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Instructional Science

, Volume 40, Issue 5, pp 785–798 | Cite as

Realism, authenticity, and learning in healthcare simulations: rules of relevance and irrelevance as interactive achievements

  • Hans RystedtEmail author
  • Björn Sjöblom
Article

Abstract

Because simulators offer the possibility of functioning as authentic representations of real-world tasks, these tools are regarded as efficient for developing expertise. The users’ experience of realism is recognised as crucial, and is often regarded as an effect of the similarity between reality and the simulator itself. In this study, it is argued that simulation as a realistic and relevant activity cannot be predesigned but emerges in the interaction between the participants, the simulator, and the context. The study draws on interaction analysis of video data from medical training. The aim is to contrast the use of two different simulators to explore the requirements needed to establish and maintain simulations as authentic representations of clinical practice. Irrespective of the realism of the simulator, glitches in the understanding of the simulation as work-related activity appear and are bridged by participants. This regularly involves an orientation to the relevant similarities with work and, simultaneously, the ruling out of irrelevant dissimilarities. In doing so, the participants rely on established professional practices to construe the situation. Moreover, the realism of the simulation is maintained through the participants’ mutual orientation to the moral order of good clinical practice and a proper simulation. It is concluded that the design of simulation activities needs to account for the possibilities of participants understanding the specific conditions of the simulation and the work practices that the simulation represents. Learning to simulate is thus something that needs further attention in its own right.

Keywords

Simulation Authenticity Medicine Interaction analysis Ethnomethodology 

References

  1. Barab, S. A., Squire, K. D., & Dueber, W. (2000). A co-evolutionary model for supporting the emergence of authenticity. Educational Technology Research and Development, 48(2), 37–62.CrossRefGoogle Scholar
  2. Dieckmann, P. (Ed.). (2009). Using simulations for education, training and research, vol 3. Berlin: Pabst Science Publishers.Google Scholar
  3. Dieckmann, P., Gaba, D., & Rall, M. (2007a). Deepening the theoretical foundations of patient simulation as a social practice. Simulations in Healthcare, 2(3), 183–193.CrossRefGoogle Scholar
  4. Dieckmann, P., Manser, T., Wehner, T., & Rall, M. (2007b). Reality and fiction cues in medical patient simulation: An interview study with anesthesiologists. Journal of Cognitive Engineering and Decision Making, 1(2), 148–168.CrossRefGoogle Scholar
  5. Garfinkel, H. (1967). Studies in ethnomethodology. Cambridge: Polity Press.Google Scholar
  6. Garfinkel, H. (2002). Ethnomethodology’s program: Working out Durkeim’s aphorism. Lanham: Rowman and Littlefield Publishers.Google Scholar
  7. Goffman, E. (1961). Encounters: Two studies in the sociology of interaction. Indianapolis: Bobbs-Merill.Google Scholar
  8. Heath, C., & Luff, P. (Eds.). (2000). Technology as action. Cambridge: Cambridge University Press.Google Scholar
  9. Hindmarsh, J. (2010). Peripherality, participation and communities of practice: Examining the patient in dental training. In N. Llewellyn & J. Hindmarsh (Eds.), Organisation, interaction and practice (pp. 218–240). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  10. Hindmarsh, J., & Pilnick, A. (2002). The tacit order of teamwork: Collaboration and embodied conduct in anesthesia. The Sociology Quarterly, 43(2), 139–164.CrossRefGoogle Scholar
  11. Husebø, S. E., Rystedt, H., & Friberg, F. (2011). Educating for teamwork: Nursing students’ coordination in simulated cardiac arrest situations. Journal of Advanced Nursing, 67(10), 2239–2255.CrossRefGoogle Scholar
  12. Issenberg, S. B., McGaghie, W. C., Petrusa, E. R., Gordon, D. L., & Scalese, R. J. (2005). Features and uses of high-fidelity simulations that lead to effective learning: A BEME systematic review. Medical Teacher, 27(1), 10–28.CrossRefGoogle Scholar
  13. Jacobsen, J., Lindekaer, A. L., Ostergaard, H. T., Nielsen, K., Ostergaard, D., Laub, M., et al. (2001). Management of anaphylactic shock evaluated using a full-scale anaesthesia simulator. Acta Anaesthesiologica Scandinavia, 45, 315–319.CrossRefGoogle Scholar
  14. Johnson, E. (2004). Situating simulators: The integration of simulators in medical practice. Lund: Arkiv förlag.Google Scholar
  15. Johnson, E. (2007). Surgical simulators and simulated surgeons: Reconstituting medical practice and practitioners in simulations. Social Studies of Science, 37(4), 585–608.CrossRefGoogle Scholar
  16. Kalyuga, S., & Renkl, A. (2010). Expertise reversal effect and its instructional implications: Introduction to the special issue. Instructional Science, 38(3), 209–215.CrossRefGoogle Scholar
  17. Koschmann, T. (2008). Introduction to special issue on learning and work. Computer Supported Cooperative Work, 17(1), 1–3.CrossRefGoogle Scholar
  18. Lantz-Andersson, A., Linderoth, J., & Säljö, R. (2009). What’s the problem? Meaning making and learning to do mathematical word problems in the context of digital tools. Instructional Science, 37(4), 325–343.CrossRefGoogle Scholar
  19. Linell, P., & Persson Thunqvist, D. (2003). Moving in and out of framings: Activity contexts in talks with young unemployed people within a training project. Journal of Pragmatics, 35, 409–434.CrossRefGoogle Scholar
  20. Lynch, M., & Woolgar, S. (1990). Representation in scientific practice. Cambridge: MIT Press.Google Scholar
  21. Petraglia, J. (1998). Reality by design: The rhetoric and technology of authenticity in education. Mahwah: Lawrence Erlbaum.Google Scholar
  22. Rystedt, H. (2002). Bridging practices: Simulations in education for the healthcare professions. Göteborg: Acta Universitetis Gothoburgensis.Google Scholar
  23. Rystedt, H. (2009). Simulering: Att återskapa vårdpraktik som lärandemiljöer [Simulation: Recreating caring practices as learning environments]. In J. Linderoth (Ed.), Individ, teknik och lärande [Individual, technology and learning] (pp. 44–66). Stockholm: Carlssons bokförlag.Google Scholar
  24. Schegloff, E. A. (2007). Sequence organization in interaction. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  25. Sjöblom, B. (2006). To do what we usually do: An ethnomethodological investigation of intensive care simulations. Linköping: Linköping University.Google Scholar
  26. Svensson, M. S. (2007). Monitoring practice and alarm technology in anaesthesiology. Health Informatics, 13(9), 9–21.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.Department of Education, Communication and LearningUniversity of GothenburgGöteborgSweden
  2. 2.Department for Child and Youth StudiesStockholm UniversityStockholmSweden

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