Abstract
Keywords
This scoping review examined the scholarship in the last 15 years on the use of live actors in simulation-based learning (SBL) for the development of social work competencies. The use of live actors as standardized or simulated clients (SCs) in SBL has the potential to address a key challenge in social work education: providing students with effective learning experiences that can prepare them for the realities of professional practice (Bogo et al., 2017; Kourgiantakis et al., 2020; Lee et al., 2020). While the use of standardized patients (SPs) was introduced in medical education as far back as the 1960s, their application in social work education in the form of SCs and SPs has only gained prominence in recent decades (Sollars & Xenakis, 2021). This scoping review was limited to literature in the last 15 years for two main reasons: we wanted to minimize overlaps with previous work undertaken in this area as discussed in the literature review below and we were interested in what could be considered as the contemporary adoption of this pedagogical technology. Following Asakura et al. (2023, pp. 1–2), we use the term “simulations” interchangeably with “trained actors” and SCs.
Social work education requires the development of core professional competencies that include interviewing skills, client engagement, interprofessional collaboration, and effective use of supervision (Bogo et al., 2017; Lee et al., 2021; Maynard, 2021). In real-world settings, these competencies involve the dynamic integration of a wide set of professional knowledges, skills, and values which include good communication, critical thinking, reflectivity, empathy, and problem-solving skills (Opačić, 2022). Apart from practicums/placements which are largely beyond the direct control of social work academics, there are limited options for authentic learning of these practice competencies in social work education. Traditionally, social work educators have mainly relied on written case studies and role-playing exercises between students or with faculty members to simulate the kinds of interactions that they aim to prepare students for (Fulton et al., 2019). However, peer-to-peer role-plays can suffer from multiple validity issues (e.g., internal and face) and lack realism and authenticity, potentially limiting the depth of learning (Badger & MacNeil, 1998; Schreiber & Minarik, 2018). In peer-to-peer role-plays, students can “sometimes be too easy on each other” (Lee et al., 2021, p. 159).
To address this gap, a number of social work educators have integrated the use of SCs played by professional/paid actors in their teaching of social work skills. The aim of actor simulations, according to Hovancsek (2007, p. 3), is “to replicate some or nearly all of the essential aspects of a clinical situation so that the situation may be more readily understood and managed when it occurs for real in clinical practice.” This approach allows students to engage with individuals trained to portray complex emotional and behavioral scenarios with the spontaneity and nuance that cannot come from peer-to-peer exercises or even student-to-staff exercises. The use of professional actors who can deliver consistent and credible performances can provide a dynamic learning environment and process that would otherwise be inaccessible. Moreover, this allows learning in a lifelike but controlled setting (Bogo et al., 2017; Lee et al., 2020). This methodology not only provides a degree of realism but also provides students with a safe space for learning without the risk of harm to real clients or to their professional relationships, enabling them to more freely explore and experiment with practice approaches (Sollars & Xenakis, 2021). For this reason, it has been argued that the use of actors as SCs is more effective in developing clinical skills compared to student-to-student role plays (Duckham et al., 2013).
The incorporation of SCs in social work education aligns with broader trends in other disciplines such as nursing, pharmacy, dietetics, and physical therapy where SCs or SPs played by trained actors are more widely used in SBL and teaching (Maynard, 2021). It has been demonstrated in these fields that interactions with professional actors can improve students’ confidence, competence, and ability to apply theoretical knowledge in practice (see, e.g., in nursing, Alharbi et al., 2024). The use of SCs in these disciplines involve analogous and even similar challenges in social work such as building rapport with clients, navigating emotionally charged situations and applying ethical decision-making in complex situations (Forrest & Derrick, 2010). Thus, the use of SCs has potential to yield similar educational benefits in social work education.
