Morgan Pamela J, Cleave-Hogg Doreen, Desousa Susan, Lam-McCulloch Jenny
Department of Anesthesia, Sunnybrook & Women's College Health Sciences Centre, University of Toronto, Canada.
Med Teach. 2006 Feb;28(1):e10-5. doi: 10.1080/01421590600568488.
High-fidelity patient simulation allows students to apply their theoretical knowledge of pharmacology and physiology to practice. The purpose of this study was to determine if experiential education using high-fidelity simulation improves undergraduate performance scores on simulation-based and written examinations. After receiving research ethics board approval, students completed a consent form and then answered a ten question multiple-choice quiz to identify their knowledge regarding the management of cardiac arrhythmias. Four simulation scenarios were presented and students worked through each scenario as a team. Faculty facilitated the sessions and feedback was given using students' videotaped performances as a template for discussion. Performance evaluation scores using predetermined checklists and global rating scales were completed. Students then reviewed the American Heart Association guidelines for the management of unstable cardiac arrhythmias. The afternoon session involved repetition of the four case scenarios with the same teams involved but different team leaders. Students then repeated the quiz they received in the morning. Descriptive statistics, paired t-test and repeated measures analysis of variance (ANOVA) were used to analyse results. Two hundred and ninety-nine students completed the study. There was a statistically significant improvement in performance on the pharmacology written test. Simulation team performance also statistically improved and a good correlation between checklist and global rating scores were demonstrated in all but one scenario. Student evaluation of the experience was extremely positive. High-fidelity simulation can be used to allow students to apply theoretical knowledge to practice in a safe and realistic environment. Results of this study indicate that simulation is a valuable learning experience and bridges the gap between theory and practice. Simulation technology has the potential to provide an enriching venue to examine the role of communication and dynamics of novice learners in team environments.
高保真患者模拟使学生能够将药理学和生理学的理论知识应用于实践。本研究的目的是确定使用高保真模拟的体验式教育是否能提高本科生在基于模拟的考试和笔试中的成绩。在获得研究伦理委员会批准后，学生们填写了一份同意书，然后回答了一份十道题的多项选择题测验，以确定他们关于心律失常管理的知识。呈现了四个模拟场景，学生们以团队形式完成每个场景。教师协助指导课程，并以学生的录像表现作为讨论模板提供反馈。使用预先确定的检查表和整体评分量表完成绩效评估分数。然后，学生们复习了美国心脏协会关于不稳定心律失常管理的指南。下午的课程涉及相同团队但不同团队领导重复四个病例场景。然后，学生们重复了他们上午进行的测验。使用描述性统计、配对t检验和重复测量方差分析（ANOVA）来分析结果。299名学生完成了这项研究。药理学笔试成绩有统计学上的显著提高。模拟团队的表现也有统计学上的改善，除了一个场景外，在所有场景中检查表和整体评分分数之间都显示出良好的相关性。学生对该体验的评价非常积极。高保真模拟可用于让学生在安全和现实的环境中将理论知识应用于实践。本研究结果表明，模拟是一种有价值的学习体验，弥合了理论与实践之间的差距。模拟技术有可能提供一个丰富的场所，以检验新手学习者在团队环境中的沟通作用和动态。
