Reconsidering Fidelity in Simulation-Based Training
Reconsidering Fidelity in Simulation-Based Training
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DOI：
10.1097/acm.0000000000000130
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发表时间：
2014-03-01
影响因子：
7.4
通讯作者：
Cook, David A.
中科院分区：
文献类型：
--
作者：
Hamstra, Stanley J.;Brydges, Ryan;Cook, David A.
在基于模拟的卫生职业教育中，模拟器保真度的概念通常被理解为模拟器看起来、感觉上和行为像人类病人的程度。虽然这可能是设计模拟器的有用指南，但这个定义强调的是技术进步和物理相似，而不是教育有效性的原则。事实上，几项实证研究表明，忠诚度似乎与教育效果无关。作者在最近对基于模拟的卫生职业教育进行系统审查时遇到了这些问题，在这个角度下，他们利用他们进行审查的经验来检查围绕模拟保真度这一主题的关键概念和假设。几个典型的与忠诚度相关的概念在解释教育效果时更有用，如学习迁移、学习者参与和暂停怀疑。鉴于这些概念更直接地影响学习体验的性质，作者提出了以下建议：(1)在基于模拟的卫生职业教育中摒弃保真度一词，代之以反映物理相似和功能任务排列的基本概念；(2)从目前强调物理相似转向关注模拟器与应用环境之间的功能对应；以及(3)关注使用学习迁移、学习者参与和暂停不相信的原则来提高教育有效性的方法。这些建议为基于模拟的卫生职业教育的研究人员阐明了基本概念，并将有助于推动这一新兴领域的发展。
In simulation-based health professions education, the concept of simulator fidelity is usually understood as the degree to which a simulator looks, feels, and acts like a human patient. Although this can be a useful guide in designing simulators, this definition emphasizes technological advances and physical resemblance over principles of educational effectiveness. In fact, several empirical studies have shown that the degree of fidelity appears to be independent of educational effectiveness. The authors confronted these issues while conducting a recent systematic review of simulation-based health professions education, and in this Perspective they use their experience in conducting that review to examine key concepts and assumptions surrounding the topic of fidelity in simulation. Several concepts typically associated with fidelity are more useful in explaining educational effectiveness, such as transfer of learning, learner engagement, and suspension of disbelief. Given that these concepts more directly influence properties of the learning experience, the authors make the following recommendations: (1) abandon the term fidelity in simulation-based health professions education and replace it with terms reflecting the underlying primary concepts of physical resemblance and functional task alignment; (2) make a shift away from the current emphasis on physical resemblance to a focus on functional correspondence between the simulator and the applied context; and (3) focus on methods to enhance educational effectiveness using principles of transfer of learning, learner engagement, and suspension of disbelief. These recommendations clarify underlying concepts for researchers in simulation-based health professions education and will help advance this burgeoning field.