Despite its growing use, the integration of actors as SCs in social work education remains under-examined in social work education and scholarly literature. This scoping review aims to synthesize the potentially disparate literature on the use of simulations using SCs in social work skills training. For example, while research points to the benefits of using SCs as a method of teaching and assessing social work student practice skills (Bogo et al., 2014), there may be other settings beyond the classroom that they are being used for. Our focus of interest is the simulation of structured scenarios using trained actors (as against peers or instructors) to play a variety of roles including client or patient, colleague or community member in interpersonal interactions across a variety of contexts such as therapeutic or case work with individuals, families and groups and interprofessional collaboration (Miller-Cribbs et al., 2017).
The aim of this scoping review is to synthesize literature in social work on the use of live actors in SBL for the development of social work practice competencies. Specifically, we looked into the following questions: (1) What are the characteristics of scholarly publications on the use of live actors in social work education and training? (2) How have live actor simulations been used in terms of purpose, the roles taken on by actors, the target participants and the theories invoked in their use? (3) What key propositions/assertions have been put forward regarding their use?, and (4) What lessons can be drawn from the literature in the use of live actors for social work education and training? In undertaking this scoping review, we hope to contribute to a growing body of research that seeks to optimize the education and training of social workers.
Review of the Literature
This scoping review is meant to take stock of work that have been undertaken in the last 15 years regarding the use of live actors in SBL for the development of social work practice competencies. Seminal work in the use of professionally trained actors as SCs in social work education was undertaken some 30 years ago (see, e.g., Carrillo, Gallant and Thyer [1993] and Carrillo and Thyer [1994]). Since then, ongoing work has been done in this area as shown in a number of similar/related studies detailed below.
Asakura et al.'s (2021) scoping review focused on the use of simulations as a research methodology in examining practice competencies in clinical social work practice. Our study differs from theirs in that our focus is on the use of actors in the teaching and assessment of practice competencies beyond clinical practice settings. The most relevant studies that have been done in our general area of interest were those of, Bogo et al. (2014), Carter et al. (2021), Kourgiantakis et al. (2020), and Logie et al. (2013). Bogo et al.'s (2014) scoping review had a narrow scope, focusing on literature on the use of simulation-based training of child welfare practitioners. Our study has a much broader scope but includes simulation-based training in child welfare practice.
The main focus of the other three was social work education. The aim of Logie et al.'s (2013, p. 6) “critical appraisal” of relevant literature was to assess the effectiveness of the use of SC simulations for teaching and evaluating social work students’ competence. They found 18 relevant articles published between 1997 and 2011 that varied in methodological quality and bore methodological limitations, highlighting for them the need for more consistency in the implementation of methods and valid assessment measures. Apart from having a broader focus beyond social work education, this current study differs from the above previous study in that the selection criteria were not confined to empirical studies and included theoretical literature. In their scoping review, Kourgiantakis et al. (2020) aimed to synthesize empirical studies between 1979 and 2019 on the use of simulations in social work education. In examining 52 selected articles, Kourgiantakis et al. (2020) found that most studies were from North America and simulations were used to teach generalist and specialized practice, with interprofessional practice being the most prominent. Kourgiantakis et al.'s (2020) review pointed to the usefulness of SBL in social work education as follows: (1) providing more authentic learning, (2) allowing students to attempt complex practice behaviors without risk of harm to real clients, (3) enabling students to learn procedural competencies and meta-competencies, (4) teaching students generalist competencies as well as a wide range of specialized competencies, and (5) in the assessment of competencies. Carter, et al.'s (Carter et al. 2021, p. 40) systematic review covering 83 articles from 2008 up to perhaps 2020 (this detail was not explicitly stated) also focused on social work education although they included findings from “alternative” disciplines and articles that inadvertently included recent graduates and working professionals. This current study is both narrower in scope in that the search and selection process was confined to social work except for interdisciplinary initiatives but is also broader in scope in that it includes literature on the use of SCs with social work professionals and supervisors/ managers as against just social work students.
