Wiebke Paulsen¹, Irene Hirschberg², Matthias Katzer², Corinna Klingler³, Katja Kühlmeyer³, Nora Ryback⁴, Carola Seifart⁵, Anna Siemens⁶, Annett Wienmeister⁷, Julia Wolters⁸ on behalf of the ‘ethik learning’ working group

¹ Institute of History, Theory and Ethics of Medicine, University Hospital RWTH Aachen

² Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School

³ Institute for Ethics, History and Theory of Medicine, Ludwig Maximilian University of Munich

⁴ University of Applied Sciences, Vienna Campus

⁵ Institute for Applied and Clinical Ethics in Healthcare, University of Marburg

⁶ Department of History, Ethics and Theory of Medicine, OVGU Magdeburg

⁷ Institute of History of Medicine and Medical Ethics, Charité – Universitätsmedizin Berlin

⁸ Clinical Ethics Unit at the UKE, University Medical Centre Hamburg-Eppendorf

Target audience: anyone who (wishes to) deliver competence-based ethics teaching in healthcare disciplines and professions and wishes to expand their methodological repertoire

Duration: 180 minutes

Objective: In this workshop, we will explore the methodological approach of the simulation laboratory (SimLab) as a potential teaching tool for ethics education in healthcare professions. Participants will receive a brief conceptual introduction, conduct a SimLab session either as participants or observers, and subsequently reflect on the learning experiences gained, the teaching method and its potential suitability for imparting ethical competencies.

Background: The didactic concept of the SimLab was developed on the model of so-called ‘Skills Labs’. Skills labs are practice-oriented learning environments that enable trainee healthcare professionals to test and further develop relevant skills for their (future) professional practice in a controlled simulation environment (lab). This approach has become increasingly established in competence- and action-oriented professional education and is already firmly established in some degree programmes, such as medicine. Skills Labs are therefore an important venue for professional competence development, alongside theoretical learning (‘in the classroom or lecture theatre’) and practical learning (‘at the patient’s bedside’). Originally, this method was designed for learning clinical practical skills, such as inserting an intravenous line or conducting a medical consultation. Nowadays, this method is also used to conduct complex interprofessional simulations – including emergency scenarios that are difficult to practise in a real-world setting. Alongside practical training, the focus is on (self-)reflection: The simulations are observed in a separate room by other learners and the lecturer via camera or a one-way mirror, and recorded where necessary. This makes it easy to identify relevant sections for the debriefing, so that these can then be reflected upon in detail under professional guidance.

Applying this methodological approach in the form of a simulation laboratory (SimLab) to teach ethical skills in healthcare professions seems an attractive prospect. Using concrete, realistic scenarios in the ‘SimLab’ learning environment, ethical competences such as perception, reflection, evaluation and decision-making skills could be taught. Simulated scenarios could thus be used to consolidate and supplement theoretical content already covered. At the same time, the selection and implementation of ethical scenarios raise questions for teaching staff: Which scenarios are suitable for learning ethical skills through simulation? How should simulation participants be prepared for their roles? What exactly is the advantage of a SimLab compared to established teaching methods (e.g. the structured discussion of a case study and traditional role-play)? How should feedback and reflection be structured in ethical scenarios where different courses of action are justifiable?

This workshop aims to explore and discuss whether and to what extent this approach can offer interesting application prospects for ethics teaching, as well as the specific challenges it entails. To this end, participants will first be briefly introduced to the theoretical and methodological foundations of the SimLab concept. A scenario from a clinical-ethical context will then be presented for an ethics teaching session in the SimLab. Participants will be divided into simulators and observers and will carry out the learning experience together.

Following this, the experiences of the simulators and observers will be reflected upon and analysed together. The possibilities, challenges and limitations of the method for ethics teaching in general will be discussed, and participants will also have the opportunity to identify points of application for their own teaching practice.

Programme:

30 mins: Welcome, round of introductions and conceptual introduction to the SimLab method

20 mins: Presentation of a SimLab scenario, allocation of roles and clarification of questions

20 mins: Preparatory small-group session for simulation participants and observers

15 mins: Break

35 mins: Conducting the simulation

45 mins: Reflection on one’s own learning experience, discussion of the scenario and the method

15 mins: Closing session

References:

Seifart C, Schönbauer A, Monteverde S, Krones T 2022. Designing simulations with simulation models for medical ethics teaching. Ethik Med 34, 319–338.

Riedel A, Eckstein C 2024. The third learning environment (skills lab) as a significant opportunity for the development of ethical competence within the framework of the primary nursing degree programme. In: Frewer A (ed.): Ethical Competencies in Medicine: German and Global Perspectives. Würzburg: Königshausen und Neumann, JEK 17, 177–198.