SPEAK: Simulated Practice to Explore Application of Knowledge (School of Pharmacy and Pharmaceutical Sciences)

Background

Trinity has a demographically varied student population, with entry routes including TAP, HEAR, DARE, mature student pathways, and international recruitment. This diversity brings a wide range of learning needs. While College support services are vital, inclusive teaching practices within Schools are equally important to help all students thrive.

Learning through failure is widely recognised as valuable in higher education, particularly in health sciences, where patient safety is paramount. However, psychological safety during early practice is essential across all disciplines. Students with weaker academic backgrounds, who experience sensory overload, or who find social interaction challenging, may find classroom-based first attempts especially daunting. Time and resource constraints also limit opportunities for individualised practice.

Motivation

This project arose from a wish to create a safe environment where students can practice alone yet receive feedback and repeat tasks without fearing judgment. This is especially beneficial for neurodivergent students, introverts, or those lacking a local support network. Flexibility in time and location ensures accessibility for students with long commutes or caregiving responsibilities.

The emergence of generative AI and emotionally adaptive avatars is a further motivation, enabling realistic, responsive, and inclusive simulations - broadening the range of patient interactions students can experience.

Relevance

While rooted in pharmacy education, SPEAK has relevance to any discipline involving dialogue (e.g., counselling, language learning, negotiation). It aligns with Trinity’s goals (including those in the draft Strategic Plan) concerning inclusive education, digital transformation, and effective communication as a graduate attribute, while offering a scalable model with potential for wide educational impact.

• Enable safe, independent practice of dialogue-based skills
  Provide students with realistic, AI-driven simulations to practice clinical and professional conversations without fear of stigma or failure.
• Promote inclusive learning experiences
  Design simulations that support neurodivergent and non-traditional students through customizable, sensory-aware, and repeatable practice environments. Patients appearing in simulations will also be diverse in their characteristics.
• Leverage generative AI within TCD’s existing digital infrastructure
  Use Trinity’s subscriptions to the greatest extent possible (while exploring the additional benefits that external tools such as A2E.ai avatars may confer) to deliver scalable, secure, and cost-effective simulations.
• Develop reusable simulation templates and guidance documents
  Create adaptable resources that can be replicated across disciplines involving dialogue (e.g., handovers, counselling, language learning, negotiation, advocacy, interviewing).
• Gather stakeholder insights
  During process of co-design and development with diverse students and other stakeholders, document feedback to inform future development and other inclusive educational practices.
• Evaluate performance and impact
  Assess tool performance, student learning, engagement, satisfaction and wellbeing using structured evaluation tools and analytics.
• Disseminate knowledge and encourage adoption
  Share knowledge, outcomes and toolkit to encourage wider uptake and further development of inclusive digital tools.

Note that several phases overlap. Furthermore, since an action research approach will be adopted, with iterative plan-act-observe-reflect cycles, these elements have been combined rather than presented as consecutive phases.

• Phase 0: Engagement with IT Services (July-Sept 2025)
  Designed to identify the optimal mechanism for managing the SPEAK project within College’s systems and initiate any required processes.

• Phase 1: Approval and stakeholder contact (Oct-Nov 2025)
  Ethics approval will be sought from the Faculty of Health Sciences Research Ethics Committee (FHS REC), since SPEAK will comprise a research project as well as an educational initiative and publication is planned. For this application, letters of support/access will be obtained from stakeholders. Participant documentation (recruitment material, participant information leaflets, consent forms), the consultation tools that will form part of co-creation (questionnaires, interview/focus group guides), and outcome evaluation tools (questionnaires, interview/focus group guides) for the later phases of the project will also be prepared for review by the Data Protection Officer (as part of the ethics approval process) and REC.
  Milestone: Ethics approval.

• Phase 2: Initial stakeholder consultation (Nov 2025)
  Recruitment and consultation with students. Consultation with Practice of Pharmacy academics, DisAbility Service, Student Learning Development, TAP Office, IT Services.

• Phase 3: Iterative case co-design, student testing and stakeholder review, refinement (Dec 2025-Feb 2027)

­   3a: 1 basic and 2 medium complexity cardiology-focused cases (Dec 2025-Dec 2026)
Development and testing primarily undertaken within framework of Senior Sophister and M.Pharm. research projects. Iterative action research cycles.
Milestone: Full working drafts by end May 2025.
Milestone: Refined and ready for main pilot (Part 1) with SF class by end Sept 2026; only minor refinement anticipated thereafter, based on pilot study outcomes.

