A scoping review of emotions and related constructs in simulation-based education research articles

BACKGROUND

While acknowledgement of emotions' importance in simulation-based education is emerging, there are concerns regarding how education researchers understand the concept of emotions for them to deliberately incorporate emotionally charged scenarios into simulation-based education. This concern is highlighted especially in the context of medical education often lacking strong theoretical integration. To map out how current simulation-based education literature conceptualises emotion, we conducted a scoping review on how emotions and closely related constructs (e.g. stress, and emotional intelligence) are conceptualised in simulation-based education articles that feature medical students, residents, and fellows.

METHODS

The scoping review was based on articles published in the last decade identified through database searches (EMBASE and Medline) and hand-searched articles. Data extraction included the constructs featured in the articles, their definitions, instruments used, and the types of emotions captured. Only empirical articles were included (e.g. no review or opinion articles). Data were charted via descriptive analyses.

RESULTS

A total of 141 articles were reviewed. Stress was featured in 88 of the articles, while emotions and emotional intelligence were highlighted in 45 and 34 articles respectively. Conceptualisations of emotions lacked integration of theory. Measurements of emotions mostly relied on self-reports while stress was often measured via physiological and self-report measurements. Negative emotions such as anxiety were sometimes seen as interchangeable with the term stress. No inferences were made about specific emotions of participants from their emotional intelligence.

CONCLUSIONS

Our scoping review illustrates that learners in simulation-based education are most often anxious and fearful. However, this is partially due to medical education prioritising measuring negative emotions. Further theoretical integration when examining emotions and stress may help broaden the scope towards other kinds of emotions and better conceptualisations of their impact. We call for simulation education researchers to reflect on how they understand emotions, and whether their understanding may neglect any specific aspect of affective experiences their simulation participants may have.

Detection of vertical interocular phase disparities using luster as cue

Interocular disparities in contrast generate an impression of binocular luster, providing a cue for their detection. Disparities in the carrier spatial phase of horizontally oriented Gabor patches also generate an impression of luster, so the question arises as to whether it is the disparities in local contrast that accompany the phase disparities that give rise to the luster. We examined this idea by comparing the detection of interocular spatial phase disparities with that of interocular contrast disparities in Gabor patches, in the latter case that differed in overall contrast rather than phase between the eyes. When bandwidth was held constant and Gabor spatial frequency was varied, the detection of phase and contrast disparities followed a similar pattern. However, when spatial frequency was fixed and Gabor envelope standard deviation (and hence number of modulation cycles) was varied, thresholds for detecting phase disparities followed a U-shaped function of Gabor standard deviation, whereas thresholds for contrast disparities, following an initial decline, were more-or-less constant as a function of Gabor standard deviation. After reviewing a number of possible explanations for the U-shape found with phase disparities, we suggest that the likely cause is binocular sensory fusion, the strength of which increases with the number of modulation cycles. Binocular sensory fusion would operate to reduce phase but not contrast disparities, thus selectively elevating phase disparity thresholds.