The Simulation Solution: Empowering Hospital Doctors To Care For Older Adults

Background The rapidly increasing older adult population necessitates training in gerontological competencies for all hospital doctors regardless of specialty. Simulation-based education (SBE) has been proposed as a potential educational intervention to achieve this. However, research in gerontological simulation is limited. This study aims to explore if SBE fosters transformative learning (TL) and influences clinical behaviour in hospital doctors.. Specifically, we explored if and how SBE facilitates the acquisition of a specific set of gerontological competencies. Methods Incorporating an instructional design approach and Mesirow’s transformative learning theory, we developed a simulation scenario focusing on the management of an older adult with delirium and Parkinson’s disease. A scoping review and national consensus mapping study were conducted to determine learning needs. Doctors within a single hospital site were invited to participate. The learners in each scenario were invited to participate in an individual semi-structured interview two to four weeks post the simulation scenario. The scenario was facilitated utilising minimal resources. Evaluation was conducted via an audio-recorded debrief and semi-structured interview. Questions were guided by the ten phases of Mesirow’s transformative learning theory. Transcripts were analysed using thematic analysis. Results Nine simulation scenarios and debriefs were followed by nine individual semi-structured interviews. Participants included hospital doctors from internal medicine, surgery and obstetrics and gynaecology. Four overarching themes continuously arose contributing to our understanding of TL of gerontological competencies through SBE: 1.)‘Creating a realistic challenge’; 2.)‘SBE as a catalyst for reflection’; 3.)’Looking to the future’ and 4.)'Gerontological simulation: a paradigm shift’. Conclusion Simulation-based education promotes transformative learning of gerontological competencies pertaining to delirium and Parkinson’s disease for hospital doctors. Future research should focus on exploring how SBE can foster the TL of broader gerontological competencies. These findings could subsequently guide the development of dedicated simulation curricula for postgraduate medical training across all hospital specialties.