Simulate to educate : a dynamic exploration of health disciplines through a comparative study

Canning, Susan and McArthur, Jan (2025) Simulate to educate : a dynamic exploration of health disciplines through a comparative study. PhD thesis, Lancaster University.

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Abstract

This thesis examines the transformative potential of simulation-based education (SBE) in healthcare disciplines, addressing its role in bridging theoretical knowledge and practical application. It responds to gaps in understanding how simulation is used across diverse disciplines, the barriers to its effective implementation, and the institutional frameworks required to support its development. The research aims to uncover how simulation supports teaching and learning, identify shared and discipline-specific practices, and provide actionable insights to enhance its impact. Motivated by the increasing emphasis on simulation in health education and its capacity to address clinical placement shortages, this study investigates simulation practices within eight disciplines: nursing, physiotherapy, occupational therapy, diagnostic radiography, therapeutic radiography, oncology, dentistry, and orthoptics. The work is shaped by key research questions: How is simulation used? What are the similarities and differences in design across disciplines? How is its effectiveness benchmarked? What support structures exist for its development? Using a qualitative case study methodology grounded in social constructivism, the study engages with participants through semi-structured interviews, live observations, and focus groups. This approach captures the nuanced perspectives of educators and students, uncovers the complexities of simulation design, and explores the challenges faced in practice. The findings reveal that simulation offers a unique safe space to fail, enabling students to build confidence and develop technical and non-technical skills without real-world risks. High-fidelity simulations prove valuable but are often over-relied upon, with some contexts better served by low- or medium-fidelity approaches. Interdisciplinary simulation, despite its potential, remains underutilised, as most programmes operate in silos. Resource inequalities and limited staff training hinder the scalability and consistency of SBE across disciplines. While some programmes integrate debriefing and reflective practices effectively, these are inconsistently applied, leaving gaps in learning outcomes. The research underscores the need for a balanced approach to simulation design, aligning resources with pedagogical objectives rather than defaulting to high-cost technologies. Developing robust benchmarking frameworks, fostering interdisciplinary collaboration, and providing targeted staff training emerge as critical steps for unlocking the full potential of SBE. By addressing these challenges, simulation becomes a powerful tool to prepare healthcare students for the complexities of clinical practice. This research contributes to a deeper understanding of SBE by offering cross-disciplinary insights and practical recommendations. It highlights the importance of equity in resource allocation, innovation in simulation design, and institutional support to create impactful learning environments. Ultimately, this thesis provides a roadmap for advancing simulation-based education, ensuring it meets the needs of students and educators while aligning with the broader goals of healthcare training and practice.