Team DFTB. Choose your own adventure: Dani Hall at DFTB19, Don't Forget the Bubbles, 2019. Available at:
Close your eyes and imagine an audience watching a horror movie at the cinema: you’ll probably picture rows of people watching through the cracks between their fingers, curled up into defensive balls as a psychopath bursts onto the screen. It’s almost as if we live the story.
This is backed up by science: put someone through an fMRI machine and read them a story about football and the motor cortex activates as if they were kicking the ball themselves; read them a story about perfume and the olfactory cortex lights up. The brain behaves as though it were an active participant. This is thanks to our mirror neurons, neurons that help us learn and adapt. These mirror neurons mirror emotions too: like Andy so brilliantly said at DFTB19, when we see someone smile, truly smile, we smile too, literally catching their joy. Whether it’s a gripping novel, a tragic news report or the recount of a resuscitation, it’s the story that affects us, because we feel true empathy for the protagonists; we feel their feelings.
This magical science of storytelling helps us learn. Embed learning into a story and that learning becomes embedded in memory. This is Narrative Theory.
But what’s this got to do with medical education? Could we harness the power of narrative theory and use it to enhance the way we teach?
We have all experienced the deep learning elicited by participation in a simulated event. And we know there is evidence in support of this. Simulation is valuable because it allows us to translate learned, theoretical knowledge into practice. It allows us to prepare for uncommon problems in a safe environment whilst receiving direct feedback on our performance. We wondered if we could create a simulation-based learning tool that used to story to add meaning to the clinical picture – bringing together the benefits of simulation training with the ideas from Narrative theory to pack a real educational punch.
#PEMadventures is a form of virtual reality simulation, that aims to encapsulate the benefits of traditional simulation training with story-telling, in a new and exciting package that is accessible and fun. Using voting app technology, simulated cases are presented to a group who then steer the direction of clinical travel, through shared decision making (voting) at key decision points in each individual patient story. Participants really can “Choose their own #PEMADVENTURE”…which means that every teaching session is different – one of the many reasons we love it! .
The cases are generally designed to highlight a recent research publication, or to illustrate a new guideline. So there is knowledge translation and consolidation, interwoven with story. We have created and delivered a wide variety of adventures so far in a range of different settings – from local small group events to bigger audiences at large international conferences. Just like your day job, you never quite know what you may have to deal with in the #PEMadventures queue. It might be Archie – a rather cute baby with bronchiolitis; it could be Bruno, a budding politician with a tricky to treat case of DKA. Whoever you are asked to manage we guarantee you will have a good time and probably learn a thing or two along the way.
So what next for the #PEMadventures team?
Whilst we continue to expand our repertoire of cases – from the everyday to the obscure – we are currently working with Don’t Forget the Bubbles to develop a series of open access on-line #PEMadventures that everyone can enjoy. We are keen to develop more meaningful strategies for evaluating the impact of our work both on stage and on-line. And of course, we are always on the lookout for future dates where we can showcase our #PEMadventures live.
This talk was recorded live at DFTB19 in London, England. With the theme of “The Journey” we wanted to consider the journeys our patients and their families go on, both metaphorical and literal. DFTB20 will be held in Brisbane, Australia.
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