Department of Pediatrics, Alberta Children's Hospital and University of Calgary, Calgary, Canada;
Division of Neonatology, Department of Pediatric and Adolescent Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota;
Pediatrics. 2014 May;133(5):e1313-23. doi: 10.1542/peds.2013-2139. Epub 2014 Apr 14.
Pediatrics has embraced technology-enhanced simulation (TES) as an educational modality, but its effectiveness for pediatric education remains unclear. The objective of this study was to describe the characteristics and evaluate the effectiveness of TES for pediatric education.
This review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards. A systematic search of Medline, Embase, CINAHL, ERIC, Web of Science, Scopus, key journals, and previous review bibliographies through May 2011 and an updated Medline search through October 2013 were conducted. Original research articles in any language evaluating the use of TES for educating health care providers at any stage, where the content solely focuses on patients 18 years or younger, were selected. Reviewers working in duplicate abstracted information on learners, clinical topic, instructional design, study quality, and outcomes. We coded skills (simulated setting) separately for time and nontime measures and similarly classified patient care behaviors and patient effects.
We identified 57 studies (3666 learners) using TES to teach pediatrics. Effect sizes (ESs) were pooled by using a random-effects model. Among studies comparing TES with no intervention, pooled ESs were large for outcomes of knowledge, nontime skills (eg, performance in simulated setting), behaviors with patients, and time to task completion (ES = 0.80-1.91). Studies comparing the use of high versus low physical realism simulators showed small to moderate effects favoring high physical realism (ES = 0.31-0.70).
TES for pediatric education is associated with large ESs in comparison with no intervention. Future research should include comparative studies that identify optimal instructional methods and incorporate pediatric-specific issues into educational interventions.
儿科学已经将技术增强模拟（TES）作为一种教育模式，但其在儿科教育中的有效性仍不清楚。本研究的目的是描述 TES 的特点，并评估其在儿科教育中的有效性。
本综述符合 PRISMA（系统评价和荟萃分析的首选报告项目）标准。通过 2011 年 5 月前的 Medline、Embase、CINAHL、ERIC、Web of Science、Scopus、主要期刊和先前综述文献的系统搜索，以及 2013 年 10 月后的更新 Medline 搜索，选择了任何语言的原始研究文章，评估了 TES 在任何阶段用于教育医疗保健提供者的使用情况，内容仅关注 18 岁或以下的患者。审查员以重复的方式摘要信息学习者、临床主题、教学设计、研究质量和结果。我们分别对模拟环境中的技能（模拟环境）进行编码，并按时间和非时间措施对患者护理行为和患者效果进行类似分类。
我们确定了 57 项使用 TES 教授儿科学的研究（3666 名学习者）。使用随机效应模型汇总效果大小（ES）。在比较 TES 与无干预的研究中，知识、非时间技能（如模拟环境中的表现）、与患者的行为以及任务完成时间的综合结果的 ES 较大（ES = 0.80-1.91）。比较高物理逼真度模拟器与低物理逼真度模拟器使用情况的研究显示，高物理逼真度的 ES 较小到中等（ES = 0.31-0.70）。
与无干预相比，TES 在儿科教育中具有较大的 ES。未来的研究应包括比较研究，确定最佳教学方法，并将儿科特定问题纳入教育干预措施中。
