Behrens Claudia C, Dolmans Diana H, Driessen Erik W, Gormley Gerard J
Medical Education Unit, Universidad Católica del Norte, Coquimbo, Chile.
School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
Med Educ. 2025 Apr;59(4):439-448. doi: 10.1111/medu.15554. Epub 2024 Oct 12.
Immersive simulations can evoke a range of emotions in students. However, little is known about how facilitators recognise and respond to students' emotions during simulations. This study aims to understand how simulation facilitators perceive and respond to students' emotions during simulation-in order to optimise learning.
We conducted semi-structured interviews with 10 simulation facilitators who had varying experiences in simulation-based practice. We explored their experiences of students' emotions in simulations and reactions to these perceived emotional states. Applying an Interpretive Descriptive methodology, drawing upon control-value theory, we iteratively and reflexively developed themes to address our research question. Based on a contrasting analysis, we used the concept of 'crafted stories' to represent our findings.
We identified three recurring issues and crafted these into stories: (1) facilitators that recognise emotions and adjust the complexity of the simulation in order to dampen intense negative emotions and 'preserve learning'; (2) those that recognise mainly negative emotions and argue that it is better to let them feel the 'heat' in order to prepare them for the realities of clinical practice; (3) those that recognise both negative and positive emotions but let the simulation run as planned for all learners and attend to emotional responses during debriefing.
Simulation facilitators become aware of students' emotional responses through a range of cues. While some facilitators continually move and react to students' emotions, others intentionally hold back from attempting to alter students' emotional responses. Facilitators' beliefs about how to optimise learning mediate how they react to students' emotional states. Beliefs about learning are predominantly shaped by their experiences in both teaching and real-world clinical practice. By understanding the delicate balancing act of students' emotional states and altering the complexity of a simulation, we have the opportunity to inform facilitator training in order to enhance learning.
沉浸式模拟能够在学生中引发一系列情绪。然而，关于引导者在模拟过程中如何识别并回应学生的情绪，我们却知之甚少。本研究旨在了解模拟引导者在模拟过程中如何感知并回应学生的情绪，以便优化学习效果。
我们对10位在基于模拟的实践中有不同经验的模拟引导者进行了半结构化访谈。我们探讨了他们在模拟中对学生情绪的体验以及对这些感知到的情绪状态的反应。运用解释性描述方法，借鉴控制价值理论，我们反复且反思性地提炼出主题，以回答我们的研究问题。基于对比分析，我们使用“精心构建的故事”这一概念来呈现我们的研究结果。
我们识别出三个反复出现的问题，并将其构建成故事：（1）引导者能够识别情绪并调整模拟的复杂性，以减轻强烈的负面情绪并“保护学习”；（2）那些主要识别负面情绪并认为最好让学生感受“热度”，以便让他们为临床实践的现实做好准备的引导者；（3）那些既识别负面情绪又识别正面情绪，但让模拟按计划对所有学习者进行，并在总结汇报时关注情绪反应的引导者。
模拟引导者通过一系列线索察觉到学生的情绪反应。虽然一些引导者会持续关注并对学生的情绪做出反应，但另一些引导者则有意克制，不试图改变学生的情绪反应。引导者关于如何优化学习的信念会调节他们对学生情绪状态的反应。关于学习的信念主要受他们在教学和实际临床实践中的经验影响。通过理解学生情绪状态的微妙平衡行为并改变模拟的复杂性，我们有机会为引导者培训提供信息，以提高学习效果。