Methodology
A scoping review provides an overview of the body of literature on a broad topic as opposed to a systematic review which is meant to assess the quality of studies and synthesize evidence around a specific research question (Arksey & O’Malley, 2005). Consistent with this notion, there was no intention to appraise the quality of the scholarship covered in this review. Notable scoping reviews in social work literature include Bogo et al. (2020), Field et al. (2021) and Hannan and Teater (2023). This review aimed to scope the state of the art and thinking around the use of actors in SBL for social work education and training as detailed in the data extraction section below. Following Arksey and O’Malley's (2005) scoping review framework, this study examined the literature in the last 15 years. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting checklist was observed (see Tricco et al., 2018).
Inclusion and Exclusion Criteria
This scoping review focused on scholarship in the use of live actors for SBL in the development of social work practice skills in the last 15 years. We were interested in scoping scholarship on simulated experiential teaching and learning involving the use of non-peer, non-teaching staff actors in the development of social work practice skills (as featured, e.g., in Asakura et al., 2022). To be included, the publications needed to be in the form of articles published in academic journals as opposed to books, grey materials, or online features.
We were not interested in the use of simulations as a research tool to examine the social work practice of professionals, as was the case in Asakura et al. (2023) and Todd et al. (2021), or of students like that in Auner et al. (2023). We were not interested in the use of simulations exclusively for observation and vicarious learning like what Tufford et al. (2021) spoke of, nor in traditional role-plays with peers or teaching staff as featured in Emlet (2010). In the same vein, we excluded literature involving the use of paid actors in video recorded sessions for students to observe like in Asakura et al. (2018). We excluded virtual simulations like in Wilson et al. (2013) and Reeves et al. (2017) or technology-based virtual patient simulations like the kind discussed by Washburn et al. (2020). Given the aim of this study, we excluded previous scoping or systematic reviews.
Search Strategy and Process
This scoping review asked the question: What is the evidence base around the use of professional actors as part of teaching and learning in social work practice skills? Following the research question, the lead team member consulted with a social science librarian in the process of developing the initial search strategy, which was then presented to the other team members for consultation. The search strategy that emerged from this was validated by running a test search. When the test search captured studies well beyond the scope of the research question, further iterative refinements were done to ensure that the search strategy was broad enough to include relevant literature but narrow enough as to exclude irrelevant literature. We limited the search to the last 15 years without geographical restrictions. However, given the language limitations of the research team, the search was confined to publications in English. We undertook the search in the following databases: ASSIA, Scopus, Social Science Premium Collection, Sociological Abstracts, and Web of Science. The searches that were executed on 20 June 2024 involved the following parameters:
Date Range: From 1 January 2009 to 20 June 2024
Search Terms: actor OR actress AND “human service” OR “social work” OR “social welfare” OR “social service” AND train* OR develop* OR educ* AND skill
The searches in the five databases yielded a total of 1,486 results, with 1355 coming from Scopus, 58 from Web of Science, 53 from Social Science Collection, 12 from Sociological Abstracts, and 8 from ASSIA.
Screening Process
The search results were uploaded to Covidence where 94 duplicates were automatically removed leaving 1,392 articles to be screened. The first two authors elected to serve as the screening panel for the inclusion and exclusion of articles. The screening process undertaken by the screening panel consisted of two phases: (1) title and abstract screening and (2) full text review. In the first phase, 1,308 were found to be irrelevant leaving 84 for the second phase. Following the full text review, only 25 articles were left in the shortlist. However, an additional 19 articles were found, one from a Google search and 18 from a search of the reference lists of the shortlisted articles published from 2020 onwards. In the end, 44 journal articles were included in this scoping review. The flowchart in Figure 1 represents the entire process before data extraction.
The search and screening process.
Data Extraction, Charting, and Analysis
Data was extracted by the fifth author in line with the data extraction plan we developed and refined following pilot testing. This plan was set out in a spreadsheet which was then used to chart the data as follows: year of publication, country of publication, purpose of the use of simulation, the target group, the target competency, the terms used/roles played by the simulator, who served as simulators, the theories referred to, and the key ideas and propositions advanced. The charted data was reviewed and validated by the first author. As appropriate, the data was analyzed in terms of frequency distribution and qualitative content analysis (Sandelowski, 2000).
