The Simulation Blues

by | 17 Jul, 2017 | 3 comments

Cultural competence and the use of simulations

It’s a strange experience to come from a background in disability advocacy and lobbying – where the culture of disability is strong and proud, and the vigilance against abuse and neglect is staunch – into a tertiary education sphere where disability culture is not often part of teaching and learning.

For me, the cultural perspective includes the lived experience of being able to identify barriers, access solutions, historical figures and events and social movements, and to know how to use our languages and apply our definitions and world view to everyday situations.

What has become apparent in the tertiary education sector, is the disadvantage of not having this cultural competence when we talk about, or develop, simulations. So let’s look at this simulations thing again from an impact angle.

Googling simulations and tertiary education, the first things that come up on the list are around space simulations. This is, I’m sure, exciting and cool as I’m assuming it’s about exploring an environment that is unknown. New terrain; the final frontier and all of that. Amazing, if it is about the environment.

But what about simulating a medical condition or bodily experience when it comes to disability?

At UTS, I’ve received the message very strongly that we believe in ethical practice. This is what sets us apart from other universities, in a really good way. This means then that we need to be aware of if, when and how we do effective simulations.

Because it is not ethical to replicate a disability bodily experience.

I know many people enjoy testing out a wheelchair or wearing a blindfold to stimulate empathy for our experience of the world. However, we don’t do activities that involve painting our skin in traditional blackface to create empathy, so what is the difference?

My go-to on this one comes from within the disability cultural community. Enter the late Stella Young into this conversation. In Stella’s ABC article on simulation, she says “You want to further your understanding of disability? No props required! Just talk to disabled people….  allies should be strengthening the voice of people with disability by speaking up alongside us, not simulating disability in tokenistic fashion”.

So for me, as a person with partial sight (as a person with visual access requirements), I’m not going to make you put on a blindfold to create empathy. We are going to learn how to use a screen reader instead – a solution focused on the environment, not the body.

Simulation is further explained by a recent article on Dr Michelle Nario-Redmond’s research. The summary of the research is the increased feelings of fear, apprehension and pity toward those with disabilities as a result of simulations, doing more harm than good.

Changes in pedagogy

So let’s really investigate why we would ever consider doing disability simulations now or in the future at UTS. The article Pedagogical Reflections on the Use of Disability Simulations in Higher Education explains that there can be a disconnect between what we intend to teach and what students learn in the realms of empathy driven experiential learning. The article goes on to say that some student responses include ‘Thank goodness I don’t have a disability’. And as I sit and read this, from my position within the Equity and Diversity Unit at UTS, I think how upset I would be if we are generating that response here. Similarly, are we asking the question in the development of new learning technologies around risk and impact on the disability community, who are already disadvantaged in terms of objectification?

So what do we do?

A well balanced perspective is the Disability Related Simulations: If, When and How to Use Them in Professional Development paper. This paper is awesome because it lists guidelines for creating effective simulations, because ultimately, I know universities like them. Here’s the list:

  1. State objectives clearly
  2. Ensure voluntary participation
  3. Illustrate challenge and solutions related to both the system and the individual
  4. Demonstrate the value of universal design
  5. Include consumers in the planning and delivery of the simulation
  6. Support positive attitude changes
  7. Debrief thoroughly and reflectively acknowledge discomfort

Suggested Alternatives

  • Learning how to use a screen reader like NVDA when developing digital platforms and content, to get the experience of using one, and the creative solutions that flow from having this knowledge.
  • Watching videos made by people who have disability so that you hear their authentic voice and story, such as this creative video on lip reading.
  • Employ people with disability as academics, support staff and guest lecturers
  • Inviting artists with disability to produce and perform the narrative alongside a technology or innovation product that can otherwise objectify and harm
  • Focusing on the environment – instead of what is the problem with this specific body, let’s look at learning technology that says, what is the problem with our (the non-disabled body’s) way of doing and thinking instead

 

3 Comments

  1. Tracy Levett-Jones

    Thanks for this interesting post Sarah. As someone who implements and evaluates simulations designed to enhance empathy I found it thought provoking.

    You might be interested in a systematic review by Margaret Bearman et al that concluded that the most effective educational interventions for enhancing empathy are simulations that allow learners to ‘step into a person’s shoes’ in order to gain new insights into their feelings, perspectives and experiences.

    Bearman, M., Palermo, C., NutrDiet, L., Williams, B. 2015. Learning empathy through simulation. Simulation in Healthcare. 10 (5), 308-319

    Cheers
    Tracy

    Reply
  2. Sue Dean

    Sarah thank you for your post which is powerful and deeply thought provoking. Your insights are a reminder that there is profound value in inter-disciplinary conversation. It can stimulate much needed debate and deeper understanding about issues that nurses, doctors and the more traditional disciplines may not be well-versed in, or may have taken for granted.

    You have outlined important principles for safe, respectful, curriculum development. It is, and should be, a touchstone for us all as we develop new learning and teaching activities here at UTS.

    Your post outlines if, when and how to offer simulation-based learning experiences.

    It prompted me to think about the unintentional harm that may occur when a learning experience simulating what it may be like to live with a disability is used in place of other more moral, contextual approaches. As you so cogently point out, simulation is simply a snapshot, offering a 2 dimensional surface-view, of what it is like to live with a disability in a world where ability is hegemonic.

    We all need to remember that simulated perspectives of real life will always fail to reveal the embodied, daily experience of living a life in the face of physical or mental challenges. Students deserve opportunities that will awaken, engage, provoke and teach them lessons they will remember for life. One, of course, is humility. The other is to do no harm.

    Reply

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