Jackson Bianca N, Brady Alana, Friary Philippa, Braakhuis Andrea, Sekula Julia, Miles Anna
Speech Science, University of Auckland, Auckland, New Zealand.
Nutrition and Dietetics, University of Auckland, Auckland, New Zealand.
BMJ Simul Technol Enhanc Learn. 2020 Jun 30;6(4):206-213. doi: 10.1136/bmjstel-2019-000455. eCollection 2020.
Simulated learning environments are increasingly common in interprofessional education (IPE). While reflection is key to simulated learning, little is known about the nature of these conversations during simulation. The aim of this exploratory paper was to quantify communicative features of conversations during interprofessional simulation scenarios between dietetics students, speech-language therapy students and their educators.
Conversations between students and educators during the pauses between simulated scenario phases were recorded and transcribed. Student and educator utterances were quantitatively analysed for speech acts, question types and elements of IPE (clinical reasoning, roles and responsibilities, client and family centred care, interprofessional collaboration, clinical procedural tasks).
Across 1340 utterances from six scenarios, analyses of conversational speech acts and question types highlighted similar patterns of usage between two educators despite different clinical scenarios and professional backgrounds. Educators used a minimally higher proportion of open compared with closed questions, and higher-level problem-solving questions predominated in comparison to simple factual questioning. Educators used more requests for action and attention and students displayed more performative and responsive acts (p<0.05). Students were exposed to all elements of IPE through conversations in all scenarios.
Conversations during pauses in immersive simulated scenarios between educators and students enable rich IPE opportunities and higher-level problem-solving. Educators encouraged students to problem solve within and across disciplines with open questions. Educators provided few factual responses to questions themselves rather diverting questions back to the students. This approach to the analysis of conversation can support educators to evaluate their own communication during interprofessional simulations.
模拟学习环境在跨专业教育（IPE）中越来越普遍。虽然反思是模拟学习的关键，但对于模拟过程中这些对话的性质知之甚少。这篇探索性论文的目的是量化营养学学生、言语治疗学学生及其教育工作者在跨专业模拟场景中的对话交流特征。
在模拟场景阶段之间的停顿期间，记录并转录学生与教育工作者之间的对话。对学生和教育工作者的话语进行定量分析，以研究言语行为、问题类型以及IPE的要素（临床推理、角色与职责、以患者及家庭为中心的护理、跨专业协作、临床程序任务）。
在六个场景的1340条话语中，对话言语行为和问题类型的分析突出显示，尽管临床场景和专业背景不同，但两位教育工作者的使用模式相似。与封闭式问题相比，教育工作者使用开放式问题的比例略高，与简单的事实性提问相比，高层次的解决问题型问题占主导。教育工作者使用更多要求采取行动和引起注意的语句，而学生表现出更多的表达性和回应性语句（p<0.05）。在所有场景中，学生通过对话接触到了IPE的所有要素。
教育工作者与学生在沉浸式模拟场景停顿期间的对话提供了丰富的IPE机会和高层次的问题解决。教育工作者通过开放式问题鼓励学生在学科内部和跨学科解决问题。教育工作者很少直接回答问题，而是将问题抛回给学生。这种对话分析方法可以支持教育工作者在跨专业模拟中评估自己的沟通情况。
