Diversity and Inclusion in Simulation: Addressing Ethical and Psychological Safety Concerns When Working with Simulated Participants

By: Leanne Picketts, Marika Dawn Warren, Carrie Bohnert
Submitted by: Marsha Harman, Rush Center for Clinical Skills and Simulation

Healthcare learners can gain necessary experience working with diverse and priority communities through human simulation. In this context, simulated participants (SPs) may be recruited for specific roles because of their appearance, lived experience or identity. Although one of the benefits of simulation is providing learners with practice where the risk of causing harm to patients is reduced, simulation shifts the potential harm from real patients to SPs. Negative effects may be amplified when SPs are recruited for personal characteristics or lived experience. Educators have an ethical obligation to promote diversity and inclusion; however, we are also obliged to mitigate harm to SPs.

This paper uses a framework of diversity practices, ethics and values and simulation standards of best practice to explore the tension between these obligations and offers a framework to guide the process of weighing potential risks and benefits when working with diverse and priority communities.

The authors provide two case study scenarios around creating simulation exercises using SPs of a specific population, and suggest approaches to minimize risk and mitigate potential harm to the participants. I think this paper will be a useful tool for SP educators to help us support diversity and inclusion in medical curricula while still protecting and supporting our SPs. 

Read the full article in BMJ Simulation and Technology Enhanced Learning here

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