Kolbe Michaela, Rudolph Jenny W
Simulation Center, University Hospital Zurich, Zurich, Switzerland.
Harvard Medical School, Center for Medical Simulation, Massachusetts General Hospital, Boston, Massachusetts, USA.
BMJ Simul Technol Enhanc Learn. 2018 Jul 9;4(3):126-132. doi: 10.1136/bmjstel-2017-000247. eCollection 2018.
The demand for highly skilled simulation-based healthcare educators (SBEs) is growing. SBEs charged with developing other SBEs need to be able to model and conduct high-quality feedback conversations and 'debrief the debriefing'. Direct, non-threatening feedback is one of the strongest predictors of improved performance in health professions education. However, it is a difficult skill to develop. Developing SBEs who can coach and support other SBEs is an important part of the faculty development pipeline. Yet we know little about how they get better at skilled feedback and the ability to reflect on it. There is scant evidence about their thoughts, feelings and dilemmas about this advanced learning process. To address this gap, we examined advanced SBE's subjective experience as they grappled with challenges in a 4-day advanced SBE course. Their reflections will help target faculty development efforts.
Using a repeated, identical free-writing task, we asked "What is the headline for what is on your mind right now?"
A five-theme mosaic of self-guiding reflections emerged: (1) metacognitions about one's learning process, (2) evaluations of sessions or tools, (3) notes to self, (4) anticipations of applying the new skills in the future, and (5) tolerating the tension between pleasant and unpleasant emotions.
The results extend simulation-based education science by advocating the motivational role of noting inconsistencies between one's intention and impact and the central role of self-regulation, emotion, and experiencing feedback and debriefing from multiple perspectives for improving advanced skills of SBEs. Recommendations for faculty development are discussed.
对高技能的基于模拟的医疗教育工作者(SBEs)的需求正在增长。负责培养其他SBEs的SBEs需要能够示范并开展高质量的反馈对话,以及“对总结进行总结”。直接、无威胁性的反馈是卫生专业教育中提高表现的最强预测因素之一。然而,这是一项难以培养的技能。培养能够指导和支持其他SBEs的SBEs是教师发展流程的重要组成部分。然而,我们对他们如何在熟练反馈及反思能力方面变得更出色知之甚少。关于他们在这个进阶学习过程中的想法、感受和困境,几乎没有证据。为了填补这一空白,我们研究了进阶SBEs在参加为期4天的进阶SBE课程时应对挑战的主观体验。他们的反思将有助于确定教师发展工作的目标。
我们使用重复的、相同的自由写作任务,提问“你此刻脑海中最重要的事情是什么?”
出现了一个由五个主题构成的自我引导反思拼图:(1)对自身学习过程的元认知,(2)对课程或工具的评估,(3)给自己的提示,(4)对未来应用新技能的预期,以及(5)容忍愉快和不愉快情绪之间的紧张关系。
研究结果拓展了基于模拟的教育科学,倡导注意自身意图与影响之间的不一致所起的激励作用,以及自我调节、情绪和从多个角度体验反馈与总结对于提高SBEs进阶技能的核心作用。文中讨论了对教师发展的建议。