Tasked with training the next generation of medical professionals, Bethany Cieslowski, MA, BSN, RN, is finding ways to improve psychological safety at the Mary Morton Parsons Clinical Simulation Learning Center (CSLC). Bethany is an Instructor in Nursing in the CSLC at the University of Virginia School of Nursing. Since joining the CSLC in 2014, one of Bethany’s top priorities has been to create a “safe container” or psychologically safe learning environment for her students to practice clinical skills and debrief performance. In 2016, Bethany had the opportunity take the Comprehensive Instructor Course at the Center for Medical Simulation (CMS) in Boston. CMS is the home of three thought leaders on the subject of psychological safety in simulation: Jenny Rudolph, Dan Raemer, and Robert Simon.
In Establishing a Safe Container for Learning in Simulation, Rudolph, Raemer, and Simon suggest, “Psychological safety encourages learning- oriented behaviors such as asking questions, sharing one’s own thinking, and asking for help” (2014). That quote, along with others from the publication and CMS’ Comprehensive Instructor Course, now permanently adorn the walls of the CSLC at the University of Virginia School of Nursing. Wanting to empower her students and promote a constructive learning environment, Bethany had the idea to hang posters with quotations about psychological safety in the simulation center.
One of the posters that now hangs in the CLSC describes the “Basic Assumption,” a core value that was developed by the Center for Medical Simulation: “We believe that everyone participating in activities at the UVA SON is intelligent, capable, cares about doing their best and wants to improve.”
Bethany noted that since taking the course, the Basic Assumption has become a permanent fixture at CLC. “We learned that some of our students say it in study groups and group projects outside of simulation,” explains Bethany. One student saw the poster and told her, “Every time I see it, I hear you saying it.”
Reactions to the posters have been positive from students and faculty: “An email from a work colleague stated, ‘I also need to share that I’m very appreciative of the new signs in the CLSC. The message that they send is powerful—thank you!!!’”
Although the posters are aesthetically pleasing, they also emphasize the values that Bethany and her colleagues practice every day: “It is all about the students and enabling them to become better clinicians. Images are meaningful. I wondered if words as images would make an impression. Make people stop and think. I wondered if our students would embrace the simulation experience more,” says Bethany. “Last week a student reacted emotionally to their performance in a simulation. I walked out of debrief with the student and we both stood in front of the poster with the quote about mistakes… her eyes looked, and she smiled. I thought, ‘wow that reached someone.’”
Currently, Bethany is excited to be working on “a study with colleagues using simulation to teach safe medication administration using Pyxis and Epic’s EHR (BCMA).” To learn more about Bethany and the team at the Mary Morton Parsons Clinical Simulation Learning Center (CSLC) at the University of Virginia School of Nursing, please visit: https://www.nursing.virginia.edu/academics/simulation/
Want to post the Basic Assumption at your institution? Here’s how: https://harvardmedsim.org/resources/the-basic-assumption/
Rudolph, Jenny W. PhD; Raemer, Daniel B. PhD; Simon, Robert EdD “Establishing a Safe Container for Learning in Simulation.” Simulation in Healthcare: Journal of the Society for Simulation in Healthcare, vol. 9, no. 6, 2014, pp. 339–349., doi:10.1097/sih.0000000000000047.