Introduction:

Autism is characterised by lifelong differences in communication, behaviour, and social interaction [1]. Despite growing recognition of autistic individuals in healthcare professions [2], little is known about supporting autistic learners in simulation-based healthcare education (SBHE). This scoping review aimed to identify existing research on autistic learners in SBHE, map the current evidence base, and identify gaps to inform future research and educational practice.

Methods:

We conducted a formal scoping review following PRISMA-ScR guidelines in May 2024 [3]. A comprehensive search strategy was developed with assistance from a research librarian, and the protocol was prospectively registered with the Open Science Framework on 12 April 2024. Eligibility criteria included studies involving autistic learners in simulation-based healthcare education contexts. We searched multiple databases between 1 January 2000 and 15 May 2024, identifying 1457 potentially relevant articles.

Results:

Despite a thorough search, no studies met our inclusion criteria, revealing a significant gap in the literature regarding autistic learners in SBHE. Through synthesis of related evidence from autism in higher education and healthcare settings, we identified potential challenges autistic learners may face in SBHE: sensory over-responsivity [1], difficulties with interpersonal communication underpinned by the ‘double empathy problem’ [3], imagination differences affecting suspension of disbelief, and distinct information processing patterns including weak central coherence.

Discussion:

We suggest adapting the Autistic SPACE framework [2] - originally developed for supporting autistic patients - to address the needs of autistic learners in SBHE. This approach emphasises considerations for Sensory needs, Predictability, Acceptance, Communication, and Empathy, providing structured recommendations for creating more inclusive simulation environments. Further research directly examining the experiences of autistic learners in SBHE is urgently needed to develop evidence-based support strategies.

Ethics Statement:

As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

References

1. Tavassoli T, Miller LJ, Schoen SA, et al. Sensory over-responsivity in adults with autism spectrum conditions. Autism. 2014;18(4):428–432.

2. Doherty M, McCowan S, Shaw SC. Autistic SPACE: a novel framework for meeting the needs of autistic people in healthcare settings. Br J Hosp Med. 2023;84(4):1–9.

3. Milton DEM. On the ontological status of autism: the ‘double empathy problem.’ Disability & Society. 2012;27(6):883–887.