Da Silva Celina, Peisachovich Eva, Anyinam Charles K, Coffey Sue, Graham Leslie, Tavangar Farideh
Medical Education and Simulation, York University, Toronto, CAN.
Simulation, Nipissing University, Toronto, CAN.
Cureus. 2020 Dec 8;12(12):e11977. doi: 10.7759/cureus.11977.
Background As simulation science continues to advance, the focus previously put on scenario creation and debriefing must now be applied to other components of the learning experience. There is a need to examine the effectiveness of pre-simulation activities and how they relate to the overall simulation experience and learning outcomes. However, few randomized controlled trials have been conducted comparing different approaches in the pre-simulation preparatory phase and the impact on learning outcomes. Methods A randomized controlled trial was conducted with undergraduate nursing students (n=83) who were randomized to a traditional paper case study (control group) or an interactive pre-simulation activity (intervention group). The use of the two-challenge rule and Satisfaction and Self Confidence in Learning (SSL) was evaluated. Results The proportion of students who utilized the two-challenge rule in the intervention group was significantly higher than the control group. Results from the two independent-samples Wilcoxon-Mann-Whitney test showed a significant difference in the median of the total score of the SSL W=2.5, p <0.001, satisfaction W=6.0, p <0.001, and self-confidence W=68.0, p <0.001 in learning between third-year nursing students in the control and intervention groups. Conclusion Our results showed significant differences in the use of the two-challenge rule by students who completed an interactive pre-simulation activity (intervention group) compared to those who completed the paper case study (control group). Additionally, students in the intervention group were more self-confident and satisfied with the entire simulation intervention than the control group. From a pedagogical perspective, this study also emphasizes the need to ground simulations in theory. Moreover, there is value in using progressive frameworks, i.e., revised Medical Research Council (2014) in simulation design and research to ensure high quality. More studies are required to examine the right dosage and type of pre-simulation activity and impact on learning outcomes.
背景 随着模拟科学的不断发展，以往对情景创建和总结汇报的关注现在必须应用于学习体验的其他组成部分。有必要研究模拟前活动的有效性以及它们与整体模拟体验和学习成果之间的关系。然而，很少有随机对照试验比较模拟前准备阶段的不同方法及其对学习成果的影响。方法 对本科护理专业学生（n = 83）进行了一项随机对照试验，这些学生被随机分为传统纸质案例研究组（对照组）或交互式模拟前活动组（干预组）。评估了双挑战规则的使用情况以及学习中的满意度和自信心（SSL）。结果 干预组中使用双挑战规则的学生比例显著高于对照组。两个独立样本的Wilcoxon - Mann - Whitney检验结果显示，对照组和干预组三年级护理学生在学习中SSL总分中位数（W = 2.5，p < 0.001）、满意度（W = 6.0，p < 0.001）和自信心（W = 68.0，p < 0.001）方面存在显著差异。结论 我们的结果表明，与完成纸质案例研究的学生（对照组）相比，完成交互式模拟前活动的学生（干预组）在双挑战规则的使用上存在显著差异。此外，干预组的学生比对照组对整个模拟干预更有自信和满意度。从教学角度来看，本研究还强调了将模拟建立在理论基础上的必要性。此外，在模拟设计和研究中使用渐进式框架（即修订后的医学研究理事会（2014））以确保高质量是有价值的。需要更多研究来考察模拟前活动的正确剂量和类型及其对学习成果的影响。
