Health Policy - Vaca Virus simulation on HP412 Global Health Security

HP412 MSc students -

This simulation proved to be an effective, engaging introduction to the reality of health-policy making. Through this experience, I was exposed to realistic difficulties in navigating complex health environments... simulations should be considered as an option for cumulative assignments across disciplines.

The lessons I learned over the course of twelve weeks taught me varying approaches and unique problems within health emergency responses. Taking part in the simulation revealed the nature of policymaking and clarified why mismatched responses often come into effect.

By choosing to stay in character, I had to make blatantly uncomfortable decisions, but the benefit in doing so provided me the ability to understand shortcomings in global health security. If we can better see what goes wrong, we can work harder to improve it.

Name

Clare Wenham

Department

Health Policy

Overview

This was a one-day simulation activity on the course HP412 Global Health Security, which recreated the governance decisions of an outbreak of ‘Vaca Virus’ in the country of ‘Esperanza’. Students were allocated to small groups, each taking on a different role in stakeholder groups in either Esperanza or in external organizations. The activity unfolded over the course of the day with new information, such as the development of vaccines, civil unrest and community resistance, which each actor had to react to in real time.

This project was facilitated by the Eden Catalyst fund.

Target audience

MSc Students taking HP412 (Global Health Security).

Details

I used the catalyst grant fund for two purposes:

- Firstly, I hired a research assistant to help me plan the simulation activity. I had decided that I needed to create a fictional pandemic outbreak, so students did not come in with differing levels of prior knowledge. The RA supported the development of the fictional background material to disseminate for students.

- Secondly, I created reusable simulation materials – video / sound content and laminated flash cards with media material and print.

The timeline on this was approximately 2-3 months, as the RA only worked part time and we had to fit this in around teaching and other requirements.

In advance of the simulation activity, students were provided, via Moodle, with:

background information about the history, economy and health systems of the fictional countries of Esperanza and its neighbour Azacion
details of the Vaca virus, including symptoms, transmission, treatment and prevention
character profiles for each of the groups that the students would role play during the simulation – various Esperanza government departments, the Beef Industry Lobby; The World Bank; The World Health Organization; Azacion Government; International Federation of Red Cross and Red Crescent; The Children of Diaz-Santiago Party (the CDSP); Medecins Sans Frontieres; Pointus (Pharmaceutical Company)

The simulation activity itself took place over 8 hours in a single day towards the end of term and involved four phases. Play card packs were handed out to the various interest groups and NGOs depending on their aim/mission. Students had to respond, in their groups, as the simulation unfolded across the day.

Academic support was provided by me and a colleague, and technical support was provided by colleagues from the Eden Centre

Assessment was in the form of a reflective blog post, with students choosing between one of three possible approaches:

How the simulation went from the perspective of the stakeholder played by the student
How the student applied learning from across the course into the work in the simulation.
The student’s personal experience and performance of the simulation, from a skills / personal / learning perspective.

I wanted to run this for two reasons. Firstly, I wanted to bring to life all the discussions we had been having in class about outbreaks. It’s very easy to sit and listen to a lecture, but I wanted to get students to think about how an outbreak actually plays out, who knows what information, what impact does fake news have, how difficult some decisions can be to make, and when these decisions depart from the “best” public health advice and are political etc. Secondly, pedagogically I think it is interesting to try new things, and to learn through participation offered just this opportunity. I wanted to know whether students would appreciate different parts of the course or topic, and whether this learning would have greater longevity.

Impact

Students really engaged in the simulation to the extent that I was very surprised. They had all done considerable preparation, made their own pre-materials, performed the characters they were assigned and learned what it was like to be in the moment when the tyranny of the urgent can supersede the most rational decision-making.

Several students told me on the day and subsequently within the reflective assessment linked to the simulation activity that they learned a lot. They gained different perspectives and insights from studying literature or learning in a routine lecture/class format. They also demonstrated that they had learning beyond the academic, and learned about negotiation practises and even team work when members are not on the same page.

Next steps

This simulation will remain a key part of my course for the years to come. The experience this year gave me greater confidence to run the simulation effectively, and make small adjustments to the material and day plan. For example – I think that the last phase (there were a total of 4) is where it started to fall apart. Students were tired, and the material of the fourth phase got a bit more far-fetched and more linked to politics than health security per se. I will reflect whether to remove this fourth phase entirely and just focus on the three initial ones, or whether I just need to change the content of this last part to keep students on track.

I also plan to write about this experience for publication.

I would encourage interested colleagues to go for it! It was a lot of work to bring this together, and required lots of imagining (and guessing) what students may or may not think in a given situation. However, it was a great experience on the day and well worth all the effort.

I think creating our simulation from a fictional event was crucial, so that particular students didn’t come with pre-formulated plans based on actual events – however, this is not without its challenges to ensure there is enough material and consistency.

Students also valued the different media formats – both press releases, newspaper clippings, tweets, radio updates and video clips.

A final gap that I think needs to be considered is how to ensure that all students have the same “amount” of work on the day. Some of the groups I created had a more pertinent role than others – for example, the Ministry of Health was in demand all day, compared to the beef lobby etc.

Colleagues considering developing their own simulation activity might also be interested in the LSE simulation special interest group LSE SIM-SIG. This is a practice exchange group for colleagues who are planning to use, or are currently using, simulations in the classroom. LSE SIM-SIG will meet once a term, and there is an online space to share resources and support. To join LSE SIM-SIG contact Jenni Carr (j.carr4@lse.ac.uk).