Simulation‐based education: understanding the socio‐cultural complexity of a surgical training ‘boot camp’
Abstract
Objective: The focus of simulation‐based education ( SBE ) research has been limited to outcome and effectiveness studies. The effect of social and cultural influences on SBE is unclear and empirical work is lacking. Our objective in this study was to explore and understand the complexity of context and social factors at a surgical boot camp ( BC ). Methods: A rapid ethnographic study, employing the theoretical lenses of complexity and activity theory and Bourdieu's concept of ‘capital’, to better understand the socio‐cultural influences acting upon, and during, two surgical BC s, and their implications for SBE . Over two 4‐day BC s held in Scotland, UK , an observer and two preceptors conducted 81 hours of observations, 14 field interviews and 11 formal interviews with faculty members ( n = 10, including the lead faculty member, session leaders and junior faculty members) and participants ( n = 19 core surgical trainees and early‐stage residents). Results: Data collection and inductive analysis for emergent themes proceeded iteratively. This paper focuses on three analytical themes. First, the complexity of the surgical training system and wider health care education context, and how this influenced the development of the BC . Second, participants’ views of the BC as a vehicle not just for learning skills but for gaining ‘insider information’ on how best to progress in surgical training. Finally, the explicit aim of faculty members to use the Scottish Surgical Bootcamp to welcome trainees and residents into the world of surgery, and how this occurred. Conclusions: To the best of our knowledge, this is the first empirical study of a surgical BC that takes a socio‐cultural approach to exploring and understanding context, complexities, uncertainties and learning associated with one example of SBE . Our findings suggest that a BC is as much about social and cultural processes as it is about individual, cognitive and acquisitive learning. Acknowledging this explicitly will help those planning similar enterprises and open up a new perspective on SBE research.
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Cleland et al's rapid ethnography interpreted learning in a surgical training boot camp in Scotland by incorporating CHAT.
“Studying medical learning as an activity system is exemplified by a rapid ethnography by Cleland et al30 which interpreted the learning in a surgical training boot camp in Scotland by incorporating CHAT.”
From Cultural Historical Activity Theory for Studying Practice-Based Learning and Change in Medical Education (2021) · cites this paper as [30]
CHAT has varied application, including undergraduate education, postgraduate education, and continuous professional development.
“CHAT has varied application as the examples presented here have included undergraduate education (eg, clinical assistantships for final year medical students),2 postgraduate education (eg, surgical training),30 and continuous professional development (eg, medical revalidation for trained doctors).32”
From Cultural Historical Activity Theory for Studying Practice-Based Learning and Change in Medical Education (2021) · cites this paper as [30]
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- Authors
- Cleland, J., Walker, K. G., Gale, M., & Nicol, L. G.
- Affiliations
- University of Aberdeen (GB)
- University of Stirling (GB)
- Corresponding author
- Cleland, Jennifer
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2016-07-11
- Volume
- 50
- Issue
- 8
- Pages
- 829-841
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W2466161796
- Cited by
- 74
- References
- 74
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 5 · 2023: 11 · 2022: 14 · 2021: 7 · 2020: 5 · 2019: 5 · 2018: 9 · 2017: 5 · 2016: 3
- FWCI
- 8.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Surgical Simulation and Training
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
- Keywords
- simulation-based education, surgical training, socio-cultural influences, activity theory, complexity theory, surgical residents, faculty perspectives, insider information, surgical training system
- MeSH terms
- Simulation Training, Anthropology, Cultural, Clinical Competence, Faculty, Female, Humans, Internship and Residency, Leadership, Male, Scotland, General Surgery, Problem-Based Learning, Social Capital
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