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Summative Simulation: learning to flip assessments

Oral Presentation 7
Dr Janine Stockdale, Dr Lorna Lawther, Dr Mary Gillespie, Mrs Debbie Cordner, Dr Billiejoan Rice

Summative Simulation: learning to flip assessments

The suggestion that simulation optimises healthcare professionals’ effectiveness in managing obstetric emergencies, continues to be evidenced (Yucel et al., 2020). Learning about human factors through team simulation, is therefore, a central component of midwifery and nursing education (Stockdale et al., 2021). Yet this creates an instructional design challenge in that learning outcomes must be summatively assessed, even though experts in simulation caution otherwise (Rosenorn-Lanng (2015). As more direction about summative simulation becomes available (El-Awaisi et al., 2022), this paper describes the implementation off a flipped summative simulation with undergraduate students and discusses the associated outcomes.


in collaboration with expert clinicians, a 7-minute simulation that depicted clinicians managing maternal sepsis, was recorded. Prior to filming, a pre-defined list of subtle system and clinical errors were agreed by the clinical team.

during a two-hour session, 63 final year midwifery students were asked to individually observe the 360o simulation video accessible via the Canvas platform. With headphones in situ, they were able to gain a panaromic view of the team’s response to maternal sepsis, while completing a structured, reflective report. The report asked them to reflect on the quality of the team dynamics, task allocation and completion, team interaction, communication and situational awareness. The reflection was not gamified, in that the students were not challenged to find a particular number of team errors. A technician was available for troubleshooting any access problems.

a summary of the student outcomes and recommendations for further implementation of a flipped summative simulation will be provided.

Summative simulation is cautioned against, however, there is a requirement that new midwives and nurses are proficient in the identification, escalation and effective care of obstetric and medical emergencies. Flipping a simulation, where the students assess a team of clinicians, offers a novel way of summatively assessing these proficiencies in order to meet the requirements of the Nursing and Midwifery Council. More research into summative simulation is required.