The integration of equity, diversity, and inclusion (EDI) principles into simulation-based education (SBE) is crucial for:
Principles of reconciliation and accessibility must also be considered. It is imperative that principles of equity, diversity, inclusion, reconciliation, and accessibility (EDIRA) align with Healthcare Simulation Standards of Best Practice™ and are considered in all components of SBE (Alrimawi et al., 2024; Watts et al., 2021).
We discuss aspects of incorporating EDI into SBE on other pages of this guide; however, the evidence and best-practice recommendations are in early stages and rapidly changing. We suggest consulting with experts when incorporating EDI in SBE to minimize potential harm to learners and others involved. Awareness and reflection are suggested for initial steps when designing and delivering SBE. The SIM-EDI tool developed by Purdy and colleagues (2023) can be used as a guide for the SIM delivery team to reflect on simulation design, delivery and debriefing through an EDI lens (Purdy et al., 2023).
The following article walks you through two case studies, highlighting considerations and strategies for addressing EDI in simulation, specifically when working with simulated patients:
Listen to this podcast for more discussion on the topic:
To learn more about principles of equity, diversity, inclusion, reconciliation and accessibility in simulation, please review the following resources:
Agic, B., Fruitman, H., Maharaj, A. Harris, H., Gagnon, L., Taylor, J., Ashraf, A., Henderson, J., Ronda, N., McKenzie, K., & Sockalingam, S. (2023, March). Health equity and inclusion framework for education and training. CAMH. https://www.camh.ca/-/media/education-files/camh-health-equity-inclusion-education-training2023-pdf.pdf
Alrimawi, I., El-Banna, M. M., O'Reilly, C., & Muhammad, K. (2024). Integrating diversity, equity, and inclusion in nursing simulation and clinical. Teaching and Learning in Nursing, 19(2), 3439-e443. https://doi.org/10.1016/j.teln.2024.01.010
Foronda, F., Jefferies, K., & Walshe, N. (2022). Teaching equity, diversity, and inclusion through simulation: A new science. Clinical Simulation in Nursing, 71, 1-2. https://doi.org/10.1016/j.ecns.2022.08.006
Ibrahim, S., Lok, J., Mitchell, M., Stoiljkovic, B., Tarulli, N., & Hubley, P. (2023). Equity, diversity and inclusion in clinical simulation healthcare education and training: An integrative review. International Journal of Healthcare Simulation, 1-14. https://doi.org/10.1016/j.ecns.2022.08.004
Nakajima, A., Teame, D., & Kostiuk, S. (2022). Equity, diversity, and inclusion in simulation. Clinical Simulation in Nursing, 71, 4-8. https://doi.org/10.1016/j.ecns.2022.08.004
Picketts, L., Warren, M.D., & Bohnert, C. (2021). Diversity and inclusion in simulation: addressing ethical and psychological safety concerns when working with simulated participants. BMJ Simulation & Technology Enhanced Learning, 7(6), 590-599. https://doi.org/10.1136%2Fbmjstel-2020-000853
Purdy, E., Symon, B., Marks, RE., Speirs, C., & Brazil, V. (2023). Exploring equity, diversity, and inclusion in a simulation program using the SIM-EDI tool: the impact of a reflexive tool for simulation educators. Advances in Simulation, 8(11) https://doi.org/10.1186/s41077-023-00250-7
Watts, P. I., Rossler, K., Bowler, F., Miller, C., Charnetski, M., Decker, S., Molloy, M. A., Persico, L., McMahon, E., McDermott, D., & Hallmark, B. (2021). Onward and upward: Introducing the Healthcare Simulation Standards of Best Practice™. Clinical Simulation in Nursing, 58,1-4. https://doi.org/10.1016/j.ecns.2021.08.006