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A professor sits with two students in a medical examiner room.

Education majors at Syracuse University participate in clinical simulations to provide hands-on experience handling hard conversations.

Syracuse University

One educator at Syracuse University is propelling real-world learning with clinical simulations to teach undergraduates how to navigate tense, awkward, unfamiliar or ethically fraught conversations in their careers.

For over 15 years, the School of Education has utilized simulations in its curriculum, establishing engaging, shared learning environments in a low-risk setting and prompting students to participate in data-based reflection and strategizing.

Whether it’s de-escalating an angry parent, addressing plagiarism in the classroom or counseling children through abuse or divorce, Syracuse students practice holding difficult conversations and learn best practices for the future.

Syracuse University’s Center for Experiential Pedagogy and Practice, which opened in March 2022, launched its first business-oriented experiential learning simulation at the end of March for students at the Whitman School of Management.

What’s a sim? A simulation, as defined by Ben Dotger, education professor and director of the Center for Experiential Pedagogy and Practice at Syracuse, is a manufactured live interaction that is recorded and takes place person-to-person with specific learning objectives.

The essential factors are “person-to-person” and “live interactions,” Dotger explains, because it differentiates the experience from a role play or a rehearsed dialogue between students.

Sims are most typically used in a clinical or medical setting to train future physicians, nurses, physical therapists or similar role to practice diagnostics or communicating with a patient.

“We try to bring to life the most common situations, the most frequent or prevalent, and we try to bring to life those that are less common but that we really need our professionals to be on point when they encounter those less common situations,” Dotger says.

A common example for a future educator may be communicating with a proactive parent who has a few questions about curriculum, whereas something less common but critical to understand is a parent who wants to remove a book from the classroom.

Syracuse’s sims: Dotger began incorporating sims into his curriculum in 2007, partnering with SUNY Upstate Medical University and its Clinical Skills Center to use their trained actors, who served as standardized patients in simulations, to become standardized parents, colleagues or students for Syracuse.

Syracuse’s the initial simulations were for educator preparation—teacher education, school leader education, school counseling, etc.—but have expanded to creative arts therapy and, most recently, business and marketing students. The university also offers simulations for veterans exiting the military and returning to campus life, with a grand total of 64 different sims.

In his course Early Foundations, Dotger’s students complete six simulations over a 15-week semester.

How it works: The simulation experience can be broken down into six phases.

The student receives a learner protocol, which comes with a “reasonable amount of information,” three to five days before the scheduled simulation, Dotger says. “That sounds a little vague, and I mean it to be a bit vague.” Sometimes, a simulation is a scheduled meeting or interaction that the student will lead with the standardized parent. Other simulations are more off-the-cuff.

“As educators, we will have interactions with parents or colleagues, sometimes on a Saturday morning in a grocery store parking lot, sometimes late afternoon in a school hallway,” Dotger explains. “We didn’t initiate the conversation; we’re not really sure what the person may be concerned about or might want to ask us. So sometimes the situations we put them in are intentionally pretty vague. The expectation remains the same: do your best.”

Then, it’s the day of the simulation. The interactions take place in an isolated room with cameras recording the entire process, which lasts around 20 minutes. Students will cycle through in a few groups of four to five simultaneous simulations.

Following the interaction, students have an immediate 10-minute group debrief with their instructor.

Then, students rewatch the simulation, reviewing what went well and what could be improved.

The next time the class meets, a few students will show their simulation footage and point out clips that demonstrate both what the student was proud of or what could be learned from. Dotger says students typically dissect about 50-50 positive versus negative feedback of their own simulations.

“My job in class is really just facilitating that whole group debrief to make sure we cover the range of issues within that given sim,” Dotger adds.

Finally, students turn in a reflection paper, time-stamping examples of their simulation successes and areas of improvement.

Learning targets: Each simulation has its own unique learning objectives, but the goal of the entire experiment is to build confidence, engage learners, apply classroom materials and create a safe space to make mistakes.

“I share with them from the very start of a given semester: I hope you make mistakes,” Dotger says. “This is a practice-based space. The mistakes are welcome; successes are welcome. Close analysis of your performance of your video is expected … There’s no one right way. And you may screw some things up, and that’s perfectly OK.”

Students, in their video reflection, engage in meaning making with the data, which is also a critical objective in the exercise.

“It’s actually some of the best teaching because they are, at times, really, really on point. And they don’t trust themselves yet,” Dotger adds.

Implementing the sim: As the instructor, Dotger does not grade how a student performs in the simulation but instead the depth of reflection and understanding of behaviors.

“My emphasis in grading the reflection is that it be grounded in data … I expect them to write their reflections based on the video evidence,” he explains.

Dotger has also found students do best with multiple simulations in a semester, as the first simulation requires some adjustment. “Students get into the first one, and about the time that they are ready to get out of it, they suddenly realize, ‘OK, this is what it is, this is what it’s not,’” Dotger explains. “But then it’s over.”

The logistics of creating a sim rely largely on having a trained professional to work with students and creating a case—establishing the role of the standardized person and equipping students with documents. But with the prevalence of clinical simulations in the medical setting globally, Dotger says finding groups who train standardized patients has been easy.

Building into business: The newest simulation came from a conversation between Erin Draper, Whitman Director of Experiential Programs at Syracuse. Dotger and Draper held a focus group with some New York City–based alumni to understand challenges recent graduates face in business roles, particularly finance, accounting and marketing.

Undergraduates trialed the business sim at the City University of New York and New York University’s Grossman School of Medicine NYSIM Center on March 31—encountering a challenging situation with a colleague and having to navigate a pressure situation.

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