Findings
The dataset comprising of 44 journal articles widely varied in scope and focus, including articles that outlined a teaching and learning approach, presented the evaluation of a teaching approach and a few theoretical articles laying out the importance and key considerations in simulation-based teaching and learning. The presentation of findings in this section follows the focus of this scoping review as outlined above: the characteristics of publications in terms of the years and countries of publication as well as funding sources, the purpose of simulation-based activities, the roles simulated and the terms used to refer to those roles, the target participants of the simulations and the settings in which they were undertaken, the theories invoked in the use of simulations and key propositions/assertions. The discussion of findings below starts with the characteristics of the studies as summed up in Table 1.
Characteristics of the Studies.
Characteristics of the Studies
The characteristics of the studies in terms of years and countries of publication provide a picture of the spread of work in the topic area across time and space. Overall, publications on the topic averaged 2.93 a year, with one to three articles a year in 11 of the 15 years. The publications peaked at eight in 2020. While there was a perceptible surge between 2017 and 2021, the trend did not suggest a steady growth in interest in this subject area. The publications were heavily centered in North America with 25 articles from the USA and 13 from Canada for a total of 38 of the 44 articles—more than 86% of the entire selection. Relatively little attention was given to the topic in the UK, Australia, and Finland, with nothing coming from countries like New Zealand, Singapore, and Hong Kong.
In terms of funding sources, over 70% (31 of the 44) of the articles provided no statement on funding. Two declared that there was no known competing interests (Chiu & Cross, 2020) or that the authors received no financial support for the project (Bogo et al., 2012). Eleven articles received funding from various sources, namely the San Diego State University (Keeney et al., 2022), the University of Toronto (Lee et al., 2021), the Stockton University (Lewis et al., 2020; Maynard, 2021), the Mount Sinai Hospital Auxiliary Board (Sollars & Xenakis, 2021), the UK Department for Education (Wilkins et al., 2018), the Social Sciences and Humanities Research Council of Canada (Bogo et al., 2013), the Larry Enkin Toronto Simulation Fund (Kourgiantakis et al., 2019; Sewell et al., 2020), and the US Center for Substance Abuse Treatment (Osborne et al., 2016; Sacco et al., 2017).
Our discussion of findings will now turn to more topic-specific details of the studies, namely: what the simulations were used for, the roles that were simulated as reflected in the terms used to refer to those roles, the intended targets of the simulation exercises including the settings in which the simulations were undertaken, the competency areas of focus, the theories referred to in the use of simulations and key assertions/points put forward in the articles. These are summed up in Table 2.
Full List of Selected Articles and Key Details.
Purpose of Simulation-Based Activities
We were interested in the distribution of emphasis given to the teaching of skills as opposed to the assessment of skills in the body of work being reviewed. We found a heavy focus on the teaching of skills and, to a much lesser extent, the assessment of skills, with 30 articles and 10 articles respectively. Only four of the 44 articles had a balanced focus on both. As to what skills were being taught form part of the discussion of key propositions/assertions below. The use of simulations in the assessment of practice skills included the assessment of students’ direct practice skills (Rawlings, 2012), meta-competence (Bogo et al., 2013), and supervision skills of supervisors and managers in the context of professional practice (Wilkins & Jones, 2018; Wilkins et al., 2018). In the evaluation of the targets’ (mostly students) performance, the approaches ranged from self-reports as in the case of Rubin and Francis (2019 to the use of standardized scales like Schreiber and Minarik's (2018) use of the Diversity and Oppression Scale. The Objective Structured Clinical Examination (OSCE) adapted for social work (Bogo et al., 2017; Bogo et al., 2012; Bogo et al., 2011; Lu et al., 2011) was the most widely used instrument for assessing practice skills. The OSCE, an existing examination traditionally used for health care professionals, was adapted for social work to measure competencies following simulation exercises with SCs/SPs (see, e.g., Bogo et al. [2011] and Bogo et al. [2017]).The OSCE involves the observation and rating of a 15-min interview with an SC and a written reflection along a set of standardized questions that are also rated using a scale (see, e.g., Bogo et al., 2012; Bogo et al., 2014).
