Department of Instructional Technology and Learning Sciences, Utah State University, Logan, USA; The Cheryl Spencer Department of Nursing, University of Haifa, Israel.
Nurse Educ Today. 2018 Oct;69:67-73. doi: 10.1016/j.nedt.2018.07.001. Epub 2018 Jul 6.
Online computer-based simulations are becoming more widespread in nursing education. Therefore, an understanding of when and how to implement the variety of instructional strategies related to these simulations is fundamental.
This study compares the effectiveness of online computer-based simulations designed using two alternative instructional approaches-Productive Failure and Simple-to-Complex sequencing-on learning of clinical reasoning skills.
Participants in this study were undergraduate nursing students (n = 103, mean age = 23.4 ± 2.1) enrolled at a university in Israel.
Participants completed two online simulations designed using Productive Failure approach (emergency medicine, mental health) and two online simulations using Simple-to-Complex approach (cardiovascular health, pediatrics). Pre- and post-test clinical reasoning evaluations were administered prior to and immediately following each simulation.
Clinical reasoning learning gains were significantly higher for online simulations designed with the Simple-to-Complex approach than simulations designed with Productive Failure approach (F (3, 288) = 9.656, P < 0.001). Students devoted significantly more time (F (1, 102) = 260.15, P < 0.001) and more attempts (F (1, 102) = 167.39, P < 0.001) in learning with Simple-to-Complex simulations than they did with Productive Failure simulations. The amount of time that students were engaged in learning with simulations was significantly associated with learning gains scores.
This study proposes that well-designed online simulations can improve nursing students' clinical reasoning. The Simple-to-Complex approach was found to be more efficient than Productive Failure for online learning. Learning with Simple-to-Complex approach was behaviorally more engaging and students' achievements were higher, which implies that instructional process facilitates learning, and therefore have to be taken in consideration by nurse educators. Integration of computerized educational modalities within nursing education is discussed.
在线计算机模拟在护理教育中越来越普及。因此，理解何时以及如何实施与这些模拟相关的各种教学策略是基础。
本研究比较了两种替代教学方法（产生性失败和从简单到复杂的顺序）设计的在线计算机模拟对临床推理技能学习的效果。
本研究的参与者是以色列一所大学的本科护理学生（n=103，平均年龄 23.4±2.1）。
参与者完成了两个使用产生性失败方法设计的在线模拟（急诊医学、心理健康）和两个使用简单到复杂方法设计的在线模拟（心血管健康、儿科）。在每个模拟之前和之后，进行了临床推理评估的前测和后测。
使用简单到复杂方法设计的在线模拟的临床推理学习收益明显高于使用产生性失败方法设计的模拟（F（3，288）=9.656，P<0.001）。学生在学习简单到复杂模拟时花费的时间（F（1，102）=260.15，P<0.001）和尝试次数（F（1，102）=167.39，P<0.001）明显多于产生性失败模拟。学生在模拟学习中的参与时间与学习收益得分显著相关。
本研究表明，精心设计的在线模拟可以提高护理学生的临床推理能力。简单到复杂的方法被发现比产生性失败方法更适合在线学习。使用简单到复杂的方法学习在行为上更具吸引力，学生的成绩也更高，这意味着教学过程促进了学习，因此必须得到护理教育者的重视。还讨论了将计算机化教育模式整合到护理教育中。
