Empowering future leaders : the value of simulation in active bystander training for medical students

Chew, Cindy and Taylor, Elaine and Pope, Lindsey and Nazir, Fozia and Paton, Catherine and Colquhoun, Kirsty and Hunter, Ian and Lydon, Emma and Young, David and O'Dwyer, Patrick (2023) Empowering future leaders : the value of simulation in active bystander training for medical students. BMJ Leader, 7 (Suppl ). e000778. ISSN 2398-631X (https://doi.org/10.1136/leader-2023-000778)

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Abstract

Disrespectful behaviour in the healthcare environment affects clinical learning, impacts those receiving such behaviour and adversely affects patient outcomes. Mandated ‘diversity training’ has minimal impact and, if poorly done, can worsen toxic work environments. Our study aimed to develop a simulation-based active bystander training (ABT) session for medical students and to evaluate the impact of this training. Method Sessions comprised short recap of students’ learning to date; prerecorded video vignettes; a card game and immersive simulation. Advocacy with inquiry debrief, facilitated by faculty with equality, diversity and inclusivity expertise followed each scenario. Students completed a validated questionnaire developed for this study, preintervention and postintervention. Results Sixty-six medical students from three teaching hospitals attended seven 3-hour sessions. The average number of students attending each session was 9 (range 7–12). The questionnaire was completed with matched pairs of preintervention and postintervention scores on a Likert scale by 58 (88%) students. There were significant deficits (p Conclusion We found significant deficits in medical students’ self-rated knowledge of recognising disrespectful behaviour at work. Simulation in ABT was effective in reversing this. This is a timely study given the new responsibilities placed on doctors by the General Medical Council to act when witnessing discriminatory behaviour or harassment at work.

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