Simulated Roles and Terms Used
We investigated the simulated roles and terms used to refer to the simulated roles taken on by the simulators to get a sense of the contexts in which the SBL was occurring. The majority of the articles, 28 of 44, spoke of “standardized clients,” “simulated clients,” or just “clients.” It is instructive to note that nine articles employed the language of “patient” with the use of the terms “standardized patients” or “simulated patients,” suggesting the influence of a medicine/health learning environment. Additionally, two of the SBL also involved simulated family members, doctors and care partners.
Target Participants and Settings
We also collated the “targets,” so to speak, of the SBL intervention. The vast majority of the articles, 38 of 44, involved students in the context of social work education. Four articles focused on social work professionals in range of practice settings, namely: child protection work, the army, health care, and child welfare work. Two of the articles involved social work managers with focus on supervisory skills.
Theoretical Framework
We were interested in scoping the extent of engagement with theory and the kinds of theories that were employed in the articles. We were mainly interested in learning and teaching theory, as opposed to, say for example, practice or subject matter theory or research theory. A significant number of articles, 32 out of the 44, made no reference to any theory. Across the rest of the articles, there was reference to adult learning principles (3), experiential learning theory (3), SBL (2), social learning theories (2), social cognitive theory (2), and psychodynamic and Bowenian theories, integrative pedagogy model, sociocultural theory, Paulo Freire's pedagogy, Self-Efficacy Theory, and a post-structural perspective. The use of psychodynamic and Bowenian theories in the sole article that used them was to explain why student-to-student role-plays are inherently problematic (see Duckham et al. [2013]). Overall, there was limited treatment of theory in discussions of the use of SCs in this body of literature.
Key Propositions/Assertions
The notable propositions and assertions that can be drawn from the articles relate to the: (1) reception of the use of simulations, (2) practice competencies being developed and (3) range of actors as client simulators employed.
Reception of the Use of SCs/Simulations. A number of articles focused on how simulations were received by students and educators. They indicated that simulations were well received by students who saw the use of SCs as a vital tool for enhancing their skills development (Maynard, 2021; Osborne et al., 2016). Students saw the use of SCs as providing a more realistic experience that more closely approximates actual work with clients (Dennison, 2011). Those who engaged in simulations that were supported by focused feedback and guided reflection reported an enhancement in knowledge, skills, professional judgment, and self-awareness (Kourgiantakis et al., 2019). Students reported that they learned more as an active participant of simulations as against just observing peers (Asakura et al., 2022). For teachers, actor SBL was very useful in addressing the limitations of written case studies and peer-to-peer role plays in teaching clinical social work practice, by increasing authenticity and student engagement (Lee et al., 2021) and creating “a structure for active learning” (Lee et al., 2020, p. 343).
Carter et al. (2018, p. 36) noted an important consideration in the use of paid actors that is rarely mentioned in literature—the additional financial and time resources needed in running simulations that might constitute additional workload that teaching staff absorb. These include the development of scenarios, the hiring of simulators and the training, coaching, supervision, and debriefing of simulators.
Competency Areas. A remarkably wide range of applications of simulations was noted across the 44 articles including client engagement, relationship building and interviewing skills (8), social work “practice skills” including communication skills (7), counselling/clinical/therapeutic skills (5), meta-competence/meta-cognition/wholistic competence (4), procedural competence (3), as well as practice skills in work with diverse clients (2), in alcohol screening and intervention (2), supervision (2), intimate partner violence (IPV) work, work with individuals and families, teamwork communication and collaboration, mental health, macro practice, health social work, diagnosing later-life depression, work with sexual minorities, cultural empathy, assessment and intervention strategies, interprofessional skills and child protection.
