Vulnerability and Fallibility can be useful soft or emotional intelligence based skills for clinical simulation facilitators, debriefers and educators to consider use authentically in order to enhance clinical simulation participants’ experiences. In this article by Erin Carn-Bennett, RN, MSN, the Bearman and Molloy (2017) term “Intellectual Streaking” will be explored in combination with these topics for clinical simulation educators to consider acquisition of and immersion into their healthcare simulation facilitation practices. Many healthcare organizations still have challenges associated with negative connotations from hierarchy. These emotional intelligence based terms provide consideration of tools for educators to challenge and influence change in this space.
Vulnerability and Fallibility Definitions Applied to Healthcare Simulation
Vulnerability for use in the healthcare simulation environment is best defined by Brene Brown who defines vulnerability as “The definition of vulnerability is uncertainty, risk, and emotional exposure. But vulnerability is not weakness; it’s our most accurate measure of courage.” In healthcare simulation facilitation there can often be a lot at stake and many soft skills such as emotional intelligence as required with careful consideration and also vulnerability in order to be able to enhance clinical simulation participants’ experiences. Self honesty, authenticity and humility are essential for the successful clinical simulation facilitator.
Everyone makes mistakes everyday and a lot of shame can be associated with the identification by individuals that a mistake has been made. However, in clinical simulation as facilitators there is a desire for participants to feel psychologically safe enough to both make mistakes and also reflect on them. Fallibility demonstrates that facilitators make mistakes and role model to share these as well.
Human fallibility is defined as a lack of perfection and the likeliness to both make and share mistakes. To embrace the art of fallibility as a healthcare simulation facilitator assists to instill a sense of intellectual humility. This acknowledges that no matter how highly educated or knowledgeable healthcare simulation facilitators may be, there is always more to learn and an embrace of imperfection of knowledge. For many people who have worked in an entrenched hierarchical organization, this concept can take some time and also experience to note as a worthwhile venture.
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Bearman and Molloy’s Term “Intellectual Streaking” in Healthcare Simulation
“Intellectual streaking” is a term coined by Margaret Bearman and Elizabeth Molloy in 2017 which resonated strongly for many healthcare simulation educators. As clinical simulation educators this resonation comes from the similarity from the “Intellectual Streaking” definition between psychological safety foundation formation and the how to process of this. Intellectual Streaking is described by Bearman and Molloy that as teachers, there is encouragement to get learners to be vulnerable, yet for many there is a presentation of the teacher that is of high status, of knowledgeable expertise and this often arrives partnered with pre-prepared scripts.
In Bearman and Molloy (2017) paper on “Intellectual Streaking”the metaphoric notion is described as “the nimble exposure of a teacher’s thought processes, dilemmas, or failures.” Intellectual streaking is described as a way for teachers to model reflection-in-action and also resilience. Although with Intellectual Streaking there is a definite tension created for teachers between credibility and vulnerability, (both required for trust) Bearman and Molloy argue that risks taking and to reveal any deficits in knowledge or performance as a teacher can be both illuminating and also valuable for both the teacher and student.
Intellectual Streaking is an opportunity for healthcare simulation based educators to carefully balance credibility and vulnerability to enhance clinical simulation based education experiences. This can be an incredibly beneficial art to attempt to weave through all clinical simulation based education spaces. Although as clinical simulation facilitators the goal is not to make participants feel at ease, as then potentially learning is not occurring, but to prioritise psychological safety should be at the forefront of all healthcare simulation based educators.
Pedestals and Perfectionism Are Not Helpful in Clinical Simulation
Uptight and perfectionistic facilitators can make healthcare simulation participants feel inferior and also not comfortable to make mistakes. To demonstrate vulnerability, own mistakes and also role model these behaviors that can assist participants to advance their clinical care and teamwork through the vessel of healthcare simulation is powerful and is a useful tool for a healthcare simulation facilitators toolbelt of skillsets.
To be honest when individuals don’t know needs to be emphasised as a super power for both those in the facilitator and participant roles in healthcare simulation based education experiences. This is an example of Intellectual Streaking and assists to challenge and flatten hierarchy as well as improve psychological safety. This can assist everyone involved in the clinical simulation experience to feel more comfortable to share their own mistakes or knowledge gaps and provide more opportunities to expand knowledge bases and challenge psychological safety challenges.
For debriefers, observe closely in clinical simulation scenarios for when a participant states that they do not know a piece of information or where a piece of equipment is located. This is a positive behavior that is a great opportunity to reinforce and increase participant confidence in a debrief environment. For a participant such as a medical student or junior member of staff, this realization that there is merit to voice knowledge gaps out loud to drive a team forward can be a game changer and an incredibly useful experience. This can also be further expanded by clinical simulation educators’ acknowledgement of their own knowledge gaps and also disclosure of any mistakes that they have made in the clinical simulation experience.
This article has discussed the use of both vulnerability and fallibility to enhance healthcare simulation based education experiences. Bearman and Molloy (2017) concept of “Intellectual Streaking” has been applied to these skillsets for healthcare simulation educators and debriefers to consider as tools to enhance clinical simulation based education experiences. Improvement to workplace culture and challenges to negative aspects of hierarchy through healthcare simulation has a lot of promise to add even more depth to improvement of patient outcomes. Tools such as vulnerability, fallibility and Intellectual Streaking should not be underestimated in the clinical simulation scenario and debrief circle environments.
How to Infuse Emotional Intelligence Into A Clinical Simulation Program
References:
- Bearman, M., & Molloy, E. (2017). Intellectual streaking: The value of teachers exposing minds (and hearts). Medical Teacher, 39(12), 1284–1285. https://doi.org/10.1080/0142159X.2017.1308475
