2023

Rikala, Pauliina; Peltoniemi, Aaron; Ruoranen, Minna; Silvennoinen, Kaisa; Hämäläinen, Raija

Simulation-based training has been shown to be an effective method of training for the demands in clinical healthcare. However, little research has examined scaffolding as an instructional strategy in simulation-based healthcare training. This study focused on scaffolding strategies that involve interaction, discussion, collaboration, and support between trainer and trainees and among trainees. Our aim was to answer the following question: How does scaffolding manifest during healthcare simulation-based training? We examined scaffolding strategies through video-recorded scaffolding episodes (n = 221), in which participants (trainees, n = 27) and instructors (trainers, n = 8) collaborated to make treatment decisions in varying multi-professional, high-fidelity healthcare simulation scenarios. A GoPro camera was used to record interactive and collaborative situations during the simulation training, and we applied theory-based content analysis to assess the data. According to our preliminary results, scaffolding can be understood as tailored interaction and support between the trainer and trainees as well as among trainees, and three categories of scaffolding strategy emerged: i) orientation talk, ii) step forward, and iii) reflection. Our results reinforce the idea that open and cross-border interaction between trainers and trainees during simulation-based training is essential in the learning process. At best, trainee-centred joint reflection during the debriefing highlighted opportunities for improvement. It is challenging, however, to find a balance between trainer-centred and trainee-centred approaches. The structure of the simulation can partly explain trainer-centred discourse; however, the question arises of how to strengthen trainee-centred reflections.