The articles detailed the use of simulations in developing a very wide range of practice skills starting more broadly with the integration of social work theory, knowledge, skills, and values into practice (Sunarich & Rowan, 2017), the development of student skills/competence and professional identity (Sollars & Xenakis, 2021) and to more specific direct practice skills such as helping skills, session management, and managing counselling challenges (Keeney et al., 2022), interprofessional practice (Nimmagadda & Murphy, 2014), communication skills in work with clients (Hyvärinen et al., 2024) and active listening skills (Rubin & Francis, 2019). Then, we noted a broad range applications of simulations in the development of a wide array of practice skills in more specialized contexts namely: the recognition of diversity in practice (Carter et al., 2018), IPV assessment (Forgey et al., 2013), mental health work (Lee et al., 2020), work with diverse clients (Lewis et al., 2020), macro practice (O’Brien et al., 2018), group practice (Schreiber & Minarik, 2018), meta competence (Bogo et al., 2012), clinical skills (Bragg et al., 2020) including recognizing later-life depression (Gellis & Kim, 2017), gay affirmative approaches (Logie et al., 2015), alcohol abuse interventions (Sacco et al., 2017), coping with emotions (Sewell et al., 2020), and end-of-life circumstances (Forrest & Derrick, 2010).
Simulations were seen as a valuable tool in preparing social work students for field education (Bragg et al., 2020; Phillips et al., 2018). Bogo et al. (2017, p. 580) spoke of simulations as a way of “bridging” classroom learning and field education. One notable exception was with Jefferies et al. (2023) who found that students developed more comprehensive psychosocial assessments when presented with video simulations compared to traditional methods, using actors or written case studies.
Simulators and the Medium. We looked at the “simulators” employed in the article. As would be expected, SBL activities mainly discussed “actors,” “paid actors,” or “professional actors” as simulators. In some cases, these actors were drawn from an in-house SP program being run by the university to serve the needs of a range of disciplines such as medicine and allied health (see Chiu & Cross, 2020; Sunarich & Rowan, 2017). This suggests an institutional, rather than a disciplinal, approach to the use of SPs and SCs. Besides paid actors, some initiative in SBL employed other—for lack of a better term—less conventional simulators although to a much lesser degree. These included drama, theatre and film and television students, service users, community volunteers, and social work clinicians/field instructors. The counts in Table 2 do not always total 44 since a few used a combination of simulators (e.g., drama students and service users) and two theoretical discussions did not involve the actual use of simulators.
The general consensus is that the use of professional/paid actors gives students the sense that they are able to “practice for professional interactions in the real world” (Carter et al., 2018, p. 36). However, there is room for other options. Duffy et al. (2021) compared the contribution of drama students with those of service users in preparing social work students for field practice, concluding that there is benefit from using both. Apart from the authenticity that paid actors and drama students can bring into simulations, Todd (2012) spoke of the potential contribution of improvisational theatre, with its principles of spontaneity and intuition, in the development of advanced practice skills, given how it allows us to reach into deep elements of practice, including unconscious and emotional knowledge, the relational nature of practice, and the variability and unpredictability that can go into interviews. Perhaps more importantly, Rubin and Francis (2019) noted the added value and educational benefits of employing field instructors and clinicians as SPs given how they can draw on direct practice experience, something that trained actors, TV, theatre, and drama students cannot provide.
Most of the simulations featured in the articles were done face-to-face. But in a world that is increasingly seeing digital communication as a mode of interaction, attention may have to be given to simulations in the digital space. Two articles prominently featured this manner of doing simulations (see Hyvärinen et al., 2024; Keeney et al., 2022).
