Original ResearchThe Facilitator's Role in London's Air Ambulance's Simulation “Moulage” Training
Section snippets
Study Design
The LAA is a highly specialized and understudied group of professionals. An ethnographic study approach was used, including the notion of “progressive focusing,”2 in which the process of inquiry involves a gradual clarification of the research question. To achieve this, observational field work was followed by in-depth interviews.
Setting and Participants
Ethnography is described as “the art and science of describing a human group,”3 and this was the key objective here. The LAA provided the observers with full access to
Purpose
The researchers gained a deeper understanding of the role of a moulage facilitator through 1-to-1 interviews. The choice of questions was informed by the findings of the observational work. Combining interviews with observational data helped understand the meaning behind the observed behaviors.
Sampling and Process
Eight team members who regularly facilitated were interviewed on an ad hoc basis using convenience sampling. Two paramedic and 3 doctor facilitators were interviewed. The interviews were recorded and
Results and Discussion
The key themes that emerged from the observational work and interviews are discussed with supporting excerpts. The true value of the interviews was realized when the interviewees explained the meaning behind observed actions and behaviors.
Timing of Feedback
Feedback was used by the facilitators both during (intrinsically) and after (extrinsically) the moulage.7 Through intrinsic feedback, the facilitators could evaluate the understanding of the learners. This was a dynamic and informal process that went hand in hand with the teaching. The field work revealed that the use of intrinsic feedback noticeably declined as the course progressed; however, the occurrence of extrinsic feedback did not fluctuate. The gradual decline in the need for intrinsic
Standardization
Standardization is seen as an important benefit of simulation.11 During an introductory seminar, participants were taught about the standard operating procedures (SOPs) to apply to upcoming moulages. This is endorsed by 1 interviewee.
“It should be when you facilitate you're running it the same for everybody” (doctor 3).
During 1 briefing session, the facilitator encouraged a discussion among the learners regarding the SOPs for treating a severe asthma attack.
LAA doctor facilitator tells learners
Scenario Development
In addition to running the moulages, senior facilitators have the role of scenario development. The observations and interviews revealed some important considerations.
Before the start of each moulage, the facilitator(s) briefed the participants (including any actors involved) and assigned roles. Contrary to recommendations in the literature,16 the learning outcomes were not mentioned until after the scenario had finished. There appeared to be a notion of “learning by doing” within the LAA, that
Summary
Overall, the observational work helped to develop the anticipated roles of the moulage facilitator. Furthermore, the incredibly complex nature of the facilitators' job was revealed to the researchers. The interviews provided the researchers with a valuable insight into the meaning behind what was silently observed. This greatly aided the researchers in developing a deep understanding of what it means to be an LAA moulage facilitator.
Conclusion
Based on what emerged from spending time immersed in their culture of training, Figure 2 shows the varying roles of an LAA moulage facilitator. Effective facilitators not only need to be experienced in their field, but they should also have the attributes of a good teacher. In this particular study, the ability to multitask was considered as particularly important by the facilitators.
Steinert24 recommends that, after understanding the culture of the organisation, a thorough needs assessment
Acknowledgments
The authors would like to thank and acknowledge London's Air Ambulance for allowing unrestricted access to their training methods.
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