Co-creating a simulation curriculum for refugee doctors with diverse learner needs

Introduction Doctors with refugee status are a heterogeneous group of learners with unknown educational needs for entering new workplaces. Better processes for integration into the healthcare workforce may improve refugee doctors’ experiences and contribute to addressing the current healthcare workforce crisis. Simulation-based education has the potential to assist with refugee doctors’ integration, but this has not yet been studied. We describe a novel approach to co-creative action research for simulation-based curriculum development. This example may inform others who are developing curricula for learners with unknown needs. Methods The simulation curriculum was developed through collaboration with the Scottish Centre for Simulation and Clinical Human Factors, The Bridges Doctor Program both based in Scotland and Vital Anaesthesia Simulation Training. Over 1 year, teaching action research cycles (plan, act, observe and reflect) were employed at both macro (whole curriculum) and micro (single scenario) levels to develop a new simulation curriculum with refugee doctors. Written and verbal feedback from faculty and learners, in addition to field note diary entries, were collected throughout the process. Results Eighteen refugee doctors participated. The resultant curriculum comprised 6 days of simulation-based learning, including an introduction to simulation, the systematic approach, multidisciplinary teamwork, collaborative decision-making and 2 days of acute medical emergency scenarios. Action research cycles influenced curriculum development at the macro level, for example, faculty learned how to use social media and concise pre-learning to maximize learner engagement. At the micro level, action research helped faculty to provide appropriate clinical knowledge sessions and change their approach to teaching behavioural skills. Discussion Simulation curriculum development for learners with unknown needs is challenging. Taking a co-creative approach throughout development increased the likelihood that the curriculum priorities were truly agreed between learners and faculty. Social connections between learners and faculty played a significant role in the success of the simulation curriculum. The co-creative action research approach could be replicated by others involved in simulation development, particularly when learners’ needs are unknown or heterogeneous.