Impact of Simulation Based Learning on Gender, and Equity Dynamics Among Inter-health Professional Teams

Overview

At Mbarara University of Science and Technology and partner sites, the investigators will explore the role of simulation in gender and equity. African societies are largely patriarchal, and this spills over into professional practice and medical education. Simulation methodology is at risk of suffering from a patriarchal dominance. The male dominance has potential to introduce power relationships between men and women learners in a scenario setting and between physicians and nurses. In the presence of such power differentials, the less dominant party could develop a "culture of silence," fail to take decisions on issues that affect them or their patients, fail to talk about these issues and take appropriate action.

To address the challenges of gender and equity: 1) the investigators will teach Advocacy Inquiry (AI) and the ladder of inference (LoI) as conversational strategies for all simulation faculty members to explore participant frames of action and thought processes, 2) the investigators will design and expose participants to simulated scenarios with embedded gender and or inter-professional power differentials, 3) study the effect of AI, the LoI and debriefed gender and equity scenarios on participant engagement strategies during gender and inter-professional conflict situations. The Ladder of Influence allows facilitators select some data / observation, add interpretation, draw conclusions and take action. Though the Ladder of influence is a powerful approach to exploring situations, its prone to challenges if users jump to conclusions quickly without being curious about what alternative interpretations of the observed data / action could be. AI uses the "show", "think" and "wonder" as a strategy to slow facilitators from jumping up the LoI to draw conclusions before exploring learner perspectives. AI and the LoI in combination encourage self-reflection and good judgment. The investigators will deliberately encourage simulation teams to have both males and females and inter-professional with opportunities for team leaders to vary with both sex and profession.

Conditions