Residents' perceptions of simulation as a clinical learning approach.
BACKGROUND
Simulation is increasingly being integrated into medical education; however, there is little research into trainees' perceptions of this learning modality. We elicited trainees' perceptions of simulation-based learning, to inform how simulation is developed and applied to support training.


METHODS
We conducted an instrumental qualitative case study entailing 36 semi-structured one-hour interviews with 12 residents enrolled in an introductory simulation-based course. Trainees were interviewed at three time points: pre-course, post-course, and 4-6 weeks later. Interview transcripts were analyzed using a qualitative descriptive analytic approach.


RESULTS
Residents' perceptions of simulation included: 1) simulation serves pragmatic purposes; 2) simulation provides a safe space; 3) simulation presents perils and pitfalls; and 4) optimal design for simulation: integration and tension. Key findings included residents' markedly narrow perception of simulation's capacity to support non-technical skills development or its use beyond introductory learning.


CONCLUSIONS
Trainees' learning expectations of simulation were restricted. Educators should critically attend to the way they present simulation to learners as, based on theories of problem-framing, trainees'a prioriperceptions may delimit the focus of their learning experiences. If they view simulation as merely a replica of real cases for the purpose of practicing basic skills, they may fail to benefit from the full scope of learning opportunities afforded by simulation.
The Wilson Centre, Ontario, Canada; Hospital for Sick Children, Ontario, Canada; Department of Paediatrics, University of Toronto, Ontario, Canada.
Catharine M
CM
Walsh
St. Michael's Hospital, Ontario, Canada; McMaster University, Ontario, Canada.
Ankit
A
Garg
The Wilson Centre, Ontario, Canada; Centre for Ambulatory Care Education, Women's College Hospital, Ontario, Canada; St. Michael's Hospital, Ontario, Canada; Centre for Faculty Development, Ontario, Canada; Department of Speech-Language Pathology, University of Toronto, Ontario, Canada.
Stella L
SL
Ng
St. Michael's Hospital, Ontario, Canada.
Fenny
F
Goyal
St. Michael's Hospital, Ontario, Canada; Department of Medicine, University of Toronto, Ontario, Canada.
Samir C
SC
Grover