From the Department of Pediatrics (T.R.), Kaiser Permanente Oakland Medical Center, Oakland; Kanbar Center for Simulation and Clinical Skills (C.A.), and Departments of Medicine (B.O.) and Pediatrics (S.V.S.), Division of Pediatric Critical Care, University of California San Francisco, San Francisco, CA.
Simul Healthc. 2019 Jun;14(3):140-145. doi: 10.1097/SIH.0000000000000354.
Experiential learning through active participation is thought to be a key benefit of simulation-based education. Recent research has challenged this assumption, suggesting that active participants learn just as well as observers. Studies report that active participants experience stress and anxiety during simulation, which may hamper learning by active participants. We undertook the current study to examine whether active participation results in different emotional arousal than observing during simulation. We hypothesized that participants in active roles experience higher levels of negative emotions than those observing and looked for evidence that this may impact learning.
Pediatric residents participate in simulations, rotating through active and observer roles, as part of their standard curriculum. We assessed both positive and negative emotional arousal with the Positive and Negative Affect Scale immediately after each simulation and assessed learning through multiple-choice questions. We used repeated measures analysis of variance to examine potential interactions between Positive and Negative Affect Scale scores and role in simulation. To explore differences in learning, we examined whether knowledge retention differed between the groups.
Residents had higher levels of both positive and negative emotional arousal in active roles compared with observing roles. We could not detect a difference in learning between the roles.
The increase in both positive and negative emotions among active participants compared with observers may have important implications for simulation design and participant learning. Future studies should be powered to detect differences in learning and examine the impact of contributing factors such as learner level and context.
通过积极参与获得的体验式学习被认为是基于模拟的教育的一个关键优势。最近的研究对这一假设提出了挑战,表明积极的参与者和观察者一样可以很好地学习。研究报告称,积极的参与者在模拟过程中会感到压力和焦虑,这可能会阻碍积极参与者的学习。我们进行了当前的研究,以检验在模拟过程中积极参与是否会导致与观察不同的情绪唤醒。我们假设积极参与的参与者比观察者经历更高水平的负面情绪,并寻找证据表明这可能会影响学习。
儿科住院医师作为其标准课程的一部分,通过积极和观察者的角色参与模拟。我们在每次模拟后立即使用积极和消极情绪量表评估积极和消极情绪唤醒,并通过多项选择题评估学习。我们使用重复测量方差分析来检查模拟中积极和消极情绪量表评分与角色之间的潜在相互作用。为了探讨学习方面的差异,我们检查了两组之间的知识保留是否存在差异。
住院医师在积极角色中的积极和消极情绪唤醒水平均高于观察角色。我们无法检测到角色之间学习的差异。
与观察者相比,积极参与者的积极和消极情绪的增加可能对模拟设计和参与者学习有重要影响。未来的研究应该有足够的能力来检测学习差异,并研究学习水平和情境等因素的影响。