Healthcare disparities within developed nations remain a critical concern, with ethnic minorities and marginalized groups experiencing pronounced inequalities. Cultural humility has emerged as a means to mitigate these disparities and enhance healthcare delivery. Simulation-based education is one of the most widely utilized pedagogical approaches in healthcare curricula across disciplines and specialities. It is recommended in the literature as an ideal strategy for teaching cultural humility to healthcare professionals. However, it is not clear what is known about integrating cultural humility into simulation-based education. This scoping review protocol provides the procedures we will take to explore the breadth of literature to explore how cultural humility is considered and incorporated in simulation-based and to identify current practices and knowledge gaps.

Methods and analysis

The review will synthesize data following the PRISMA-ScR guidelines for scoping reviews. A comprehensive database (MEDLINE, CINAHL Plus with Full Text, APA PsycINFO and Scopus), grey literature and reference screening will be conducted to identify eligible literature to answer the research question. The quality of the included literature and the risk of bias will be carried out using The Mixed Method Appraisal Tool (MMAT) for primary research papers and the ACCODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) checklist will be used to assess the quality of grey literature. The data will be analysed using descriptive statistics and basic qualitative content analysis.

Virtual simulation can have a positive impact on student outcomes; still, guidance from an educator and a reliable connection to the internet are cited as important factors for a positive learning experience. However, when students are asked to complete the simulation outside of class time, it remains unknown how their experience is impacted.

Objective

The objective of this scoping review is to answer the question: What are health professional student experiences with virtual simulation completed asynchronously outside of the physical or virtual classroom setting without a live facilitator?

Inclusion criteria

We will include published peer-reviewed evidence about any health professional student completing virtual simulation outside of a course context. To be included, the virtual simulation activity needs to be required as part of a course.

Methods

We will use the scoping review methodology from the Joanna Briggs Institute (JBI). Published literature will be located through Medline and Embase (via Ovid), CINAHL, Education Source Complete and ERIC (via Ebsco) and the Web of Science Core Collection. We will search for qualitative, quantitative and mixed-method studies written in English, French or Portuguese. No date limit will be applied. Two reviewers will independently screen articles in the Covidence systematic review management software. Data will be extracted and presented in a narrative summary with tables.

Facilitator-led debriefing is commonplace in simulation-based education and has been extensively researched. In contrast, self-led debriefing is an emerging field that may yet provide an effective alternative to well-established debriefing practices. The term ‘self-led debriefing’, however, is often used across a variety of heterogeneous practices in a range of contexts, leading to difficulties in expanding the evidence base for this practice. Evidence, specifically exploring in-person group self-led debriefings in the context of immersive simulation-based education, is yet to be appropriately synthesized. This protocol explains the rationale for conducting an integrative review of this topic whilst summarizing and critiquing the key steps of the process.

Research Aim and Question

The aim of this integrative review is to systematically search, analyse and synthesize relevant literature to answer the following research question: With comparison to facilitator-led debriefings, how and why do in-person self-led debriefings influence debriefing outcomes for groups of learners in immersive simulation-based education?

Methods

This is a protocol to conduct an integrative review aligned to Whittemore and Kanfl’s established five-step framework. The protocol fully addresses the first two steps of this framework, namely the problem identification and literature search stages. Seven databases (PubMed, Cochrane, EMBASE, ERIC, SCOPUS, CINAHL Plus and PsycINFO) will be searched comprehensively to optimize both the sensitivity and precision of the search in order to effectively answer the research question. It also outlines and appraises the various procedures that will be undertaken in the data evaluation, analysis and presentation stages of the process.

Discussion

This review will attempt to address a gap in the literature concerning self-led debriefing in immersive simulation-based education, as well as identify areas for future research. Integrative reviews aim to provide a deeper understanding of complex phenomena and we detail a comprehensive explanation and justification of the rigorous processes involved in conducting such a review. Finally, this protocol highlights the applicability and relevance of integrative reviews for simulation-based education scholarship in a wider context.

This scoping review aims to examine and map the current state of faculty development for healthcare simulation educators. This review will include an exploration of the range and type of faculty development programs designed to enhance simulation-based education (SBE).

Introduction

Simulation has become a staple method for educating health professionals, but no standard approaches exist for training simulation instructors, both for initial training and ongoing professional development. As this education modality continues to expand, there is a need to better understand what interventions and approaches improve the knowledge, skills, abilities and other attributes (KSAOs) for those who are responsible for the design, delivery and evaluation of simulation-based educational sessions.

