High fidelity simulation in healthcare: negotiating the roles while negotiating the real.
Résumé
For the last thirty years in the USA, and earlier in Europe, a new practice has been developed
in health care education: high fidelity simulation. A robot that plays the role of the patient
allows medical teams to train at scenarios. National surveys about adverse events pointed out
the impact of dysfunctions of communication methods within the teams : something that is
locally, contingently, cooperatively produced. As a solution, surveys recommended the use and
development of this practice (e.g Kohn et al. 2000, Michel et al. 2009) . The new challenge is
then at the same time technological but first and foremost pedagogical: teamwork as an
educational aim in its own right.
This communication is drawn from a fieldwork we are conducting on medical simulated
practices at the simulation department of a french university of medicine. Our theoretical
approach is situated within the tradition of ethnomethodology (Garfinkel 1967) and multimodal
conversation analysis (Mondada 2014, Nevile 2009). The aim of this research is to provide
health care education professionals with an expertise on what they are actually trying to teach,
to train for, and to evaluate, for these are topics that can be respecified through our disciplinary
lenses.
The health care professionals use two relevant roles while working as a team : the team leader
and the team follower (West et al. 2015). During the sessions and its debriefings, trainers
and trainees try to define and prescribe what a leader and a follower should do or not, and what
they should have done or not. Our talk will focus on several interactional episodes video -
recorded during simulation sessions. We will show how these roles are achieved and recognized
through an interactional work of multimodal resources patterns, how they are still negotiated
despite an initial agreement. We will show that these roles acquire new tasks regarding the
simulation work (Hindmarsh et al. 2014) itself in this new sociotechnical environment.
References:
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