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Article

Learning to manage complexity through simulation: students' challenges and possible strategies

Citation
Gormley GJ & Fenwick T (2016) Learning to manage complexity through simulation: students' challenges and possible strategies. Perspectives on Medical Education, 5 (3), pp. 138-146. https://doi.org/10.1007/s40037-016-0275-3

Abstract
Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students’ challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.  Wearing video glasses, participants took part in asimulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as atheoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.  Students’ challenges in coping with clinical complexity included being: a)unprepared for ‘diving in’, b)caught in an escalating system, c)captured by the patient, and d)unable to assert boundaries of acceptable practice.  Many characteristics of complexity can be recreated in award-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a)taking time to size up the system, b)attuning to what emerges, c)reducing complexity, d)boundary practices, and e)working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.

Keywords
Complexity; Simulation; Medical students

Journal
Perspectives on Medical Education: Volume 5, Issue 3

StatusPublished
Author(s)Gormley, Gerard J; Fenwick, Tara
Publication date30/06/2016
Publication date online31/05/2016
Date accepted by journal31/05/2016
URLhttp://hdl.handle.net/1893/26137
PublisherSpringer
ISSN2212-2761
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