Inclusion criteria

This scoping review will consider empirical research and other relevant published works that address faculty development for simulation educators in health professions education. This will include faculty development interventions, conceptual and theoretical frameworks, recommendations for implementation and other discussions of issues related to faculty development for SBE. These may include experimental, quasi-experimental, observational, qualitative studies, commentaries and perspectives.

Methods

The following electronic databases will be searched: Medline (Ovid); EMBASE (Ovid); CINAHL (EBSCO); ERIC (EBSCO); PsycInfo (Ovid); and Web of Science without time limits. Reference lists of eligible studies will be back-searched, and Google Scholar and Scopus will be used for forward citation tracking. The findings will be summarized in tabular form and a narrative synthesis, to inform recommendations and areas for future research and practice.

Student stress is well-documented within the field of simulation-based medical education. However, current research is unclear as to what level of stress is optimal for an enhanced educational experience. This ambiguity may partly be due to the use of one or a small number of stress metrics in study designs.

Objective

Our study will aim to evaluate the feasibility of measuring the human stress response during medical simulation, using a suite of techniques.

Methods

Audiovisual (video spectacles), biochemical (serum cortisol and plasma metanephrine/normetanephrine), physiological (blood pressure, galvanic skin response and heart rate) and psychological (State-Trait Anxiety Inventory and Big Five Inventory-2) markers of stress will be monitored during two randomized medical simulations of differing complexities.

Virtual reality (VR) simulation is a rapidly expanding disruptive technology within healthcare professions education with the possibility of significantly transforming how healthcare education is delivered. There is a perceived gap in the current synthesized literature of how VR is being used to teach and assess key skills relating to situational awareness (SA) and decision-making (DM) across the spectrum of undergraduate healthcare professions. This paper details the scoping review protocol that will address this current gap.

Research questions

The scoping review will examine ‘What is known about the use of VR within simulation training for SA and DM behavioural skills in healthcare professions education?’. This main question will be addressed by synthesizing the answers to three sub-questions: (1) In what contexts is VR used within simulation training for SA and DM behavioural skills in healthcare professions education? (2) What outcome measures are used to examine the impacts of VR use within simulation training for SA and DM behavioural skills in healthcare professions education? (3) What educational theories underpin VR use within simulation training for behavioural skills in healthcare professions education?

Methods

Nine databases, PubMed, PsychINFO, Embase, Scopus, Web of Science, CINAHL, ERIC, and Google Scholar, will be searched using a pre-defined search strategy with explicit inclusion and exclusion criteria. A data extraction template will be used to map out the data before summarizing, synthesis and reporting.

Conclusion

This scoping review aims to address the current gap in the literature regarding what is known about VR simulation and DM and SA across undergraduate health education programmes, identifying current trends and uses as well as gaps in the published literature for further exploration.

Simulation-based education is now an established and curricula-integrated pedagogical activity in health professions education with the debriefing component seen to be critical to learning. There is limited empirical research examining the debrief activity, specifically addressing the question of how are interactions in simulation debriefing related to participant learning? The research that does exist is disparate, with researchers selecting different foci of interest, thus producing siloed knowledge. There is a need to both synthesise the current literature whilst simultaneously furthering the subject knowledge.

Methods

This is a protocol to undertake a systematic meta-ethnography in accordance with Noblit and Hare’s established methodology, consisting of seven phases. At the core of this approach is the process of reciprocal translation, where the key interpretations (termed ‘metaphors’) of included studies are juxtaposed with one another to enable new concepts to emerge. This protocol presents the first two phases, covering aspects of question formulation and search strategy utilising PICOS and STARLITE frameworks. We also present the protocol for the deeply interpretive analytical phases (four through six).

Discussion

We provide a comprehensive rationale for undertaking a meta-ethnography, and throughout emphasise the way we intend to navigate the tensions in a predominately positivist systematic review and deeply interpretive nature of a qualitative synthesis. We discuss the issue of quality appraisal in qualitative syntheses and present a modified framework which will function to enable contextual interpretation and bring a sense of collective rigor, and detail why quality appraisal should not be used to exclude articles. Lastly, we highlight the reflexive nature of a meta-ethnography where the final findings are imbued with the researchers’ identity.