Simuleringsbaserad träning i katastrofmedicin : En analys av pedagogik, kognitiv fidelitet och instruktörers erfarenheter

This thesis explores the application of simulation-based training in disaster medicine, with a specific focus on cognitive fidelity and the experiential learning cycle. Conducted as a qualitative study at the Center of Disaster Medicine and Traumatology (KMC) in Linköping, Sweden, the research examines how different simulators support the learning processes of participants and if they engage cognitive processes relevant to micro- and macro cognition, such as stress, problem- solving decision-making and memory load. The study investigates how simulation at KMC align with the four concepts in the learning cycles (Experiencing, Reflecting, Thinking and Acting), as well as which cognitive processes the educators perceive are used in the simulations. Data was collected at six different observation points during courses at KMC (including Stop The Bleed, Tactical Emergency Casualty Care, Tactical Combat Casualty Care, Emergo Train System, Casualty Scene Collaboration and Special Care Management) as well as during five semi structured interviews with course instructors. The analysis included a deductive content analysis and a thematic analysis to evaluate both the theoretical application of Kolb’s model and the practical challenges and advantages of simulators identified by the educators. The findings indicate that simulation training at KMC supports multiple stages of the learning cycle, particularly acting and experiencing as well as reflecting and thinking, through the hands- on experience and the reflecting generated in the After Action Reviews. While many simulators provided valuable opportunities for skill acquisition and rehearsal under realistic environments, some limitations were noted in terms of cognitive fidelity. Educators highlighted both strengths, such as the engagement, safe learning environments and visualization of logistics, and challenges such as technological limitations, varying levels of realism and cost with the use of simulators. The study concludes that simulation-based educators in disaster medicine benefits form aligning the education with cognitive and pedagogical models, and that an increased cognitive fidelity (especially at a macro level) may improve the preparedness of healthcare workers at a more professional level. The results offer insights into how simulation tools can be re-worked to better support and enhance the education in disaster medicine.