Guest Poster

    As schools increase hands-on learning, students actively participate in more scenarios. Active participation means the student is physically practicing a skill or process. For example, a student performing CPR on a manikin is an active participant in the basic life support (BLS) scenario.

    Passive or observational learning in simulation is when a student watches another student practice a skill or process. A student watching the BLS scenario from the earlier example is a passive participant.

    Active participation in formative and summative scenarios is crucial in establishing muscle memory and enhancing learning, but combining active and passive participation can improve understanding and retention more than active learning alone.

    Here are three ways passive participation improves simulation learning:

    1. Provides context: Despite our best efforts to promote psychological safety in simulation, students still experience a stress response. This helps active participants’ learning and retention, but it can also prevent their awareness of the bigger picture. They see the skill they are practicing, but not the surrounding context. For example, a student might successfully insert an IV, but he or she might forget to communicate what the procedure is and why it’s being performed with the simulated patient. Passive participants are more likely to notice the lapse thanks to their perspective.
    2. Improves communication: During the debrief period, passive participants can describe their observations during the scenario. In addition to improving their learning and retention, communicating with their peers in a simulation environment translates to stronger communication in the field.
    3.  Avoids vanity distractions: The alternative to passive participation is allowing the student to actively participate, recording their actions, and reviewing the recording with them. While this is a valid teaching method, some students can be distracted by their appearance or the sound of their voice in the recording. By watching another student, these students are better able to focus on the active participant’s proficiency at the intended skill.
    4. Conserves space and time: Lab space is limited. If each student is required to actively participate in a scenario, the space has to be reserved long enough for the scenario to be run multiple times, depending scenario’s number of participants and class size. Lab space and instructor time can each be conserved by practicing passive and active participation.

    At Carolinas Simulation Center, we are constantly trying to improve our scenarios. Combining passive and active participation is one way we’ve succeeded.

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    Dawn Swiderski, MSN, CHSE has been the Director of Carolinas Simulation Center at Atrium Health for over 11 years. She was a Trauma Intensive Care Nurse Educator for over six years prior to that. She is the chair of an informal simulation alliance spanning three regions in North & South Carolina, Carolinas Healthcare Simulation Alliance (CHSA)- Piedmont, Western and Midlands (CHSA-P, CHSA-W, and CHSA-M).