A longitudinal study on the impact of simulation on positive deviance through speaking up.

Background: Students reported positive learning outcomes during a simulation study addressing compliance and speaking up.

Purpose: Investigate if the impacts of the simulation had a lasting effect on participants after moving into practice.

Method: Semi-structured interviews focusing on memory of the study, psychological impacts, educational impacts, professional impacts, and experiences in practice were conducted with Advanced Care Paramedics (3) and Respiratory Therapists (7) between 19 and 24 months after the original study.

Discussion: Participants indicated the simulation helped them develop the skill and confidence to speak up, preparing them to speak up in practice. Primary findings included: (i) the importance of experience for speaking up, (ii) the benefit of high-impact simulation, and (iii) the importance of simulation training.

Conclusions: Simulation for speaking up should occur early. Conducting high-impact simulations for speaking up is a practical and actionable intervention that appears to enhance confidence, ability, and likelihood of speaking up in practice.