Transforming Novice Learners into Experts through Performance, Reproduction, and Representation: A Performance Studies Analysis of High-Fidelity Simulation in Healthcare Education

Abstract

Simulation is a major component in healthcare education and utilizes many performance-based practices, especially when it includes trained actors to perform as patients receiving simulated care by healthcare learners. The literature that guides the processes of these “high-fidelity” simulations is mostly written from a healthcare perspective, even when the authors are discussing concepts related to performance and theater. This dissertation seeks to address this imbalance by identifying and exploring a wide array of themes that emerge when simulation in healthcare education is framed as a performance, including immersivity, liveness, perceptual multistability, improvisation, and performativity. These themes are grounded on the twin concepts of representation and reproduction to highlight the degree to which simulation shapes its participants and the world they inhabit. What is represented and reproduced – and how it is done through simulation – has a high potential to be replicated in healthcare practice with actual patients. Additionally, the COVID-19 pandemic, which took place in the final two years of writing this dissertation, disrupted the status quo and challenged many of the practices and theories that long informed simulation pedagogy and performance studies. This disruption, however, created the opportunity to reimagine our respective disciplines and thus improve our practices. Ultimately, this dissertation highlights the performative, interpretive, and performance aspects at play within simulation in healthcare education so that simulation producers can further enhance the intentionality of what they represent and reproduce at their facilities. This can only lead to better outcomes for their learners and for the healthcare community.