Integrating a Gamified Virtual Simulation with Classroom Instruction to Improve Speaking Up: An Experimental Mixed-Methods Study

59 Pages Posted: 23 Sep 2022

See all articles by Efrem Violato

Efrem Violato

Northern Alberta Institute of Technology, Centre for Advanced Medical Simulation

Brian Witschen

Northern Alberta Institute of Technology

Jordan Watson

Thompson Rivers University

Date Written: September 8, 2022

Abstract

Background: Challenging authority through speaking up to ensure patient safety is a difficult yet essential aspect of interpersonal communication and patient care. Existing interventions for speaking up are inconsistent though prior experience appears to be important for speaking up in the future. To provide experience and improve speaking up behaviour in Respiratory Therapy students an intervention was developed that integrates a Gamified Virtual Simulation (GVS) with curriculum on patient advocacy and a high-intensity in-person simulation. GVSs have demonstrated potential for improving interprofessional collaboration and communication. Development of the intervention was guided by Kolb’s Learning Cycle.

Research Questions:

1. Can a GVS improve students’ performance during a high-intensity simulation?

2. Does perceptual experience during high-intensity simulation differ based on completing a GVS?

3. Will the GVS influence learning related to speaking up.

Methods: One week prior to classroom instruction on patient advocacy students were randomly assigned to a GVS or No Intervention condition. The GVS used a Choose-Your-Own-Adventure format requiring students to advocate for a patient by using CUS (Concerned, Uncomfortable, Safety Issue). One month after the conclusion of classroom instruction participants completed a high-intensity simulation requiring speaking up to ensure patient safety. Rates of speaking up were measured. After the in-person simulation participants completed a questionnaire related to the VS and classroom instruction followed by a semi-structured interview. The analysis used a mixed-methods approach to integrate both data forms. The study was approved by the NAIT Research Ethics Office (#2021-03).

Results: The GVS improved rates of speaking up and the use of CUS during the in-person simulation. The GVS prepared participants for the classroom instruction on patient advocacy and supported learning and retention of classroom material. GVS condition participants believed the GVS helped during the simulation and better understood how to speak up, escalate a challenge, and appeared more confident. All participants found the simulations to be beneficial to their development as healthcare professionals.

Conclusions: Integrating a GVS with classroom instruction and an in-person simulation utilizing Kolb’s Learning Cycle can improve performance during in-person simulation, providing the opportunity to gain experience speaking up and support learning on patient advocacy.

Note:
Funding Information: This study was funded by a Mitacs Accelerate Grant #IT18354

Conflict of Interests: The authors have no competing interests to declare that are relevant to the content of this article.

Ethical Approval: Ethics approval was granted by the Northern Alberta Institute of Technology Research Ethics Board (#2021-03)

Keywords: Simulation, Virtual Simulation, Speaking Up, Positive Deviance, Interprofessional, Healthcare

Suggested Citation

Violato, Efrem and Witschen, Brian and Watson, Jordan, Integrating a Gamified Virtual Simulation with Classroom Instruction to Improve Speaking Up: An Experimental Mixed-Methods Study (September 8, 2022). Available at SSRN: https://ssrn.com/abstract=4213659 or http://dx.doi.org/10.2139/ssrn.4213659

Efrem Violato (Contact Author)

Northern Alberta Institute of Technology, Centre for Advanced Medical Simulation ( email )

Brian Witschen

Northern Alberta Institute of Technology ( email )

Jordan Watson

Thompson Rivers University

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