Abstract:

This CE webinar will discuss how observer roles in healthcare simulation are as effective as active participant roles for bowel preparation education among interprofessional healthcare workers.

Background: Adequate bowel preparation is a critical aspect of colonoscopy, mainly pivoting on the education and counseling provided to the patient (1). Simulation-based education has traditionally prioritized individual or one-to-one practice of skills, known as active participation, over learning through observing fellow learners (2). The efficacy of observer roles in simulation-based education scenarios remains underexplored, with concerns that it may not be as effective in learning as the active participant role (3). This may be due to an interpretation of Kolb’s experiential learning theory, in which active experimentation is essential to the learning process. We hypothesize that learning through observing is as effective as doing so through active participation. Through this study, we aim to compare the effectiveness of the observer role versus the active participant role in an interprofessional cohort of healthcare professionals using simulation-based education.

Methods: An interprofessional cohort of healthcare professionals including residents, fellows, nurses, and allied health staff, involved in bowel preparation education to patients were randomized to either an active participant group (control) or an observer group (intervention). Both groups received standardized education on bowel preparation techniques prior to the simulation sessions. Pre- and post-tests were administered to assess participant knowledge regarding bowel preparation before and after the intervention. Additionally, pre- and post-activity self-efficacy questionnaires were administered on a 5-point Likert scale. The scores were analyzed using appropriate statistical methods to compare the effectiveness of the observer role versus the active participant role in simulation-based education.

Results: Both groups demonstrated substantial improvements in the post-test and post-activity self-efficacy scores. The control group (pre-test 8.40 ± 1.81; post-test 10.40 ± 2.72) and the observer group (pre-test 7.92 ± 2.36; post-test 10.77 ± 2.13) demonstrated a statistically significant increase in the knowledge gained (p<0.05) due to the intervention. There was no significant difference between both groups when comparing the pre-test (p=0.55) or post-test (p=0.70) scores, indicating that the observer role plays an equal part in learning. The self-efficacy scores revealed a median difference of +0.8 (4.1 to 4.9) in the control group and +1.1 (3.9 to 5.0) in the observer group (p=0.64). These findings demonstrate a comparable transfer of new knowledge and self-assessed counseling skills between both observers and active participants.

Conclusion: Observer roles in healthcare simulation are equally as effective as the active participant role for bowel preparation education in an interprofessional cohort of healthcare workers. Both methods contribute significantly to enhancing participants’ knowledge of and self-efficacy in performing counseling for bowel preparation. Incorporating larger and more prominent observer roles in simulation-based educational activities offers a re-interpretation of the experiential learning theory, and may offer a cost-effective, resource-efficient, and time-efficient solution for facilitators and participants

Learning Objectives:

1. Analyze the impact of observer roles in simulation-based education by comparing knowledge retention and self-efficacy scores between observer and active participant groups, using statistical findings from the study.
2. Valuate the effectiveness of observer roles in clinical simulation-based education for bowel preparation training by critiquing the study’s results and discussing implications for interprofessional education
3. Understand the role of the directed observer in healthcare simulation-based education