Digital clinical simulations to to promote equity mindsets: Insights from a staggered randomized experiment in an online course

Abstract

Given the widespread evidence of discriminatory behavior and widening racial disparities, it is imperative that educators address systemic inequities in education. Clinical simulations are a promising vehicle for helping educators identify and disrupt inequity in teaching. We developed a short digital learning intervention—a digital clinical simulation (DCS) and associated asynchronous video-based simulation debrief (VD). We studied the effectiveness of each component of this intervention using a staggered randomized experiment within the first unit of an 8-week online professional development course (N = 787). We found no statistically significant differences in equity beliefs between participants in the two experimental conditions of the study (DCS-only, and DCS + VD) and the control condition. In a qualitative analysis of reflection responses, we found that only 26.2% participants independently showed some evidence of equity-based reasoning in their simulation post-DCS self-reflections, but that 42.9%\showed some evidence of equity-based reasoning in their post-VD self-reflection. These findings suggest that shifts toward equity might not manifest immediately after the digital clinical simulation. More research is needed on how digital clinical simulations may affect the trajectories of equity development and what effects other components, such as personalize.