Irvine Susan, Martin Jenepher
Medical Student Programs, Eastern Health Clinical School, Monash University and Deakin University, Victoria, Australia.
Clin Teach. 2014 Apr;11(2):94-8. doi: 10.1111/tct.12060.
There has been a shift from the initial learning of skills on patients in the clinical setting to initial learning in a simulated environment, using part-task models, with the risk of a task focus to the learning. We contend that quality learning in both the simulated and the clinical environment is crucial to enhance the transferability of skills to the clinical setting.
We describe teaching strategies, with the sequencing of events and increasing complexity, for the simulated training of basic procedural skills. These teaching strategies can be readily implemented into basic skills training to 'bridge' the gap between the simulated environment and the clinical setting.
We suggest that our approach takes basic skills training beyond a task-focused approach to exemplify clinical scenarios encountered in real life. We argue that there is a need to broaden the focus of medical student training in basic procedural skills, and that the use of a preceptor model of supervision in the clinical setting better enables the transferability of the skills. Although our strategies are based on learning theory, well-designed research is required to test the efficacy in improving medical student learning.
技能学习的方式已发生转变，从最初在临床环境中对患者进行技能学习，转向使用部分任务模型在模拟环境中进行初始学习，存在学习以任务为重点的风险。我们认为，在模拟环境和临床环境中的高质量学习对于提高技能向临床环境的可转移性至关重要。
我们描述了用于基本程序技能模拟训练的教学策略，包括事件的顺序安排和复杂性的增加。这些教学策略可以很容易地应用于基本技能训练，以“弥合”模拟环境与临床环境之间的差距。
我们建议，我们的方法将基本技能训练从以任务为重点的方法拓展，以举例说明现实生活中遇到的临床场景。我们认为有必要拓宽医学生基本程序技能训练的重点，并且在临床环境中使用带教监督模式能更好地实现技能的可转移性。虽然我们的策略基于学习理论，但需要精心设计的研究来测试其在改善医学生学习方面的效果。
