Evaluating clinical simulations for learning procedural skills: A theory-based approach
Evaluating clinical simulations for learning procedural skills: A theory-based approach
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DOI：
10.1097/00001888-200506000-00006
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发表时间：
2005-06-01
影响因子：
7.4
通讯作者：
Kneebone, R
中科院分区：
文献类型：
--
作者：
Kneebone, R
基于模拟的学习正在医学教育中广泛建立。它为初学者学习侵入性手术技能提供了明显的好处，特别是在临床暴露减少的环境中。然而，模拟往往被接受不加批判，与不适当的重点放在技术的复杂性，以牺牲理论为基础的design.The作者提出了四个关键领域，支持基于模拟的学习，并总结了每个的理论基础。这些是（1）获得技术熟练度（心理学技能和学习理论，反复练习和定期强化的重要性），（2）专家援助的地方（维果茨基对辅导员支持的解释，即根据每个学习者的需要提供帮助），（3）在专业背景下学习（情境学习与当代学徒制理论）;（4）学习的情感成分（情绪对学习的影响）。作者然后提供了批判性地评估新的或现有的模拟的四个标准，基于上述理论框架。这些是：（1）模拟应允许在安全的环境中进行持续的、有意识的练习，确保最近获得的技能在确定的课程中得到巩固，确保定期强化;（2）模拟应在适当时提供专家导师，确保这种支持在不再需要时消失;（3）模拟应映射到现实生活中的临床经验，确保学习支持在实际实践社区中获得的经验;（4）模拟学习环境应提供一个支持性、激励性和以学习者为中心的环境，这有利于学习。
Simulation-based learning is becoming widely established within medical education. It offers obvious benefits to novices learning invasive procedural skills, especially in a climate of decreasing clinical exposure. However, simulations are often accepted uncritically, with undue emphasis being placed on technological sophistication at the expense of theory-based design.The author proposes four key areas that underpin simulation-based learning, and summarizes the theoretical grounding for each. These are (1) gaining technical proficiency (psychomotor skills and learning theory, the importance of repeated practice and regular reinforcement), (2) the place of expert assistance (a Vygotskian interpretation of tutor support, where assistance is tailored to each learner's needs), (3) learning within a professional context (situated learning and contemporary apprenticeship theory), and (4) the affective component of learning (the effect of emotion on learning).The author then offers four criteria for critically evaluating new or existing simulations, based on the theoretical framework outlined above. These are: (1) Simulations should allow for sustained, deliberate practice within a safe environment, ensuring that recently-acquired skills are consolidated within a defined curriculum which assures regular reinforcement; (2) simulations should provide access to expert tutors when appropriate, ensuring that such support fades when no longer needed; (3) simulations should map onto real-life clinical experience, ensuring that learning supports the experience gained within communities of actual practice; and (4) simulation-based learning environments should provide a supportive, motivational, and learner-centered milieu which is conducive to learning.