Department of Medicine, University of Toronto, Ontario, Canada.
Simul Healthc. 2012 Aug;7(4):236-42. doi: 10.1097/SIH.0b013e31825993f2.
Educators often simplify complex tasks by setting learning objectives that focus trainees on isolated skills rather than the holistic task. We designed 2 sets of learning objectives for intravenous catheterization using goal setting theory. We hypothesized that setting holistic goals related to technical, cognitive, and communication skills would result in superior holistic performance, whereas setting isolated goals related to technical skills would result in superior technical performance.
We randomly assigned practicing health care professionals to set holistic (n = 14) or isolated (n = 15) goals. All watched an instructional video and studied a list of 9 goals specific to their group. Participants practiced independently in a hybrid simulation (standardized patient combined with an arm simulator). The first and the last practice trials were videotaped for analysis. One-week later, participants completed a transfer test in another hybrid simulation scenario. Blinded experts evaluated performance on all 3 trials using the Direct Observation of Procedural Skills tool.
The holistic group scored higher than the isolated group on the holistic Direct Observation of Procedural Skills score for all 3 trials [mean (SD), 45.0 (9.16) vs. 38.4 (9.17); P = 0.01]. The isolated group did not perform better than the holistic group on the technical skills score [10.3 (2.73) vs. 11.6 (3.01); P = 0.11].
Our results suggest that asking learners to set holistic goals did not interfere with their attaining competent holistic and technical skills during hybrid simulation training. This exploratory trial provides preliminary evidence for how to consider integrating hybrid simulation into medical curricula and for the design of learning goals in simulation-based education.
教育者经常通过设定专注于孤立技能而非整体任务的学习目标来简化复杂任务。我们使用目标设定理论为静脉置管术设计了 2 组学习目标。我们假设设定与技术、认知和沟通技能相关的整体目标将导致整体表现更好，而设定与技术技能相关的孤立目标将导致技术表现更好。
我们随机分配有经验的医疗保健专业人员设定整体（n = 14）或孤立（n = 15）目标。所有人都观看了教学视频并研究了与他们小组相关的 9 个目标列表。参与者在混合模拟（标准患者与手臂模拟器相结合）中独立练习。第一次和最后一次练习试验都被录像以供分析。一周后，参与者在另一个混合模拟场景中完成转移测试。盲法专家使用直接观察手术技能工具评估所有 3 次试验的表现。
在所有 3 次试验中，整体组的整体直接观察手术技能评分均高于孤立组[平均值（SD），45.0（9.16）与 38.4（9.17）；P = 0.01]。孤立组在技术技能评分上并未优于整体组[10.3（2.73）与 11.6（3.01）；P = 0.11]。
我们的结果表明，要求学习者设定整体目标不会干扰他们在混合模拟培训期间获得整体和技术熟练程度。这项探索性试验为如何考虑将混合模拟纳入医学课程以及设计基于模拟的教育中的学习目标提供了初步证据。
