Structural Competency in Simulation-Based Health Professions Education: A Call to Action and Pragmatic Guide

Area of Science:

• Health Professions Education
• Social Determinants of Health
• Medical Simulation

Background:

• Health inequities persist despite individual-level interventions.
• A need exists to address systemic factors influencing health outcomes.
• Simulation offers a unique platform for experiential learning in healthcare.

Purpose of the Study:

• To introduce Metzl and Hansen's Five-Step Model for structural competency.
• To explore the application of structural competency in simulation-based health professions education.
• To provide a guide for educators to integrate structural competency into simulation design.

Main Methods:

• Conceptual framework development based on Metzl and Hansen's model.
• Discussion of metacognitive principles in simulation.
• Guidance for collaborative design of simulation components (objectives, cases, debriefs).

Main Results:

• Structural competency can be integrated as a performance domain in simulation.
• Simulation design can be adapted to teach identification and challenging of inequity drivers.
• Educators can be empowered to address systemic factors in health.

Conclusions:

• Cultivating structural competency in simulation advances diversity, equity, and inclusion.
• Simulation-based education can shift paradigms towards recognizing and challenging health inequity drivers.
• This approach is applicable across various health professions education settings.