Cassara Michael, Schertzer Kimberly, Falk Michael J, Wong Ambrose H, Hock Sara M, Bentley Suzanne, Paetow Glenn, Conlon Lauren W, Hughes Patrick G, McKenna Ryan T, Hrdy Michael, Lei Charles, Kulkarni Miriam, Smith Colleen M, Young Amanda, Romo Ernesto, Smith Michael D, Hernandez Jessica, Strother Christopher G, Frallicciardi Alise, Nadir Nur-Ain
Northwell Health/Zucker School of Medicine Manhasset NY.
Stanford University School of Medicine Palo Alto CA.
AEM Educ Train. 2019 Dec 27;4(Suppl 1):S22-S39. doi: 10.1002/aet2.10418. eCollection 2020 Feb.
Procedural competency is an essential prerequisite for the independent practice of emergency medicine. Multiple studies demonstrate that simulation-based procedural training (SBPT) is an effective method for acquiring and maintaining procedural competency and preferred over traditional paradigms ("see one, do one, teach one"). Although newer paradigms informing SBPT have emerged, educators often face circumstances that challenge and undermine their implementation. The goal of this paper is to identify and report on best practices and theory-supported solutions to some of these challenges as derived using a process of expert consensus building and reviews of the existing literature on SBPT.
The Society for Academic Emergency Medicine (SAEM) Simulation Academy SBPT Workgroup convened approximately 8 months prior to the 2019 SAEM Annual Meeting to perform a review of the literature and participate in a consensus-building process to identify solutions (in the form of best practices and educational theory) to these challenges faced by educators engaging in SBPT.
Thirteen distinct educational challenges to SBPT emerged from the expert group's primary literature reviews and consensus-building processes. Three domains emerged upon further analysis of the 13 challenges: learner, educator, and curriculum. Six challenges within the "learner" domain were selected for comprehensive discussion in this paper, as they were deemed representative of the most common and most significant threats to ideal SBPT. Each of the six challenges aligns with one of the following themes: 1) maximizing active learning, 2) maintaining learner engagement, 3) embracing learner diversity, 4) optimizing cognitive load, 5) promoting mindfulness and reflection, and 6) emphasizing deliberate practice for mastery learning. Over 20 "special treatments" for mitigating the impact of the 13 challenges were derived from the secondary literature search and consensus-building process prior to and during the preconference workshop; 11 of these that best address the six learner-centered challenges are explored, including implications for educators involved in SBPT.
CONCLUSIONS/IMPLICATIONS FOR EDUCATORS: We propose multiple consensus-generated solutions (in the form of best practices and applied educational theory) that we believe are suitable and well aligned to overcome commonly encountered learner-centered challenges and threats to optimal SBPT.
操作能力是独立从事急诊医学工作的一项基本前提条件。多项研究表明,基于模拟的操作培训(SBPT)是获取和保持操作能力的一种有效方法,且优于传统模式(“看一个,做一个,教一个”)。尽管出现了一些为SBPT提供指导的新范例,但教育工作者常常面临挑战并难以实施这些范例的情况。本文的目的是确定并报告针对其中一些挑战的最佳实践和理论支持的解决方案,这些方案是通过专家共识构建过程以及对SBPT现有文献的综述得出的。
学术急诊医学协会(SAEM)模拟学院SBPT工作组在2019年SAEM年会前约8个月召开会议,对文献进行综述,并参与共识构建过程,以确定针对从事SBPT的教育工作者所面临的这些挑战的解决方案(以最佳实践和教育理论的形式)。
专家组的主要文献综述和共识构建过程中出现了13个不同的SBPT教育挑战。对这13个挑战进行进一步分析后出现了三个领域:学习者、教育工作者和课程。本文选择了“学习者”领域中的六个挑战进行全面讨论,因为它们被认为是对理想的SBPT最常见且最重大的威胁的代表。六个挑战中的每一个都与以下主题之一相符:1)最大化主动学习,2)保持学习者参与度,3)接纳学习者多样性,4)优化认知负荷,5)促进正念和反思,6)强调刻意练习以实现掌握学习。在会前研讨会之前和期间进行的二次文献检索和共识构建过程中,得出了20多种减轻这13个挑战影响的“特殊处理方法”;本文探讨了其中最能应对以学习者为中心的六个挑战的11种方法,包括对参与SBPT的教育工作者的启示。
结论/对教育工作者的启示:我们提出了多种通过共识产生的解决方案(以最佳实践和应用教育理论的形式),我们认为这些方案适合且与克服常见的以学习者为中心的挑战以及对最佳SBPT的威胁相契合。