Previous research suggests removing instructors from simulation-based learning environments is popular with students who report greater task immersion and decreased anxiety. However, the specific impact of social evaluation anxiety on students’ immersion and performance remains equivocal.
N=31 paramedic students completed two simulation-based clinical scenarios in random order, one in the presence of an instructor and one without. Students’ distraction and time-to-completion were quantified via review of head-mounted video cameras, anxiety via continuous heart-rate (HR), and performance via two expert assessors reviewing video footage using a structured clinical assessment checklist. One-on-one, in-depth interviews followed with 12 randomly selected students.
Students completed scenarios 1.8 minutes quicker when instructors were ‘absent’ compared to ‘present’ (6.6 vs. 8.4 min, p<.001), approximately half of this additional time was spent interacting with instructors (61.4 sec, SD=33.4). Peak HR was higher in the instructor ‘present’ than ‘absent’ group (121 vs. 116 bpm, p=.035), but no between-group difference was found for average HR (98 vs. 100 bpm, p=.407). Interview data suggested students felt greater stress in the presence of instructors. No statistical difference was evident between students’ performance scores in the instructor ‘absent’ versus ‘present’ conditions (71.6% vs. 69.4% respectively, p=.314).
Students were more immersed, reported being less stressed and distracted, and were significantly quicker at completing clinical tasks with instructors absent, with no detriment to performance. Removing instructors during simulation-based training is likely to enhance students’ immersion and potentially decrease social evaluation anxiety, but immediate performance is unlikely to improve.
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