Table 3 Summary of selected studies
From: Observer roles that optimise learning in healthcare simulation education: a systematic review
| Reference | Research paradigm, design & samplinga | Participants | Intervention | Learner Observation Style | Results |
|---|---|---|---|---|---|
| Bell, Pascucci, Fancy, Coleman, Zurakowski and Meyer [24] | Mixed methods | Health professionals from four disciplines (n = 192) | Use of improvisational actors in difficult conversations to teach communication and relational skills to practicing health professional | Non-directed role: no use of observational tool or verbal guidance reported | No difference between observers and hands on learners in: perceived realism; usefulness of actors; usefulness of scenarios; and, opinions on non-actor role play |
| Post-simulation survey design with qualitative and quantitative analysis | Teaching faculty (n = 33) | ||||
| Convenience sample | Actors (SP) (n = 10) | ||||
| Hands on participants (47 %) | |||||
| Observers (53 %) | |||||
| Harder, Ross and Paul [25] | Ethnographic stud | Bachelor of Nursing students year 3 (n = 84) | Role assignment within regular simulation session with analysis of experience and perceptions of learning within different role | Non-directed role: no use of observer tool or verbal guidance reported | Students preferred assignment to nursing roles rather than observer or non nursing role |
| Observational design with focused interview and journal review of selected participants | Participant/observation (n = 84) interview (n = 12) | All participants experienced both roles | Structured role descriptions positively affected learning outcomes | ||
| Volunteer sample | journal review (n = 4) | ||||
| Hober and Bonnel [11] | Qualitative | Bachelor of Nursing “senior” students (n = 50) | Immersive simulation scenarios with students randomly assigned to active or observer roles | Directed observer role: observer tool – educator provided activity guidelines | Observer role beneficial, less stressful |
| Survey and interview design | Observers (n = 23) | All completed survey | Use of a guided observer tool useful | ||
| Convenience sample | hands on learners (n = 27) | Observers interviewed | Able to reflect in action and on action | ||
| Kaplan, Abraham and Gary [27] | Quantitative | Bachelor of Nursing “junior” students (n = 92) | Immersive simulation scenarios - | Directed observer role: observer tool -checklist | No difference in knowledge |
| Randomised groups | Observers (n = 46) | participants self selected roles | |||
| Convenience sample | Scenario participants (n = 46) | Unclear whether observers self selected or were assigned | Limited as aggregated post satisfaction survey data | ||
| Post scenario knowledge test and satisfaction survey | |||||
| Lau, Stewart and Fielding [22] | Quasi experimental randomised to roles | Medical students (bilingual) year 1 (n = 160) | Student role plays with comparison of learning between interpreter role play and observer role | Directed observer role: observer tool -checklist | Observers rated post knowledge higher than learners in interpreter role-play |
| Convenience sample | Self rated pre & post knowledge | ||||
| Smith, Klaassen, Zimmerman and Cheng [26] | Mixed methods with increasing variables over three years | Bachelor of Nursing “junior” students | Introduction of simulation year 1 | Non-directed role: no use of observational tool or verbal guidance reported | No significant difference in learning outcomes, student perceptions or peer evaluations |
| Introduction non nursing participatory roles year | |||||
| Convenience sample | year 1 (n = 67) | Introduction non participatory observer roles year 3 | |||
| year 2 (n = 72) | |||||
| year 3 (n = 85) | |||||
| Note only the year 2 and 3 data were included in review | |||||
| Stegmann, Pilz, Siebeck and Fischer [20] | Quantitative | Medical students (n = 200) | Comparison of participatory role and observer role in simulated patient scenario with and without observation tool | Non-directed and directed observer roles compared: checklists and feedback scripts used | Observational learning (especially if supported by observer script) more effective than learning by doing |
| Crossover design 2x2x2 pre-test post-test | |||||
| Stiefel, Bourquin, Layat, Vadot, Bonvin and Berney [23] | Quantitative | Medical students (masters level) (n = 124) | Individual training with simulated patient encounter | Non-directed role: no use of observer tool or verbal guidance reported | Measured outcomes no difference |
| Randomised into 2 group | Individual training (n = 49) Group training (n = 75) -participated in simulation (n = 14) observed (n = 61) | Group training with simulated patient encounter | Those who observed but did not participate felt they did not meet their learning objectives as well compared to the other 2 groups | ||
| Evaluation using instructor rating scale and student questionnaire | Group training with observation of simulated encounter | ||||
| Convenience sample | |||||
| Thidemann and Soderhamn [21] | Quasi experimental | Bachelor of Nursing student year 2 (n = 144) | Immersive mannequin simulation with random allocation to groups | Directed observer role: observer tool with specific task focus | Post-test scores higher in all groups independent of rol |
| Pre - and post-simulation knowledge test and student questionnaire | Four volunteers within each group allocated to participatory and in scenario observer roles – remainder observers (n = 72) | More satisfaction with nurse role | |||
| Convenience sample over two consecutive years |