Taking simulation out of its “safe container”—exploring the bidirectional impacts of psychological safety and simulation in an emergency department

Advances in Simulation - Tập 7 Số 1 - 2022
Eve Purdy1, Laura Borchert2, Anthony El-Bitar2, Warwick Isaacson1, Lucy Bills1, Victoria Brazil2
1Gold Coast University Hospital Emergency Department, Southport, Queensland, Australia
2Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia

Tóm tắt

AbstractBackgroundSimulation facilitators strive to ensure the psychological safety of participants during simulation events; however, we have limited understanding of how antecedent levels of psychological safety impact the simulation experience or how the simulation experience impacts real-world psychological safety.MethodsWe explored the experience of participants in an embedded, interprofessional simulation program at a large tertiary emergency department (ED) in Australia. We engaged in theoretical thematic analysis of sequential narrative surveys and semi-structured interviews using a previously derived framework of enablers of psychological safety in healthcare. We sought to understand (1) how real-world psychological safety impacts the simulation experience and (2) how the simulation experience influences real-world psychological safety.ResultsWe received 74 narrative responses and conducted 19 interviews. Simulation experience was both influenced by and impacted psychological safety experienced at the individual, team, and organizational levels of ED practice. Most strikingly, simulation seemed to be an incubator of team familiarity with direct impact on real-world practice. We present a model of the bidirectional impact of psychological safety and simulation within healthcare environments.ConclusionOur model represents both opportunity and risk for facilitators and organizations engaging in simulation. It should inform objectives, design, delivery, debriefing, and faculty development and firmly support the situation of simulation programs within the broader cultural ethos and goals of the departments and organizations.

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