Abstract
Left long behind are our myriad experiences of designing, evaluating, or employing in research and training, the complex, sophisticated, costly simulators, part-task trainers of the past. These approximated work scenarios through high fidelity simulations of operating aircraft, military weapon systems, nuclear power plant or chemical processing plant operations, and more. Now comes assessments of developmental advances in simulation training systems meant to prepare other groups of occupational specialists who occasionally must deal with risky situations that are not always predictable, despite the planning efforts of their respective professional communities. Emergency responders, healthcare providers in disaster response, police in crowd control or civil unrest, civil crisis managers, military tragedies, and so on, each present a need to train and prepare for the eventual unknowns of crisis response. This book concerns well-designed simulation training for such settings.
Flandin writes in the introduction: “Learning in these contexts is difficult to relate an action to its effects on the situation, with rapid changes in dynamics and entangled variables. It is impossible to go back and learn by repetition; and it is necessary to anticipate in a situation that is uncertain, poses multiple risks, cannot be fully understood and presents phenomena that may never before have been encountered.” … “These are areas in which simulation is a necessity because it is impossible and/or unacceptable to learn on the job. It is impossible because of the rarity of crises or disasters, and unacceptable because of the risks involved for the professionals and those they serve. All are dynamic environments that may evolve without operator intervention.”
While the demands of many work settings have become more complex, interrelated, and perhaps less easy to be taught and learned, the editors argue that simulation training has been too specifically focused and narrow. They selected 13 chapters to describe the potential of new perspectives on simulation training, its strengths and limitations; identify how it can be used to achieve strong learning outcomes within occupational preparation and ongoing development; and suggest how practice-based approaches to learning can be harnessed effectively.
The contributors empirically or conceptually analyzed characteristics and effects of simulation training programs, mainly in the dimensions of the activity deployed and/or the experience lived by trainees. As the title implies, the book presents research on various simulation training programs in occupations involving healthcare workers [5 chapters on healthcare, victim rescue, and population protection]; firemen [2 chapters], police officers [2 chapters], military service members [2 chapters], and civil security leaders [1 chapter]. There are substantial points in common for these areas of intervention that bring them together in this book. How can new simulations be effectively designed, implemented, and experienced by learners in these scenarios?
No doubt readers will enjoy the book’s revisit to the age-old debate over simulator fidelity versus validity, especially in the healthcare sector which tends to favor high fidelity simulations, creating confusion between fidelity and its many components with the “reproduction of the real.” Various chapters cover issues arising from recent significant advances in electronic and digital technologies.
The editors certainly meet their four objectives: (1) discuss theoretical, methodological, and practical issues related to trainees’ experiences and activities in simulation training; (2) provide evidence of how lived experience can foster or hinder learning in simulation; (3) identify conceptual bases and empirical applications to learning through simulation experimentation; and (4) contribute to domain-related and generic orientations for simulation design.
The book presents a comprehensive account of the various ways ergonomic approaches to analyses of experience and activity in the context of simulation training: (a) help identify learning opportunities and obstacles and provide a detailed description of the learning process and outcomes; (b) point toward promising design orientations for simulation-based vocational education and training; and (c) contribute to understanding practice-based professional learning. In occupations where risk is high for both the practitioners and those who are serviced by them, the ability to provide learning experiences through simulations, which avoid harm, and still offer scenarios, options, and ways of representing occupationally based experiences brings with it enormous potential.
Part of this book adopts a French-speaking analytical and procedural orientation focused on activities and experience. This includes ergonomics from a cognitive and activity perspective central to the Francophone approach. In a design-based healthcare research paradigm, Vincent Boccara’s chapter promotes a methodological approach called “ergo-scripting,” stating that the design of learning scenarios must be supported by both ergonomic and didactic analyses of work. The process all ergonomists recognize includes (1) engage all actors (sponsors, designers, and users) in developing the design project for the simulation for training; (2) analyze the work trainees are expected to undertake and then examine existent training courses from the perspective of trainers and trainees to identify baseline production and training situations; and (3) script training situations, developing scenarios to simulate workplace situations to enable trainees to develop vocational skills. An illustration presents a virtual training environment used to train medical leaders in non-technical skills they need to cope with a mass casualty event (e.g., an attack).
A civil security crisis management chapter describes how civil security leaders develop and reinforce dispositions to act efficiently during crisis management situations through various features of interprofessional simulation training. They inductively derive four dimensions for understanding and transforming individual and collective activity. Ergonomics methods (direct observations, field notes, interviews, and self-confrontation interviews) were employed to analyze protection, rescue and care stakeholders and decision makers’ experience and actions in two crisis simulations in operational command posts (e.g., chemical or radiological attack scenarios). Some of these lessons are reflective of how the US Department of Homeland Security’s Community Emergency Response Teams (CERT) design their training scenarios. [Several years ago, this book reviewer, G.P.K., participated and got certified in several CERT training sessions].
A chapter on Geriatrics describes developing a digital virtual simulation training tool for caregivers in geriatrics, analyzing testers’ activity and the figurations produced through simulation training. This design-based research account explores innovative avenues, addressing difficult healthcare challenges like communicating with patients, for example, those with Alzheimer’s disease or other forms of dementia. Another chapter analyzes the activity of firefighters during full-scale simulated rescue situations. It models six typical collective configurations.
A lengthy, detailed read, this book will pay great dividends to those involved in planning and training for professional response in crises management.