Comparison of the observer role vs. active participant role in interprofessional simulation-based education for affective skills: a randomized-controlled trial

Background: Adequate bowel preparation is a critical aspect of colonoscopy, mainly pivoting on the education provided by the relevant healthcare professionals to the patient. Conventional methods of counselling education for these healthcare professionals have prioritized one-to-one practice of the skill over learning through observing fellow learners during simulation-based learning activities. The efficacy of observer roles in simulation for bowel preparation education remains underexplored. This study aims to compare the effectiveness of observer roles versus hands-on practice in simulation-based education. Methods: A simulation-based session was conducted for healthcare professionals involved in bowel preparation education to patients. Learners were randomly assigned to either an observer role in simulation group or a one-to-one practice group. Both groups received standardized education on bowel preparation techniques. Pre- and post-activity self-efficacy scores were collected using a 5-point likert scale. The scores were analyzed using appropriate statistical methods to compare the effectiveness of observer roles versus one-to-one practice. Results: Both groups demonstrated substantial improvements in self-efficacy scores post-activity. A median difference of + 0.8 was seen in the control group whereas + 1.1 in the observer group (p = 0.64), revealing comparable increase in confidence of observer and active participants in performing counselling of patients for bowel preparation. This similarity was refelcted in the post-test as well, in which both groups reached a score of 11 out of 13 (p = 0.7). Conclusion: Observer roles in simulation are equally effective as hands-on practice for bowel preparation education for healthcare professionals. Both methods contribute significantly to enhancing participants’ self-efficacy in performing bowel preparation counselling. Incorporating observer roles in simulation-based education can offer a cost-effective, resource-efficient, and time-efficient solution for this education.