The minimal relationship between simulation fidelity and transfer of learning
The minimal relationship between simulation fidelity and transfer of learning
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DOI：
10.1111/j.1365-2923.2012.04243.x
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发表时间：
2012-07-01
影响因子：
6
通讯作者：
Grierson, Lawrence
中科院分区：
文献类型：
--
作者：
Norman, Geoff;Dore, Kelly;Grierson, Lawrence
医学教育2012环境高保真模拟器越来越受欢迎，尽管成本可能接近六位数。这是合理的，因为模拟器已经被证明可以产生大量的学习收益，这些学习收益可能会转移到实际的患者护理情况中。然而，最常见的是，从模拟器中学习与在非干预控制组中学习进行比较。这未能澄清模拟器保真度和学习之间的关系，以及是否可以以低得多的成本实现类似的收益。目的对基于临床表现的高保真模拟(HFS)和低保真模拟(LFS)学习的比较研究进行综述。方法使用多种搜索策略，共找到24项对比HFS和LFS的研究，并包括一些性能测量。这些研究涉及三个领域的学习：听诊技能、外科技术和复杂的管理技能，如心脏复苏。结果与非干预控制组相比，HFS和LFS学习均导致学习成绩的持续提高。然而，几乎所有的研究都表明，HFS与LFS相比没有明显的优势，平均差异在1%到2%之间。讨论影响学习的因素以及这一令人惊讶的发现的原因。
Medical Education 2012 Context High-fidelity simulators have enjoyed increasing popularity despite costs that may approach six figures. This is justified on the basis that simulators have been shown to result in large learning gains that may transfer to actual patient care situations. However, most commonly, learning from a simulator is compared with learning in a no-intervention control group. This fails to clarify the relationship between simulator fidelity and learning, and whether comparable gains might be achieved at substantially lower cost. Objectives This analysis was conducted to review studies that compare learning from high-fidelity simulation (HFS) with learning from low-fidelity simulation (LFS) based on measures of clinical performance. Methods Using a variety of search strategies, a total of 24 studies contrasting HFS and LFS and including some measure of performance were located. These studies referred to learning in three areas: auscultation skills; surgical techniques, and complex management skills such as cardiac resuscitation. Results Both HFS and LFS learning resulted in consistent improvements in performance in comparisons with no-intervention control groups. However, nearly all the studies showed no significant advantage of HFS over LFS, with average differences ranging from 1% to 2%. Discussion The factors influencing learning, and the reasons for this surprising finding, are discussed.