances participant learning. Sparse data exist in the literature about learner attitudes towards simulated death. Our objective was to establish a link between exposure to simulated death and learner attitudes regarding simulation. Our hypothesis was that exposure to simulated death will positively affect learner attitudes towards simulation.

Methods Anonymous surveys were distributed to participants of simulations conducted by our department from January 2014 to December 2015. Collected survey data included total number of simulation scenarios, exposure to death and participants’ views towards simulation afterwards. Participants also rated the simulation on a Likert scale. We compared demographic and simulation data for participants who experienced simulated death versus participants who did not. Exposure to death and clinical level were included as predictor variables in logistic regressions using the simulator experience variables as outcomes.

Results 250 survey responses were analysed. 64% of participants were attendings. 82% of participants experienced death during simulation. The group that experienced simulated death gave significantly higher ratings (4.77 vs 4.50, p=0.004) and a higher percentage of maximum ratings on the Likert scale (83% vs 59%, p=0.0002). More participants who experienced death thought that simulated death could enhance learning (76% vs 59%, p=0.021). When adjusted for training level, those who experienced death in simulation were nearly twice as likely to think that death can enhance learning (p=0.049) and 133% more likely to give the simulation the highest rating (p=0.036).

Conclusions Survey participants who experienced simulated death were more likely to think that death can enhance learning and more likely to give the simulation the highest rating, thereby demonstrating that exposure to simulated death positively affects learner attitudes regarding simulation.

  • simulation
  • death
  • healthcare education
  • learner attitude
  • survey

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Footnotes

  • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content. The specific contributions made by each author are as follows: Conception and design of study: CHP, DW, DK, SDM, AIL, AG. Acquisition of data: CHP, DW, DK, AG. Analysis and/or interpretation of data: CHP, DW, DK, SDM, AIL, AG. Drafting the manuscript: CHP, SDM, AG. Revising the manuscript critically for important intellectual content: CHP, DW, DK, SDM, AIL, AG. Approval of the version of manuscript to be published: CHP, DW, DK, SDM, AIL, AG.

  • Competing interests None declared.

  • Ethics approval Exemption was granted from the Mount Sinai Program for the Protection of Human Subjects for the need for written consent because we collected anonymous survey responses that did not contain any personal medical information.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional unpublished data from the study include the individual anonymous survey responses. The data are currently stored at the Icahn School of Medicine at Mount Sinai and can be obtained with the authors' permission.

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