PG5 Developing digital simulation: faculty reflections on online facilitation. (10th November 2020)

• Record Type: Journal Article
• Authors: O'Sullivan, Owen; Powell, Jennifer; Campbell, Lloyd; Bignell, Anita; Parish, Sandra; Billon, Grégoire
• Is Part Of: BMJ simulation & technology enhanced learning. Volume 6(2020)Supplement 1
• Page Start: A32
• Page End: A33
• Publication Date: 2020-11-10
• Subjects: Medicine -- Simulation methods -- Periodicals; Medical innovations -- Periodicals; 610.113
• DOI: 10.1136/bmjstel-2020-aspihconf.54
• Languages: English
• ISSNs: 2056-6697

Abstract

Abstract : Background: Transitioning to digital simulation presents facilitators with several challenges beyond platform orientation and operating procedure familiarisation. Summary of Work: An existing full-day simulation course for psychiatric trainees was adapted for online delivery over a half-day. In-house testing and a piloting phase (three half-day pilots) were conducted. Testing was across two video-conferencing platforms, Kaltura and Zoom. Faculty experience levels ranged from novice to highly experienced (i.e., several years' experience). Two facilitators ran each session. Sessions were passively observed by other faculty members. Following each session, observations and reflections were logged and organised thematically. Summary of Results: In comparisons with non-digital simulation, several themes consistently emerged: a distinctly higher cognitive load, the overall challenge of engaging a group through a more constrained medium, associated relative constraints in transitioning to break-out teaching sessions, technical issues as highly distracting and, finally, potential barriers to psychological safety (incl. challenges in rapport building, limitations in inter-participant engagement, platform-related barriers to fluency in debriefing). Discussion: Faculty described experiencing a higher cognitive load and a 'live TV effect' i.e., an experience of intense focus on the facilitator. Aside from relatively recent orientation to the platform, this was attributed to the diminished ease with which participants can communicate casually with each other, the consequent need for more active chairing and the requirement to monitor several modalities to ensure smooth running of proceedings (e.g., audio and visual input and output, moderator chat and 'off-stage' faculty stage management instructions and updates). This higher cognitive load was described as fatiguing over a half-day session however, faculty were confident this could decrease with more familiarity with the platform. There were similar reflections regarding participants and their likely issues in focusing for extended periods online. 1 It was agreed this may potentially render a ceiling on session duration. This was factored into future scheduling of sessions. Conclusion: Platform instability (e.g., audio-visual lag, connection disruption) was described as a stressor for facilitators and felt to undermine fluency and potentially psychological safety. Ensuring clear delineation of technician and faculty roles in relation to platform orientation and assertive management of technical issues helped decrease faculty cognitive load and supported the achievement and maintenance of psychological safety. Breakout rooms and novel ice-breaker techniques are to be considered to encourage early inter-participant engagement. Owing to the additional demands of facilitating digital simulation, there may be a faculty development need for media-style training. References: Wiederhold BK. Connecting through technology during the coronavirus disease 2019 pandemic: avoiding 'zoom fatigue'. Cyberpsychology, Behavior, and Social Networking 2020;23(7). DOI: 10.1089/cyber.2020.29188.bkw.