Empowering future leaders: the value of simulation in active bystander training for medical students

Chew, C., Taylor, E., Pope, L. , Nazir, F., Paton, C., Colquhoun, K., Hunter, I., Lydon, E., Young, D. and O'Dwyer, P. (2023) Empowering future leaders: the value of simulation in active bystander training for medical students. BMJ Leader, 7(S2), e000778. (doi: 10.1136/leader-2023-000778)

Abstract

Disrespectful behaviour in the healthcare environment affects clinical learning, impacts those receiving such behaviour and adversely affects patient outcomes. Mandated ‘diversity training’ has minimal impact and, if poorly done, can worsen toxic work environments. Our study aimed to develop a simulation-based active bystander training (ABT) session for medical students and to evaluate the impact of this training. Method: Sessions comprised short recap of students’ learning to date; prerecorded video vignettes; a card game and immersive simulation. Advocacy with inquiry debrief, facilitated by faculty with equality, diversity and inclusivity expertise followed each scenario. Students completed a validated questionnaire developed for this study, preintervention and postintervention. Results: Sixty-six medical students from three teaching hospitals attended seven 3-hour sessions. The average number of students attending each session was 9 (range 7–12). The questionnaire was completed with matched pairs of preintervention and postintervention scores on a Likert scale by 58 (88%) students. There were significant deficits (p<0.001) in students’ self-rated knowledge with a mean preintervention score of 38.2 (SD 5.9) out of a maximum score of 55. This compared with postintervention score of 49.1 (SD 4.8). The mean increase in total score postintervention was 11.0 (95% C.I 9.4 to 12.5; p<0.001). Conclusion: We found significant deficits in medical students’ self-rated knowledge of recognising disrespectful behaviour at work. Simulation in ABT was effective in reversing this. This is a timely study given the new responsibilities placed on doctors by the General Medical Council to act when witnessing discriminatory behaviour or harassment at work.

• Item Type: Articles
• Additional Information: This study was funded by Association for the Study of Medical Education(Excellent Medical Education Award).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: O'Dwyer, Professor Patrick and Pope, Professor Lindsey and Chew, Cindy and Nazir, Dr Fozia and Paton, Mrs Catherine and Taylor, Dr Elaine and Hunter, Dr Ian and Lydon, Dr Emma and Colquhoun, Dr Kirsty
• Authors: Chew, C., Taylor, E., Pope, L., Nazir, F., Paton, C., Colquhoun, K., Hunter, I., Lydon, E., Young, D., and O'Dwyer, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: BMJ Leader
• Publisher: BMJ Publishing Group
• ISSN: 2398-631X
• ISSN (Online): 2398-631X
• Copyright Holders: Copyright © Author(s) (or their employer(s)) 2023
• First Published: First published in BMJ Leader 7(S2):e000778
• Publisher Policy: Reproduced in accordance with the publisher copyright policy