Macdougall, L., Martin, R., McCallum, I., and Grogan, E. (2013). Simulation and stress: Acceptable to students and not confidence busting. The Clinical Teacher. 10. pp.38-41.

This article challenges the idea that simulation must be conducted in highly-controlled environments to be successful. They sought to create a stressful environment surrounding simulation. Ways to create this were by adding true-life factors to the simulator, such as requiring lab results to actually be sent to the lab (adding appropriate and realistic time delays into the scenario), and making physical phone calls to hospital staff regarding the patients in simulation.

Students in the study self-evaluated using Likert-scale questionnaires. Pre- and post-session scores were evaluated, as well as free-text comments. Students were encouraged to share their thoughts on the study, as well as their own performance in the simulations.

This is exactly the kind of thing I tell my instructor customers— effective training is a combination of people, processes, and technology. The technology is but a small part of the training event, possibly only seconds or minutes within the immersive simulation on a screen but the events surrounding the simulation are what sometimes matters more. Take the student through a tactical approach to the simulator, have them interact with dispatch, higher headquarters, or adjacent units during the simulation (call in a report of contact, wait for actual response) have them complete reporting requirements after the simulation, put them through a mock trial if unauthorized use of force was applied, etc. This study proves that applying additional stress into the simulation is an effective use of time and resources and not counter-productive in developing the trainee’s confidence.

Additional sources for this week’s reading:

Geary, S.P., Spencer, T. R., and Woolley, W.L. (2013). Death in simulation: Comparing the stress to the educational value. Annals of Emergency Medicine, 62:4, pp S16-S17.

Yardley, S. (2011), Death is not the only harm: Psychological fidelity in simulation. Medical Education, 45: 1062. doi:10.1111/j.1365-2923.2011.04029.x

Ho, T. (1994). Individual and situational determinants of the use of deadly force: A simulation. American Journal of Criminal Justice. 18:1. pp 41–60.

Bennell, C., Jones, N. J. and Corey, S. (2007) Does use-of-force simulation training in Canadian police agencies incorporate principles of effective training? Psychology, Public Policy, and Law. 13:1. pp 35-58.