Cultivating psychological readiness for major incident attendance through high-fidelity simulation: A scoping literature review.

Abstract

Abstract Objective: This scoping review aimed to identify studies in which major incident high-fidelity simulation (HFS) had been utilised to improve critical thinking skills, emotional preparedness and mental resilience amongst undergraduate and/or postgraduate learners; and collate this information to help improve teaching and learning practices. Background: Major incidents present challenging and unpredictable working environments for emergency service personnel, therefore training those with a response role is vital. NHS England’s Emergency Preparedness, Resilience and Response (EPRR) Framework specifies training recommendations for responder organisations, yet limited guidance exists to define the educational quality of the discussion-based learning, table-top scenarios and live-play exercises advocated. High-Fidelity Simulation (HFS) has gained recognition as an effective method for advancing clinical acumen, yet few studies have attempted to validate its capability for cultivating psychological readiness. Methods: A database search was conducted using AMED, CINAHL Plus, EMBASE, MEDLINE and Trip(pro); and we screened the results for relevance. Studies scoring 2- or less on the Harbour and Miller (2001) Framework were excluded; and Cochrane recommendations were utilised for data extraction and results independently assessed by two reviewers. Findings: Using PRISMA scoping review guidelines, 2,459 articles were screened for relevance and a total of 6 studies were deemed suitable for inclusion. Results from the reviewed literature were analysed to ascertain if advancements in critical thinking, emotional preparedness and/or mental resilience were apparent. HFS was universally found to enhance critical thinking and decision-making skills; but none of the studies robustly appraised developments in emotional preparedness or mental resilience. Conclusion: A sparsity of high-ranking evidence exists to guide teaching and learning developments in major incident HFS; alongside a research-knowledge gap for cultivating emotional preparedness and mental resilience. However, a causal relationship between major incident HFS and advancing critical thinking skills amongst learners training to work in disaster environments was identified.