探索模拟中的观察者角色和临床推理：范围综述。

Exploring the observer role and clinical reasoning in simulation: A scoping review.

机构信息

School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Australia.

School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.

出版信息

Nurse Educ Pract. 2022 Feb;59:103301. doi: 10.1016/j.nepr.2022.103301. Epub 2022 Jan 20.

DOI:10.1016/j.nepr.2022.103301

PMID:35091285

Abstract

AIM

This scoping review aimed to explore nursing students experience as simulation observers and their level of engagement in learning through use of clinical decision-making models and learning scaffolds.

BACKGROUND

A gap continues to exist between the published empirical literature, the role and experiences of the simulation observer and teaching scaffolds that enhance learning outcomes, despite the increased understanding of simulation and its role in preparing nursing students for practice. Further, little is known about the nursing student's experience of clinical reasoning whilst observing simulation and the impact of scaffolding observations using clinical decision-making models.

DESIGN

This scoping review was conducted using the methodological framework of Arksey and O'Malley (2005) and the PRISMA checklist for systematic reviews (Page et al., 2020).

METHODS

A comprehensive search of the literature published in Medline and CINAHL databases between 1999 and 2020 was undertaken in May 2019. The studies selected for this review (n = 18) were analyzed thematically. The validated Mixed-Methods Appraisal Tool assessed quality of the quantitative, qualitative and mixed methods studies.

RESULTS

The role of the observer in simulation was explored and included observation to transform practice in self and observation to transform practice in others, namely peers in the nurse role in simulation. Application of the MMAT indicated that of the 18 studies included only 6 (33.3%) had a clear research question. Research aims or objectives were found in another six studies (33.3%). In this review 13 studies (72%) included answers to the research question or aim, three (17%) did not and in two (11%) it was impossible to tell.

CONCLUSIONS

Results of this review indicate the paucity of research relating to nursing student's experience of clinical reasoning while observing simulation. Further, it highlights the value of nurse educators optimizing the observer role and maximizing learning by scaffolding observer activities within the simulation experience.

摘要

目的

本范围综述旨在探讨护理学生作为模拟观察者的体验，以及他们通过使用临床决策模型和学习支架来参与学习的程度。

背景

尽管人们对模拟及其在培养护理学生实践能力方面的作用有了更多的了解，但在已发表的实证文献、模拟观察者的角色和经验以及增强学习成果的教学支架之间仍然存在差距。此外，人们对护理学生在观察模拟时的临床推理体验以及使用临床决策模型来观察支架的影响知之甚少。

设计

本范围综述使用 Arksey 和 O'Malley（2005 年）的方法框架和 Page 等人（2020 年）的系统评价 PRISMA 清单进行。

方法

2019 年 5 月，对 Medline 和 CINAHL 数据库中 1999 年至 2020 年期间发表的文献进行了全面搜索。对本综述选择的研究（n=18）进行了主题分析。经过验证的混合方法评估工具评估了定量、定性和混合方法研究的质量。

结果

模拟观察者的角色得到了探讨，包括观察以改变自我实践和观察以改变模拟中他人的实践，即模拟中的护士角色中的同伴。应用 MMAT 表明，在包括的 18 项研究中，只有 6 项（33.3%）有明确的研究问题。另外 6 项研究（33.3%）发现了研究目的。在本综述中，13 项研究（72%）回答了研究问题或目的，3 项研究（17%）没有回答，2 项研究（11%）无法判断。