Say Richard, Visentin Denis, Betihavas Vasiliki, Minutillo Susannah
College of Health and Medicine, University of Tasmania, Sydney, New South Wales, Australia.
Faculty of Medicine & Health, University of Sydney, Sydney, New South Wales, Australia.
Int J Nurs Educ Scholarsh. 2019 Oct 4;16(1):ijnes-2019-0009. doi: 10.1515/ijnes-2019-0009.
Background Cognitive load theory (CLT) uses an understanding of brain architecture for educational design, with implications for simulation. Since working memory is limited, minimising extraneous cognitive load improves learning of new tasks (intrinsic load) and use of existing knowledge (germane load). This study evaluates the effectiveness of low-fidelity simulation (LFS) utilising CLT principles in the assessment and management of the deteriorating patient (AMDP). Method CLT design principles informed the choice of LFS and simulation design. The self-rated ability of 13 undergraduate nurses across seven aspects of AMDP was measured in a pre-post design. Results Self-rated ability increased from 2.98 (SD = 0.19) to 4.47 (SD = 0.12) (p < 0.001), with improvements across all AMDP aspects. Conclusion This study indicates that CLT informed design has benefits for simulation. LFS may be preferred to high fidelity simulation for AMDP teaching and medical simulation for novice learners.
背景 认知负荷理论（CLT）利用对大脑结构的理解进行教学设计，对模拟有一定启示。由于工作记忆有限，将无关认知负荷降至最低可提高新任务（内在负荷）的学习以及现有知识（相关负荷）的运用。本研究评估了运用CLT原则的低保真模拟（LFS）在病情恶化患者评估与管理（AMDP）中的有效性。方法 CLT设计原则为LFS及模拟设计的选择提供了依据。在前后测设计中测量了13名本科护士在AMDP七个方面的自评能力。结果 自评能力从2.98（标准差=0.19）提高到4.47（标准差=0.12）（p<0.001），AMDP的所有方面均有改善。结论 本研究表明，基于CLT的设计对模拟有益。对于AMDP教学和新手学习者的医学模拟，LFS可能比高保真模拟更受青睐。
