Learners' Experiences During Rapid Cycle Deliberate Practice Simulations: A Qualitative Analysis

Simul Healthc. 2019 Feb;14(1):18-28. doi: 10.1097/SIH.0000000000000324.


Introduction: Rapid Cycle Deliberate Practice (RCDP) is a team-based simulation method, emphasizing repetitive practice over reflective debriefing, with progressively more challenging rounds, frequent starts and stops, and direct coaching. Although some studies have shown improved performance, no study has evaluated learners' perceptions. We aimed to explore learners' experiences during RCDP.

Methods: This was a qualitative study of participants' perceptions regarding RCDP during their pediatric emergency medicine rotation. Participants completed surveys about RCDP learning. A purposive sample of residents and nurses were interviewed. Two coders analyzed all interview transcripts to identify emerging themes. Constant comparison analysis was performed until thematic saturation was achieved.

Results: Forty-four participants completed surveys. Participants found RCDP interruptions beneficial and felt that they learned most during interruptions. Participants who were able to compare traditional and RCDP simulations felt that RCDP allowed more focused correction of mistakes, acquisition of new skills, and timely practice of team behaviors. Fourteen participants were interviewed. Three themes emerged. (1) The real-time corrections during RCDP allowed for learning and creation of new skills through repetition and practice. (2) The RCDP allowed learners to gain confidence, decrease anxiety, and learn in a safe environment. (3) By introducing new information in smaller chunks, participants maximized learning without cognitive overload.

Conclusions: Rapid Cycle Deliberate Practice is well received by learners. Because of frequent interruptions, learners noted early error correction, a safe learning environment, and skill improvement during RCDP. Learners recognized that the progressive advancement of RCDP helped prevent cognitive overload. Future studies should measure cognitive load and skills retention.

MeSH terms

  • Attitude of Health Personnel*
  • Clinical Competence
  • Educational Measurement
  • Emergency Medicine / education*
  • Emotions
  • Female
  • Formative Feedback
  • Group Processes
  • Humans
  • Internship and Residency / organization & administration*
  • Male
  • Nursing Staff, Hospital / psychology*
  • Patient Care Team / organization & administration
  • Pediatrics / education*
  • Perception
  • Problem-Based Learning
  • Qualitative Research
  • Self Efficacy
  • Simulation Training / organization & administration*