Enhancing bias awareness through co-designed simulation-based education: A qualitative study

Cognitive biases are predictable deviations in judgement occurring when people process and interpret information from their environment. Educational interventions which support healthcare professionals and students to surface cognitive bias, and mitigate negative influences are recommended to prevent serious adverse patient safety events. Co-designing simulation-based education enhances authenticity and offers a platform for sharing lived experiences. To examine how healthcare professionals and students developed their understanding and awareness of cognitive biases through their experiences and reflections following a co-designed simulation activity. Scaffolded upon serious adverse patient safety event data analysis and healthcare staff and consumer interviews, a participatory action research approach was utilised to co-design a simulation-based education intervention with healthcare consumers and professionals. We used a qualitative interpretivist lens to explore healthcare professional and student understanding and awareness of cognitive bias. The debrief of four simulations was audio recorded, transcribed, and analysed using thematic analysis. Twenty healthcare professionals, and two nursing students participated in four occurrences of the simulation intervention. Based on the debrief data, five themes were developed: 1) An authentic and meaningful learning experience, 2) Humanness of cognitive bias, 3) Intersection between physical health, mental health, and cognitive bias, 4) Factors contributing to cognitive bias in healthcare, and 5) Strategies to manage cognitive bias. Cognitive biases can negatively influence healthcare professional and student decision making. Our co-designed simulation facilitated participant reflection to explore their understanding and awareness of cognitive bias. • Cognitive bias can affect decision-making and impact the experience and safety of care. • Co-designed simulation can help surface cognitive bias; stimulating discussion and reflection. • Co-designing simulation with healthcare consumers enhances authenticity and learning. • Strategies to mitigate cognitive bias should be individual and systemic.