ReviewBMJ simulation & technology enhanced learning2021
Diversity and inclusion in simulation: addressing ethical and psychological safety concerns when working with simulated participants.
Review in BMJ simulation & technology enhanced learning, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Development of a standardized role script template for simulated participant scenarios - results of a multi-step consensus process in the German-speaking countries.GMS journal for medical education · 2026Guideline
- Contextualizing the ASPE standards of best practice: reflecting on the past, present, and future of SP methodology.Advances in simulation (London, England) · 2026Article
- Education that Empowers: A critical realist evaluation of a novel incivility-focused immersive simulation.Advances in simulation (London, England) · 2026Article
- Pre-roling: an operational framework for facilitators and simulating participants (SPs) to prepare for both acting and educating safely.Advances in simulation (London, England) · 2026Review
- Psychological Harm in High-Fidelity Simulation: A Concept Analysis.Nursing research and practice · 2026Review
- Responding to Families Who Express Biases: An Adaptable Standardized Participant Communication Simulation to Train Upstander Pediatric Providers.MedEdPORTAL : the journal of teaching and learning resources · 2026Article
- Narrative-driven virtual reality serious game to support type 1 diabetes self-management in children.Scientific reports · 2025Article
- Universal Design for Learning (UDL) in simulation-based health professions education.Advances in simulation (London, England) · 2025Article
- Engaging and supporting standardized patients involved in equity-seeking healthcare training: a qualitative study.International journal of medical education · 2025Article
- Inclusive pedagogy in online simulation-based learning in undergraduate nursing education: A scoping review.Journal of advanced nursing · 2025Article
- PEARLS debriefing for social justice and equity: integrating health advocacy in simulation-based education.Advances in simulation (London, England) · 2024Article
- CPR training as a gender and rights-based healthcare issue.Health promotion international · 2024Observational
- Ten recommendations for hosting a Diversity, Equity, Inclusion, and Justice (DEIJ) journal club.PLoS computational biology · 2024Article
- Moving towards deep equity, diversity, inclusivity and accessibility in simulation: a call to explore the promises and perils.Advances in simulation (London, England) · 2024Article
- Diverse Integration of Simulated Patients in Medical Education for Communication, Language, and Clinical Skills in Hungary.Advances in medical education and practice · 2024Article
- A quality improvement approach to integrating social determinants of health objectives into pediatric simulation.AEM education and training · 2023Article
- Exploring equity, diversity, and inclusion in a simulation program using the SIM-EDI tool: the impact of a reflexive tool for simulation educators.Advances in simulation (London, England) · 2023Article
- Gender-Affirming Care With Transgender and Genderqueer Patients: A Standardized Patient Case.MedEdPORTAL : the journal of teaching and learning resources · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Healthcare learners can gain necessary experience working with diverse and priority communities through human simulation. In this context, simulated participants (SPs) may be recruited for specific roles because of their appearance, lived experience or identity. Although one of the benefits of simulation is providing learners with practice where the risk of causing harm to patients in the clinical setting is reduced, simulation shifts the potential harm from real patients to SPs. Negative effects of tokenism, misrepresentation, stereotyping or microaggressions may be amplified when SPs are recruited for personal characteristics or lived experience. Educators have an ethical obligation to promote diversity and inclusion; however, we are also obliged to mitigate harm to SPs. The goals of simulation (fulfilling learning objectives safely, authentically and effectively) and curricular obligations to address diverse and priority communities can be in tension with one another; valuing educational benefits might cause educators to deprioritise safety concerns. We explore this tension using a framework of diversity practices, ethics and values and simulation standards of best practice. Through the lens of healthcare ethics, we draw on the ways clinical research can provide a model for how ethical concerns can be approached in simulation, and suggest strategies to uphold authenticity and safety while representing diverse and priority communities. Our objective is not to provide a conclusive statement about how values should be weighed relative to each other, but to offer a framework to guide the complex process of weighing potential risks and benefits when working with diverse and priority communities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.