Hatala Rose, Cook David A, Zendejas Benjamin, Hamstra Stanley J, Brydges Ryan
Department of Medicine, University of British Columbia, Vancouver, BC, Canada,
Adv Health Sci Educ Theory Pract. 2014 May;19(2):251-72. doi: 10.1007/s10459-013-9462-8. Epub 2013 May 28.
Although feedback has been identified as a key instructional feature in simulation based medical education (SBME), we remain uncertain as to the magnitude of its effectiveness and the mechanisms by which it may be effective. We employed a meta-analysis and critical narrative synthesis to examine the effectiveness of feedback for SBME procedural skills training and to examine how it works in this context. Our results demonstrate that feedback is moderately effective during procedural skills training in SBME, with a pooled effect size favoring feedback for skill outcomes of 0.74 (95 % CI 0.38-1.09; p < .001). Terminal feedback appears more effective than concurrent feedback for novice learners' skill retention. Multiple sources of feedback, including instructor feedback, lead to short-term performance gains although data on long-term effects is lacking. The mechanism by which feedback may be operating is consistent with the guidance hypothesis, with more research needed to examine other mechanisms such as cognitive load theory and social development theory.
尽管反馈已被确定为基于模拟的医学教育（SBME）中的关键教学特征，但我们仍不确定其有效性的程度以及其可能有效的机制。我们采用了荟萃分析和批判性叙述综合法，以检验反馈对SBME程序技能培训的有效性，并研究其在这种情况下的作用方式。我们的结果表明，在SBME的程序技能培训中，反馈具有中等效果，汇总效应量显示反馈对技能结果的支持率为0.74（95%置信区间0.38-1.09；p<.001）。对于新手学习者的技能保持，终结性反馈似乎比同期反馈更有效。包括教师反馈在内的多种反馈来源可带来短期的绩效提升，但缺乏关于长期效果的数据。反馈可能起作用的机制与指导假设一致，需要更多研究来检验其他机制，如认知负荷理论和社会发展理论。
