Patient simulations are a great asset to clinical practice [1]. Unlike role plays, they use professional actors, unknown to the public, trained to simulate patients. In Co-Constructive Patient Simulation (CCPS; [2, 3]) a facilitator has additionally guided a learner to prepare a script that helps reflect on a clinical case that the learner encountered in real life and that seems fit for sharing with colleagues to reflect upon. This script is then shared with actors in preparation of the patient simulation session. The patient simulation session itself has participants unfamiliar with the case, of whom two or three are invited to volunteer as interviewers of the actors being patient simulators (Ps). In this way professionals from the same or different disciplines can be brought together to reflect about clinical situations that pose ethical or societal dilemmas, clinical challenges, or practical difficulties according to a particular format described earlier [3]. They can exchange critiques and have a unique co-created experience and thereby develop communities of practice (CoP), that is, a group of individuals engaged in the shared pursuit of knowledge, professional affiliation, and social identity. The question was whether this also could be done at international conferences with a temporary international group of colleagues, thereby creating international communities of practice (ICoP), educating twenty-first century fit child psychiatrists [4]. For the CCPS set-up and debriefing process we refer to Perlman et al. submitted [5] and Martin et al. [2, 3].
In previous studies [2, 3, 5] shortcomings of traditional education in child and adolescent psychiatry (CAP) that can be overcome by CCPS have been described, such as: 1. Supervision takes place after clinical encounters; 2. Learning goals are driven by the instructor rather than the learner; 3. Limited ability to reflect and act in real time; 4. Lesson plans can become ossified. By contrast, through CCPS, 1. supervision shifts from a hierarchical to an equal encounter; 2. Learning goals become driven by the learner rather than the supervisor; 3. Reflection and action shift to happen in real time; 4. Lessons become lively and will impact the learner more meaningful through their emotional involvement.
In addition, there are clear advantages to developing collaborative spaces at international conferences, however transient: CAPs already decided to gather in a particular location for educational purposes whether, from isolated remote, rural or under-sourced areas or academic hotspots; equitable participation in a supportive, risk-free, and collegial space is facilitated. In addition to these logistic considerations, ICoPs can support common international training goals through shared development of knowledge, skills, and attitudes, or implementation of evidence-based knowledge in CAP across cultures worldwide. This helps enhance a global common understanding, language and practice of CAP bridging cultural, religious, gender and societal differences and inequality.
In this study, the first session being also part of a larger study involving digital CCPS sessions, [5] we sought to address several of these advantages by creating and studying two ICoPs in CAP characterized by: 1) cooperation between international participants; 2) the use of human simulation, in real-time, following the co-constructive patient simulation (CCPS) model; 3) the application of the principles of design-based research (DBR) [6] and an objective evaluation framework for improvements [7].