Integrating Virtual Simulation with Course Curriculum to Improve Patient Advocacy through Speaking Up

Purpose: Healthcare teams consist of interdisciplinary groups of health professionals that tend to be hierarchically structured. Often it is necessary to challenge authority through speaking up, however, within hierarchies’ individuals tend to demonstrate obedience to authority. Speaking up is an essential skill for preventing patient harm that must be developed. Virtual Simulation integrated with curriculum using Kolb’s Learning Cycle is a promising avenue for improving interprofessional collaboration. Methods: An experimental design was used to determine if a gamified VS along with instruction on patient-advocacy would increase the rate of speaking up in Respiratory Therapy students (n=34) during in-person simulation delivered one month after the classroom instruction. The in-person simulation required students to challenge a senior anesthesiologist to prevent patient harm. Effects of personality and individual differences were also examined. Results: The VS resulted in speaking up at a higher rate than in the control condition (p=0.04) and used CUS more often (p<0.001). No individual differences or personality measures were predictive of speaking up. Conclusion: The findings from the present study support the integration of VS with course curriculum on patient-advocacy, showing improved performance during in-person simulation one month after course delivery. Longitudinal investigation is necessary to determine if the improved performance is indicative of increased likelihood of speaking up in the future.