Making the invisible visible : a place for utilizing activity theory within in situ simulation to drive healthcare organ
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DEBATE ARTICLE
Open Access
Making the invisible visible: a place for utilizing activity theory within in situ simulation to drive healthcare organizational development? Gerard J. Gormley1* , Anu Kajamaa2 , Richard L. Conn1
and Sarah O’Hare1
Abstract Background: The healthcare needs of our societies are continual changing and evolving. In order to meet these needs, healthcare provision has to be dynamic and reactive to provide the highest standards of safe care. Therefore, there is a continual need to generate new evidence and implement it within healthcare contexts. In recent times, in situ simulation has proven to have been an important educational modality to accelerate individuals’ and teams’ skills and adaptability to deliver care in local contexts. However, due to the increasing complexity of healthcare, including in community settings, an expanded theoretical informed view of in situ simulation is needed as a form of education that can drive organizational as well as individual learning. Main body: Cultural-historical activity theory (CHAT) provides us with analytical tools to recognize and analyse complex health care systems. Making visible the key elements of an in situ simulation process and their interconnections, CHAT facilitates development of a system-level view of needs of change. Conclusion: In this paper, we theorize how CHAT could help guide in situ simulation processes—to generate greater insights beyond the specific simulation context and bring about meaningful transformation of an organizational activity. Keywords: General practice, Community-based healthcare, In situ simulation, Activity theory
Introduction Adaptability and agility are crucial attributes for any progressive organization and no more so than in healthcare. With one of the largest workforces in the world, there is a continual need to generate and implement new practices into workplace contexts. This represents a major challenge not just for individual workers, but for educators, whose responsibility is to train the workforce. Increasingly, in situ simulation is being utilized as means * Correspondence: [email protected] 1 Centre for Medical Education, Queen’s University Belfast, Belfast, Northern Ireland Full list of author information is available at the end of the article
of translating evidence in to real world practice. As this modality increases in its use in healthcare, there is a need to further enhance our understanding of in situ simulation and for it to be guided by theoretical models to optimize its impact. Cultural-historical activity theory (CHAT) [1] is a theoretical framework that provides us with analytical tools to understand complex activities such as real world clinical practice—yet has gained little attention regarding in situ simulation. In this article, we will consider the role of in situ simulation, introduce the concept of CHAT and then theorize its potential to guide and inform in situ simulation and bring about organizational change.
© The Author(s). 2020 Open Access This article is licensed und
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