Jersby Maureen Anne, Van-Schaik Paul, Green Stephen, Nacheva-Skopalik Lili
Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
Department of Social Sciences, Teesside University School of Social Sciences and Law, Middlesbrough, UK.
BMJ Simul Technol Enhanc Learn. 2017 Jul 6;3(3):88-93. doi: 10.1136/bmjstel-2016-000167. eCollection 2017.
High-Fidelity Simulation (HFS) has great potential to improve decision-making in clinical practice. Previous studies have found HFS promotes self-confidence, but its effectiveness in clinical practice has not been established. The aim of this research is to establish if HFS facilitates learning that informs decision-making skills in clinical practice using MultipleCriteria DecisionMaking Theory (MCDMT).
The sample was 2nd year undergraduate pre-registration adult nursing students.MCDMT was used to measure the students' experience of HFS and how it developed their clinical decision-making skills. MCDMT requires characteristic measurements which for the learning experience were based on five factors that underpin successful learning, and for clinical decision-making, an analytical framework was used. The study used a repeated-measures design to take two measurements: the first one after the first simulation experience and the second one after clinical placement. Baseline measurements were obtained from academics. Data were analysed using the MCDMT tool.
After their initial exposure to simulation learning, students reported that HFS provides a high-quality learning experience (87%) and supports all aspects of clinical decision-making (85%). Following clinical practice, the level of support for clinical decision-making remained at 85%, suggesting that students believe HFS promotes transferability of knowledge to the practice setting.
Overall, students report a high level of support for learning and developing clinical decision-making skills from HFS. However, there are no comparative data available from classroom teaching of similar content so it cannot be established if these results are due to HFS alone.
高保真模拟（HFS）在改善临床实践中的决策制定方面具有巨大潜力。先前的研究发现HFS能提升自信心，但其在临床实践中的有效性尚未得到证实。本研究的目的是确定HFS是否能促进学习，从而运用多标准决策理论（MCDMT）为临床实践中的决策技能提供信息。
样本为本科二年级预注册成人护理专业学生。MCDMT用于衡量学生对HFS的体验以及它如何培养他们的临床决策技能。MCDMT需要进行特征测量，对于学习体验，这些测量基于支撑成功学习的五个因素，对于临床决策，则使用一个分析框架。该研究采用重复测量设计进行两次测量：第一次在首次模拟体验后，第二次在临床实习后。基线测量数据来自学者。使用MCDMT工具对数据进行分析。
在初次接触模拟学习后，学生报告称HFS提供了高质量的学习体验（87%），并支持临床决策的各个方面（85%）。临床实习后，对临床决策的支持水平仍为85%，这表明学生认为HFS促进了知识向实践环境的迁移。
总体而言，学生报告对通过HFS学习和培养临床决策技能给予高度支持。然而，没有来自类似内容课堂教学的可比数据，因此无法确定这些结果是否仅归因于HFS。
