Bridging the Gap: Technological Mediation and the Development of Humanistic Skills in Medical Simulation: Lessons from Covid-19 and the Impact of Immersive Media and Minimal Viable Simulation (MVS)

Abstract

This thesis provides a chronological account of the integration of innovation and technology within medical simulation and training from 2014 to 2023 at Torbay and South Devon NHS Foundation Trust (TSDFT). Responding to the backdrop of a constantly changing technological and clinical (epidemiological) landscape, it seeks to develop a methodology for assessing the role of technology in improving medical simulation and training. The research critically challenges the current trend towards high-fidelity simulations, driven by manufacturers' technology-centric marketing strategies that frequently impose cost constraints and limit perceived educational outcomes. Motivated by the Francis Report's (2013) findings, this practice-based study explores the potential of immersive media, such as 360-degree video and virtual reality, to supplement medical simulation activities, with a particular emphasis on enhancing empathy and compassion in healthcare education. Central to this research was the development of two innovative practical outputs: PatientVR, an immersive patient perspective experience aimed at fostering empathy and understanding, and the concept of minimal viable simulation (MVS), which offers a more sustainable and humanistic approach to simulation-based education. The study draws upon diverse theoretical frameworks, including film theory, narrative medicine, and sociometrical perspectives, to interrogate the complex interplay between technology, education, and the human experience. The research employs a multidisciplinary approach, combining practice-based research, ethnographic observation, discourse analysis, and a technological and materials-based approach to the construct of simulations. The findings demonstrate the potential for immersive media and MVS to enhance empathy, compassion, and human connection in medical simulation. The study also highlights the importance of interdisciplinary collaboration and the value of bridging the divide between the arts, humanities, and healthcare in the context of simulation-based education. The thesis concludes that the current terminology used to describe 'soft' or 'non-technical' skills in healthcare education is insufficient and advocates for the incorporation of humanities-based concepts and language, terming these qualities as ‘humanistic skills’. It does this through presenting novel approaches to recording simulations for reflective learning, emphasising the importance of film theory in the application of camera work, particularly through the innovative use of patient perspective films. This underscores the need for medical education to include film theory and visual interpretation skills in its curriculum. The research's most significant contribution is the introduction of MVS, which represents a major step forward in medical simulation optimisation, emphasising the importance of aligning clinical and interpersonal experiences more closely with educational objectives rather than technological capabilities. By reframing the conversation around technology and humanism in medical simulation, this research invites educators, researchers, and practitioners to imagine new possibilities for fostering empathy, compassion, and human connection in the face of an ever evolving technological landscape.