Learning from the point-of-view simulation of illness experiences for healthcare professions: a scoping review of the literature

Oral Presentation 4
Miss Milda Karvelyte, Dr Janet Rogers, Prof Gerard J Gormley

Learning from the point-of-view simulation of illness experiences for healthcare professions: a scoping review of the literature.

Introduction: Healthcare professionals (HCPs) who experienced ill-health were noted to demonstrate more empathic care approach towards their patients. Simulation can provide participants opportunities to feel aspects of illness in a supported and safe setting. Until 2020 no overarching review was provided analysing the impact/extent of this practise on empathic skills.

Objectives: Establish from the evidence base the overall knowledge about simulation-based learning methods of creating illness experiences for HCPs and the impact on their empathic skills.

Methods: Arksey and O’Malley’s methodological framework informed our scoping review of articles relevant to our research question. Three databases (Medline, Embase and Web of Science) were searched in November - December 2020 and a sample of 516 citations was exported to Covidence Systematic Review Software© for screening. Following review and application of our exclusion/inclusion criteria - 77 articles were selected by February 2021 to be included in the review.
 
Outcomes: Of the 77 articles, 52 [68%] were based in the USA, 37 (48%) were qualitative in nature and 17 (22%) used a mixed-methods model. Majority of artic les within the scope (87%) reported positive impact and a range of emotions evoked on learners. For example, loss of independence throughout paralysis or impairment simulations, left the majority of participants feeling vulnerable “somebody they did not want to be, something negative”. Often learners gained a greater sense of not only imagined empathy but also activated desire to demonstrate empathic care towards their patients in the future. For instance, providing more time, ensuring conveyed information is well understood and maintaining eye contact. However, a few studies noted more negative effects and additional debriefing was required post-simulation. For instance, auditory hallucination studies reported a decreased willingness to help or interact with individuals with a mental illness; they did not engender goodwill or a desire to have contact, but rather facilitated social distance and negative emotions, as well as an increase in attitudes regarding forced treatment. A sense of suspicion and less positive attitudes toward older adults was likewise observed in some simulations of old age. Learners were observed to internalise perceived experiences of illness and critically reflected on their empathetic role as healthcare providers.

Conclusions: A wide range of simulation methods and techniques, instilling an embodied emotional experience, appear to have a positive impact on empathy and could be argued as offering a complementary approach in healthcare education; although, the long-term impact remains largely unknown.