2019 HSC Section 2 - Practice Management

McKinley & Phitayakorn

EMOTIONAL INTELLIGENCE AND SIMULATION Benefits of Incorporating Simulation into Emotional Intelligence Development Simulation has the potential to facilitate several goals of EI development. One of the key first steps of EI development is increased self-knowledge. Simulation rooms may be equipped with video capture and replay technology, which would allow trainees to watch themselves after the simulated experience is over and gain clearer understanding of their own performance. Self-knowledge is also augmented through simulation because of the way in which simulations frequently end with reflective debriefing sessions in which participants are asked to describe their subjective expe- rience of the simulation. These types of replay and reflection opportunities are not typical of clinical work and are one of the distinguishing features of simulation that lends it an advantage in enlightening simulation participants to their own patterns of thought and behavior. One could imagine individuals believing themselves to be good listeners and then on review of a simulation session, realize that they interrupted a simulated patient multiple times. Simulation is also ideal for EI development because it provides an arena in which patients can come to no harm. This feature of simulation can be used to maximally support participants as they test out emotional management strategies in which they are not well developed or do not feel comfortable using. It is precisely the low- stakes environment of simulation that makes it the ideal training ground for partici- pants as they practice the EI strategies with which they are least comfortable. For example, baseline EI assessment may demonstrate that a surgical resident has a low level of development in assertiveness. Simulation may provide the kind of low stakes, safe context in which that resident could practice assertiveness before engaging in assertiveness strategies on the wards with real patients. Finally, the structured nature of simulation could benefit EI development because it allows for standardization of scenarios that demand engaging in emotional manage- ment. One benefit of standardization is that it can provide the opportunity for controlled repetition and practice of situations with which participants struggle. Stan- dardization also makes possible the fair comparison of individuals. Creating standard- ized emotional experiences may allow for discrimination between individuals to identify strengths and areas for future improvement, and it also enables accurate mea- surement of EI development gains by creating the possibility of repeated testing of an individual within an emotionally charged experience after that individual has under- gone some other type of EI development intervention. Current Uses of Simulation in Medicine Relevant to Emotional Intelligence Simulation is already being used across a broad range of specialties and training levels to target interpersonal skills, communication, professionalism, and team functioning, all domains that EI is thought to underpin. 37–44 For example, in one study of 55 interns from multiple specialties, researchers used simulation via standardized patient actors to improve performance of the residents in disclosing medical error, a task that re- quires sensitivity to one’s own and others emotions. 42 The investigators incorporated a debriefing session after the medical disclosure scenario in which simulation partic- ipants reviewed a video recording of their simulation exercise either alone or with a faculty member. In the following month, the interns completed an online tutorial aimed at increasing their knowledge of medical error disclosure guidelines before returning for a second simulation session. Both self-rating and external reviewer ratings of the interns’ interpersonal skills and communication and professionalism in medical disclo- sure encounter improved significantly by the second session. This combined use of

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