The Simulated Human: An Actor-Network exploration of the materialities of mobilising practice learning in uncanny spaces

Abstract

The use of simulated human mannequins in nursing education is widely assumed to provide active learning of clinical skills in the safety of a realistic ward environment without causing harm to patients. While the uptake of this pedagogy increases, research into its efficacy has concentrated mostly on student perceptions and outcomes with little regard for the perceptions of the lecturers or in relation to the purpose of simulation in nursing education. The body of research has been criticised for being considered only from a positivist perspective that might not adequately fit with the complexities and particular subtleties of how practice learning is mobilised in this context. This study has been guided by Actor-Network Theory so as to trace the sociomaterial assemblages and identify the practices, patterns and connections that facilitate effective learning of immediate life support skills. Data were gathered by performing ethnographic observations of the delivery of the immediate life skills course at a nursing school in Scotland and by conducting in-depth interviews with the lecturers. These were analysed thematically and the datasets compared in an iterative way. The findings suggest that the lecturers employ elements of both the real and the imagined nursing practice by creating a hybridity between their own past clinical experiences and the past placement experiences of the students in the simulated scenarios and projecting them into future imaginings of practice. They draw greatly on the strength of this uncanny space to make the unreal real, using the hybridity to enact a form of créolité, which seems to facilitate this method of practice learning. This assemblage provides a bridge or scaffolding between the two spheres of practice placement and creates a hybrid space where opposing elements in nursing education are comingled effectively. This study is the first to consider this particular pedagogy in a sociomaterial way through a postcolonial lens. While this study is very small and cannot be generalised to the wider population of nursing schools, it has opened up new possibilities in understanding this dynamic and multifaceted pedagogy from a more critical perspective so that future research might follow.