Ryall Tayne, Judd Belinda K, Gordon Christopher J
Physiotherapy Department, Canberra Hospital, ACT Health, Canberra, ACT, Australia.
Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia; Sydney Nursing School, The University of Sydney, Sydney, NSW, Australia.
J Multidiscip Healthc. 2016 Feb 22;9:69-82. doi: 10.2147/JMDH.S92695. eCollection 2016.
The use of simulation in health professional education has increased rapidly over the past 2 decades. While simulation has predominantly been used to train health professionals and students for a variety of clinically related situations, there is an increasing trend to use simulation as an assessment tool, especially for the development of technical-based skills required during clinical practice. However, there is a lack of evidence about the effectiveness of using simulation for the assessment of competency. Therefore, the aim of this systematic review was to examine simulation as an assessment tool of technical skills across health professional education.
A systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Medical Literature Analysis and Retrieval System Online (Medline), and Web of Science databases was used to identify research studies published in English between 2000 and 2015 reporting on measures of validity, reliability, or feasibility of simulation as an assessment tool. The McMasters Critical Review for quantitative studies was used to determine methodological value on all full-text reviewed articles. Simulation techniques using human patient simulators, standardized patients, task trainers, and virtual reality were included.
A total of 1,064 articles were identified using search criteria, and 67 full-text articles were screened for eligibility. Twenty-one articles were included in the final review. The findings indicated that simulation was more robust when used as an assessment in combination with other assessment tools and when more than one simulation scenario was used. Limitations of the research papers included small participant numbers, poor methodological quality, and predominance of studies from medicine, which preclude any definite conclusions.
Simulation has now been embedded across a range of health professional education and it appears that simulation-based assessments can be used effectively. However, the effectiveness as a stand-alone assessment tool requires further research.
在过去20年中，模拟技术在卫生专业教育中的应用迅速增加。虽然模拟主要用于培训卫生专业人员和学生应对各种临床相关情况，但将模拟用作评估工具的趋势也在增加，特别是用于培养临床实践所需的基于技术的技能。然而，关于使用模拟进行能力评估的有效性缺乏证据。因此，本系统评价的目的是检验模拟作为卫生专业教育中技术技能评估工具的情况。
对护理及相关健康文献累积索引（CINAHL）、教育资源信息中心（ERIC）、医学文献分析与联机检索系统（Medline）和科学引文索引数据库进行系统评价，以识别2000年至2015年间以英文发表的关于模拟作为评估工具的有效性、可靠性或可行性测量的研究。对所有全文审阅文章，采用麦克马斯特定量研究批判性评价来确定方法学价值。使用人体模拟病人、标准化病人、任务训练器和虚拟现实的模拟技术均包括在内。
根据检索标准共识别出1064篇文章，筛选出67篇全文文章以确定其是否符合条件。最终纳入综述的文章有21篇。研究结果表明，当模拟与其他评估工具结合使用以及使用多个模拟场景时，其评估效果更强。研究论文的局限性包括参与者数量少、方法学质量差以及医学研究占主导地位，这使得无法得出任何明确结论。
模拟现已融入一系列卫生专业教育中，基于模拟的评估似乎可以有效使用。然而，作为独立评估工具的有效性需要进一步研究。
