Acad Med. 2023 Dec 1;98(12):1443-1450. doi: 10.1097/ACM.0000000000005317. Epub 2023 Jul 11.
Health care distance simulation (HCDS) replicates professional encounters through an immersive experience overseen by experts and in which technological infrastructure enriches the learning activity. As HCDS has gained traction, so has the movement to provide inclusive and accessible simulation experiences for all participants. However, established guidelines for best practices in HCDS regarding justice, equity, diversity, and inclusion (JEDI) are lacking. This study aimed to generate consensus statements on JEDI principles in synchronous HCDS education using the nominal group technique (NGT).
Professionals with experience in HCDS education were invited to generate, record, discuss, and vote on ideas that they considered best practices for JEDI. This process was followed by a thematic analysis of the NGT discussion to provide a deeper understanding of the final consensus statements. An independent group of HCDS educators individually reviewed and recorded their agreement or disagreement with the consensus statements created by the NGT process.
Eleven independent experts agreed on 6 key practices for JEDI in HCDS. Educators need to (1) be aware of JEDI principles, (2) be able to define and differentiate JEDI, (3) model JEDI in their environment, (4) have expertise and comfort facilitating conversations and debriefing around JEDI issues, (5) be advocates within their organizations to ensure equitable educational experiences, and (6) achieve JEDI without compromising educational objectives. Experts were divided on the approach to technology to ensure equitable learning experiences: some believed that the most basic technology accessible to all learners should be used, and some believed that the technology used should be determined by the competency of the students or faculty.
Structural and institutional barriers in HCDS education persist despite agreement on key JEDI practices. Conclusive research is needed to guide the optimal policy in HCDS toward creating equitable learning experiences while bridging the digital divide.
健康照护距离模拟（HCDS）通过专家监督的沉浸式体验复制专业互动，并且技术基础设施丰富了学习活动。随着 HCDS 的普及，为所有参与者提供包容和可及的模拟体验的运动也在发展。然而，在 HCDS 中关于公正、公平、多样性和包容性（JEDI）的最佳实践指南尚未建立。本研究旨在使用名义小组技术（NGT）就同步 HCDS 教育中的 JEDI 原则生成共识声明。
邀请具有 HCDS 教育经验的专业人员生成、记录、讨论和投票，提出他们认为在 JEDI 方面的最佳实践。然后对 NGT 讨论进行主题分析，以更深入地了解最终的共识声明。一组独立的 HCDS 教育工作者单独审查并记录他们对 NGT 过程创建的共识声明的同意或不同意。
11 名独立专家就 HCDS 中的 6 项 JEDI 关键实践达成一致。教育者需要（1）了解 JEDI 原则，（2）能够定义和区分 JEDI，（3）在其环境中体现 JEDI，（4）拥有专长和舒适感，能够促进围绕 JEDI 问题的对话和讨论，（5）在其组织内成为倡导者，以确保公平的教育体验，以及（6）在不影响教育目标的情况下实现 JEDI。专家们对确保公平学习体验的技术方法存在分歧：一些人认为应该使用所有学习者都能获得的最基本技术，而另一些人则认为应该根据学生或教师的能力来确定使用的技术。
尽管在关键 JEDI 实践上达成一致，但 HCDS 教育中仍存在结构性和制度性障碍。需要进行确凿的研究，以指导 HCDS 中的最佳政策，在弥合数字鸿沟的同时创造公平的学习体验。
