Division of General Internal Medicine, Mayo Medical School, MN 55905, USA.
Med Teach. 2013;35(1):e867-98. doi: 10.3109/0142159X.2012.714886. Epub 2012 Sep 3.
Although technology-enhanced simulation is increasingly used in health professions education, features of effective simulation-based instructional design remain uncertain.
Evaluate the effectiveness of instructional design features through a systematic review of studies comparing different simulation-based interventions.
We systematically searched MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Scopus, key journals, and previous review bibliographies through May 2011. We included original research studies that compared one simulation intervention with another and involved health professions learners. Working in duplicate, we evaluated study quality and abstracted information on learners, outcomes, and instructional design features. We pooled results using random effects meta-analysis.
From a pool of 10,903 articles we identified 289 eligible studies enrolling 18,971 trainees, including 208 randomized trials. Inconsistency was usually large (I2 > 50%). For skills outcomes, pooled effect sizes (positive numbers favoring the instructional design feature) were 0.68 for range of difficulty (20 studies; p < 0.001), 0.68 for repetitive practice (7 studies; p = 0.06), 0.66 for distributed practice (6 studies; p = 0.03), 0.65 for interactivity (89 studies; p < 0.001), 0.62 for multiple learning strategies (70 studies; p < 0.001), 0.52 for individualized learning (59 studies; p < 0.001), 0.45 for mastery learning (3 studies; p = 0.57), 0.44 for feedback (80 studies; p < 0.001), 0.34 for longer time (23 studies; p = 0.005), 0.20 for clinical variation (16 studies; p = 0.24), and -0.22 for group training (8 studies; p = 0.09).
These results confirm quantitatively the effectiveness of several instructional design features in simulation-based education.
尽管科技增强模拟在医疗保健专业教育中越来越多地被使用，但有效的基于模拟的教学设计特征仍然不确定。
通过系统地回顾比较不同模拟干预措施的研究，评估教学设计特征的有效性。
我们通过系统搜索 MEDLINE、EMBASE、CINAHL、ERIC、PsycINFO、Scopus、主要期刊和之前的综述文献，截至 2011 年 5 月。我们纳入了原始研究，比较了一种模拟干预与另一种模拟干预，并涉及医疗保健专业学习者。我们采用随机效应荟萃分析合并结果。
从 10903 篇文章中，我们确定了 289 项符合条件的研究，共纳入 18971 名学员，包括 208 项随机试验。不一致性通常很大（I2>50%）。对于技能结果，汇集的效应大小（有利于教学设计特征的正数）为难度范围（20 项研究；p<0.001）0.68、重复练习（7 项研究；p=0.06）0.68、分布式练习（6 项研究；p=0.03）0.66、互动性（89 项研究；p<0.001）0.65、多种学习策略（70 项研究；p<0.001）0.62、个性化学习（59 项研究；p<0.001）0.52、掌握学习（3 项研究；p=0.57）0.45、反馈（80 项研究；p<0.001）0.44、时间更长（23 项研究；p=0.005）0.34、临床变异（16 项研究；p=0.24）0.20，以及小组培训（8 项研究；p=0.09）-0.22。
这些结果定量证实了基于模拟教育中几种教学设计特征的有效性。