­   3b: 2 high complexity cardiology-focused cases (April 2026-Dec 2026)
Utilising A2E.ai avatars and building on prior learning from Phase 3a.
Milestone: Refined and ready for main pilot (Part 1) with SF class by end Sept 2026; only minor refinement anticipated thereafter, based on pilot study outcomes.

­   3c: 1 basic, 2 medium, 2 high complexity infection-focused cases (Sept 2026-Feb 2027)
Building on prior learning from Phases 3a and 3b. Primarily undertaken within framework of St Louis College of Pharmacy Advanced Pharmacy Practice Experience elective (visiting Pharm.D. students under my supervision) and Senior Sophister pharmacy projects.
Milestone: Refined and ready for main pilot (Part 2) with SF class by mid-Jan 2027; only minor refinement anticipated thereafter, based on pilot study outcomes.

• Phase 4: Iterative architecture and workflow development, testing and refinement (Dec 2025-Jan 2027)
  In parallel with cases, the system’s architecture and workflow will be developed, trialed and refined. Integration of A2E.ai will commence in April 2026, so only 1 year’s subscription (Apr 2026-Mar 2027) will be required, while still accommodating pre-pilot testing/refinement of this element and the two main pilot phases.
  Milestone: Fully working systems by Sept 2026.
  Milestone: Fully refined systems by Jan 2027 (i.e. after main pilot Part 1 and feedback from wider College community).

• Phase 5: Development of replication toolkit (Dec 2025-Mar 2027)
  Documentation of workflows, challenges, solutions etc. will take place throughout the project (Dec 2025-Feb 2027). These will be synthesized and refined into the final toolkit (informed by trialing by naïve users) from Dec 2026-March 2027).
  Milestone: Final toolkit by mid-March 2027.

• Phase 6: Piloting with full SF Pharmacy class
  Two phases of full-class piloting will enable any adaptations arising from the first pilot to be evaluated. The themes (cardiology and infection) align with the SF Pharmacy Objective Structured Clinical Examination (OSCE) themes in semesters 1 and 2.

­   Part 1: Piloting of 5 cardiology cases (Oct/Nov 2026)
Milestone: Analysis and implementation of pilot outcomes by mid-Dec 2026.

­   Part 2: Piloting of 5 infection cases (Jan/Feb 2027).
Milestone: Analysis and implementation of pilot outcomes by mid-Mar 2027.

• Phase 7: Dissemination to, and consultation, of wider academic community (Dec 2026-Feb 2027)
  Following refinement arising from the SF student class pilot, the five cardiology cases and a questionnaire will be shared with the wider College community to raise awareness and gauge interest in SPEAK, as well as to solicit broader feedback from academic stakeholders and inform refinement of both the simulations and the replication toolkit.
  Milestone: Analysis and implementation of feedback completed by end Feb 2027.
  Milestone: Invitation to all interested parties to join community of practice via SharePoint where replication toolkit will be hosted (March 2027 and open thereafter).
  Note that further dissemination will take place after the 18-month project timeframe.

• Phase 8: Data collection and analysis (Nov 2025-Mar 2027)
  Data collection and analysis will be ongoing throughout the project, in keeping with its action research approach. Besides ongoing informal feedback from stakeholders collaborating in SPEAK’s design and development, plus data generated by the simulation system throughout the project, key data collection points will be:

­   SF Pharmacy student feedback after each of the two main pilots (Nov 2026, Feb 2027): Wide reach through anonymous surveys and richer qualitative data through targeted interviews and focus groups.

College community feedback after sample circulation (Dec 2026).

Tangible deliverables

• Simulation hub hosting 10 pharmacy-specific simulations at various complexity levels (written/oral dialogue, with/without avatars, with/without feedback).
• Evaluation tools and metrics
• Case studies: Documented examples of simulations in use showcasing implementation and impact.
• Replication toolkit on SharePoint site
  • Technical integration framework and workflow
  • Simulation and feedback templates
  • Guidance documentation comparing development approaches and functionality.
• Insights into diverse students’ needs and preferences; student usage and feedback.
• Dissemination outputs: Conference presentations, journal articles, community of practice.

Other benefits

• Improved student learning, confidence and readiness for practice.
• Greater inclusivity in learning.
• Institutional leadership: Trinity positions itself as a leader in ethical, inclusive, and scalable use of generative AI for simulation, feedback and assessment in higher education.
• Staff professional development: Experience with AI tools, simulation design, and inclusive pedagogy, with the potential to inform Trinity’s broader strategy on these matters.
• Encouragement of cross-disciplinary collaborative partnerships, fostering interdisciplinary innovation.