Tag Team Simulation: Journal Club

Journal Club Article: Levett-Jones, T., Andersen, P., Reid-Searl, K., Guinea, S., McAllister, M., Lapkin, S., … & Niddrie, M. (2015). Tag team simulation: An innovative approach for promoting active engagement of participants and observers during group simulations. Nurse education in practice, 15(5), 345-352. [abstract]

Rationale for the Study

The authors state that “when simulations are conducted in large groups, maintaining the interest of observers so that they do not disengage from the learning experience can be challenging. We implemented Tag Team Simulation with the aim of ensuring that both participants and observers had active and integral roles in the simulation.”

Background 

“However, in nursing programs, where there may be hundreds of students, resource limitations often lead to simulations being conducted as group activities. Evidence suggests that when this happens, learners who take on an observer role instead of being an actual participant in the simulation, can lose interest and disengage from the learning experience” (Kettlewell, 2012; Harder et al., 2013).

The importance of active participation in education and simulation is highlighted. However, in simulation an observing role from watching through one way glass, auditorium or via video conference is part of increasing engagement and providing an alternative view or ‘lens’ from the non-active members. Learning can occur from this observation aspect, but the authors highlight the issue of a passive role, less immersion and boredom ensuing.

One of the most innovative parts of this article is that the idea was taken from performative theatre. It’s really interesting to take ideas from other professional fields and try them in the nursing environment and take some risks and consider new approaches to education delivery.

Tag Team Simulation (TTS)

“TSS is designed for groups of approximately 20 learners, with each participant and observer having a specific, active and integral role in the simulation.

  1. The narrator/director (the educator).
  2. The protagonist  (leading character- trained simulator actor, student or educator).
  3. The actors (the students).
  4. The audience (active observers).
  5. The set ( an authentic learning environment with high level of fidelity).
  6. The play (simulation scenario)

One of the unique features of TTS is that there are no formal scripts. The TTS play is comprised of a prologue, two acts, an intermission, a debrief and an epilogue.”

Results

The Satisfaction with Simulation Experience Scale (SSES) was used to measure student’s perceptions.

444 second year nursing students submitted the surveys from a population of 536 giving a response rate of 83%.

“The results of an independent sample t test revealed that those who participated in the simulation experience (the actors) reported slightly higher satisfaction with the simulation experience than observers (audience). However, the difference was not statistically significant on the SSES or any of the three subscales.”

Take Home Messages from the Article:

  • Simulation observers can lose interest and disengage from the learning experience.
  • Tag Team Simulation ensures that both participants and observers have equally active and integral roles in simulation.
  • A Tag Team pain simulation implemented with second year nursing students revealed no significant difference in satisfaction scores.

Summary

The holy grail for the perfect education approach continues, but this is a reasoned approach to the very real challenge of large group sessions and how to improve the educational approach. One question that I would like to know in regards to nurse training, relates to the increasing deregulation on the number of nursing enrollments in higher education and universities and the impact on the quality of education (I presume this is becoming a global phenomena with the predicted global nursing shortage?). Many simulation courses provide a 1:6 or 2:6 instructor to participant ratio for a quality learning experience. Is this article just responding to changing times and the stretch on nurse education resources?

Keywords: Tag Team Simulation; TTS; Simulation;active participation

Reference

Levett-Jones, T., Andersen, P., Reid-Searl, K., Guinea, S., McAllister, M., Lapkin, S., … & Niddrie, M. (2015). Tag team simulation: An innovative approach for promoting active engagement of participants and observers during group simulations. Nurse education in practice, 15(5), 345-352. [abstract]

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