Discussion and Applications to Practice
The findings in this scoping review suggest that there has been no steady growth in interest in this topic area and whatever attention that has been given to it continues to be heavily concentrated in a particular part of the English-speaking world. In their respective scoping reviews, Asakura et al., 2021 and Kourgiantakis et al. (2020) had charted an overwhelmingly heavy North American concentration in scholarship in this area and the findings in this current scoping review indicate that this remains to be the case. Notwithstanding the fact that seminal work in this area was done more than three decades ago, the use of simulations has yet to break ground in other countries and in particular practice areas. Cross et al. (2021, p. 1), for example, spoke of the provision of simulation training as “a new movement” in the training of child protection professionals. This is puzzling considering that the general consensus seems to be that simulations offer a level of authenticity in learning and assessment unmatched by any other pedagogical approach. A possible explanation for this is the significant resources required for such an initiative. Simulations in some universities are run through an institutional SP/SC program that support academic staff in recruiting, securing, and training needed talent. Even with such support, the running of simulations would still constitute workload beyond general standardized workload models. For academics who employ simulations in their teaching without such institutional support, this can constitute a rather sizable hidden workload that is difficult to initiate and sustain. If the use of simulations is to gain traction, an institutional approach that financially supports these teaching initiatives would have to be an integral part of the plan.
An important question around the use of simulations has to do with the focus/thrust of social work practice and education. There is a concerning bent towards competencies in individualist and clinical interventions. While Duffy et al.'s (2013, pp. 481, 487) argument on the value of SCs in developing “clinical skills” in the context of “therapeutic relationships” is not questionable, the individualist conceptions of social work and such interventions would need to be critically interrogated. For example, in discussing the application of simulations in motivational interviewing, Bragg et al. (2020, p. 242) had noted how “Social workers frequently encounter
If the use of simulations were to be taken as a given, there is also the question around what seems to be a widely accepted notion—that of a “standardized” client or patient. The idea is to ensure that the presentation of the client or patient or whatever role it is that is being simulated is consistent, following a set standard, across different learners. It can be argued that standardization would be an essential consideration in the use of simulations for assessment. Otherwise, the validity and reliability of assessments could be called into question. However, the drive towards standardization would have to be balanced with the drive for authenticity to the extent that unscripted responses and behaviors may be appropriate in certain scenarios. Todd's (2012) notes about the potential usefulness of improvisational theatre would be of relevance here which brings us to the question about the simulators.
The most widely used simulators appeared to be paid actors. The use of paid “professional” actors lends the exercise an air of credibility given the kind of training and skills they bring into the simulation. This makes the use of theatre and drama students, as featured in some of the articles, a less desirable option given the inevitable comparison between professionals and students. However, even the use of professional actors can be called into question. All the training in the world cannot make up for lived experience, perhaps something that some but not all paid actors can bring to the table. Given this, service user involvement in simulations becomes worthy of serious consideration, if only to acknowledge service users as knowledge holders and give flesh to the principles of co-production and service user involvement often invoked in social work education. It is telling, however, that only one (Duffy et al., 2021) of the 44 articles referred to the employment of service users in simulations.
A key limitation of this scoping review is that the search was confined to literature written in English. This rendered work and scholarship on this topic in non-English speaking countries beyond the scope of this review. There were also limitations in the search terms used. The search terms employed in this study may have excluded alternative terms more commonly used in other countries to refer to key concepts such as “social care.”
The review mapped the evidence on how simulations have been used in social work education and training in the last 15 years. In doing so, it provides a comprehensive overview of the current state of knowledge on this topic, offering valuable insights for social work educators and program developers. The review found limited interest in this topic across time and geographic space. Taking the merits of using live actors in SBL as a given, the findings point to the need to think though important considerations including the potentially heavy hidden workload implications for staff, the need to strike a balance between standardization and authenticity, the theoretical/pedagogical underpinnings informing the use of this teaching methodology and the place of end users and those with lived experience in the learning and teaching encounters. An overarching question that needs to be asked about the use of live actors for the development of social work competencies has to do with our understanding of social work itself. The findings point to the need for a critical examination in teaching practice and in research of the assumptions informing the use of simulations in social work education that take into consideration the tensions in competing understandings of social work (particularly relating to the structural versus individual debate) and consequent thrusts of social work education.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This scoping review was funded by the University of South Australia.
