Duch Christensen Margrethe, Oestergaard Doris, Dieckmann Peter, Watterson Leonie
From the Nykøbing Falster Sygehus (M.D.C.), Nykøbing Falster; CAMES - Herlev (D.O., P.D.), Herlev, Denmark; and Sydney Clinical Skills and Simulation Centre (L.W.), Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Simul Healthc. 2018 Oct;13(5):306-315. doi: 10.1097/SIH.0000000000000300.
Remotely facilitated simulation-based training (RF-SBT) is less positively appraised than face-to-face, locally facilitated simulation-based training (LF-SBT), despite being considered as an acceptable alternative. This study compared the perceptions of learners after RF-SBT and LF-SBT to explain differences between the two and identify relevant theories that would guide future practice.
Telephone interviews were conducted with 21 newly graduated doctors and nurses who completed a standardized simulation course delivered in both RF-SBT and LF-SBT formats.
Participants reported that both SBT formats to be highly beneficial, however, were less positive about RF-SBT. They described a range of psychosocial and cognitive responses that explained their positive and negative attitudes to different aspects of the training. These perceptions, occurring across both formats, included a sense of the following: belonging to instructor and group, surveillance, responsibility, realism, contextual understanding, conscious mental effort, control of attention, and engagement with task. Participants associated these perceptions and ensuing attitudes to SBT with factors arising during, and/or existing before, the SBT as if in an input-output process model. The former 'enabling' factors related to human interaction, technology, and instructional design, whereas the latter 'precursor' factors reflected pre-existing attributes of the participants and instructors. These findings are supported by several theoretical models of which the technology acceptance model is arguably the best fit.
Locally facilitated simulation-based training is easier to use and experience than RF-SBT; however, the latter's negative impact may be concealed by SBT's overarching very high perceived value. The technology acceptance model is an appropriate conceptual model to explain these processes.
尽管远程辅助模拟培训(RF-SBT)被视为一种可接受的替代方案,但其评价不如面对面的本地辅助模拟培训(LF-SBT)积极。本研究比较了学习者在接受RF-SBT和LF-SBT后的看法,以解释两者之间的差异,并确定可指导未来实践的相关理论。
对21名新毕业的医生和护士进行了电话访谈,他们完成了以RF-SBT和LF-SBT两种形式提供的标准化模拟课程。
参与者报告称,两种模拟培训形式都非常有益,但对RF-SBT的评价较低。他们描述了一系列心理社会和认知反应,这些反应解释了他们对培训不同方面的积极和消极态度。这些在两种形式中都出现的看法包括以下几种感觉:属于指导教师和团队、受监督、有责任感、真实感、情境理解、有意识的脑力劳动、注意力控制以及参与任务。参与者将这些对模拟培训的看法及随之产生的态度与模拟培训期间和/或之前出现的因素联系起来,就好像是在一个输入-输出过程模型中一样。前者的“促成”因素与人际互动、技术和教学设计有关,而后者的“先行”因素反映了参与者和指导教师预先存在的属性。这些发现得到了几个理论模型的支持,其中技术接受模型可能是最契合的。
本地辅助模拟培训比RF-SBT更容易使用和体验;然而,后者的负面影响可能被模拟培训总体上非常高的感知价值所掩盖。技术接受模型是解释这些过程的合适概念模型。