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Vicarious learning during simulations: Is it more effective than hands-on training?
Abstract
Medical Education 2012: 46: 1001–1008
Context Doctor–patient communication skills are often fostered by using simulations with standardised patients (SPs). The efficiency of such experiences is greater if student observers learn at least as much from the simulation as do students who actually interact with the patient.
Objectives This study aimed to investigate whether the type of simulation-based learning (learning by doing versus vicarious learning) and the order in which these activities are carried out (learning by doing → vicarious learning versus vicarious learning → learning by doing) have any effect on the acquisition of knowledge on effective doctor–patient communication strategies. In addition, we wished to examine the extent to which an observation script and a feedback formulation script affect knowledge acquisition in this domain.
Methods The sample consisted of 200 undergraduate medical students (126 female, 74 male). They participated in two separate simulation sessions, each of which was 30 minutes long and was followed by a collaborative peer feedback phase. Half of the students first performed (learning by doing) and then observed (vicarious learning) the simulation, and the other half participated in the reverse order. Knowledge of doctor–patient communication was measured before, between and after the simulations.
Results Vicarious learning led to greater knowledge of doctor–patient communication scores than learning by doing. The order in which vicarious learning was experienced had no influence. The inclusion of an observation script also enabled significantly greater learning in students to whom this script was given compared with students who were not supported in this way, but the presence of a feedback script had no effect.
Conclusions Students appear to learn at least as much, if not more, about doctor–patient communication by observing their peers interact with SPs as they do from interacting with SPs themselves. Instructional support for observing simulations in the form of observation scripts facilitates both vicarious learning and learning by doing. An observation script may focus learners’ attention on the important aspects of doctor–patient communication and increase the content-related accuracy of peer feedback.
... Diverse instruction and guidance strategies were described and varied based on who or what provided support. Human tutor strategies included verbal guidance (n = 35) [ [30,34,[62][63][64][65][66][67][68][69][70][71][72][73][74][75][76], modelling (n = 10) [32,46,50,54,57,61,[77][78][79][80], checklists (n = 3) [49,81,82], collaboration scripts (n = 2) [83,84] and encouragement (n = 1) [59] (Table 2). Computer tutor strategies were audio prompts (n = 16) [34, 39, 58, 85-92, 94-97, 126], visualization (n = 11) [55,60,85,90,91,95,[98][99][100][101][102], step-by-step guides (n = 8) [30,31,49,76,98,99,103,104], modelling (n = 6) [45,56,[105][106][107], intelligent tutoring systems (n = 3) [108][109][110] and pause buttons (n = 2) [93,111]. ...
... Most human tutors were more knowledgeable others (MKO) (n = 31, 62.00%) [29, 32, 33, 35-38, 43, 44, 46, 50-53, 57, 59, 62-74, 118, 119], followed by peers (n = 9, 18.00%) [78,[80][81][82][83][84][121][122][123], combined MKOs and peers (n = 7, 14.00%) [17, 40-42, 48, 54, 61], and near peers (n = 2, 4.00%) [77,79]. One article did not specify who provided guidance and support (n = 1, 2.00%) (75). ...
... Eleven articles described peer tutors (i.e., instances where learners taught one or more fellow learners of similar ability) [120]. When peers instructed or guided each other, they used verbal guidance most frequently (n = 4) [78,[121][122][123], followed by modelling (i.e., demonstrations) (n = 2) [78,123], checklists (n = 2) [81,82], and collaboration scripts (n = 2) [83,84] (Table 3). Compared to the strategies used by MKOs, peers used fewer complex strategies; for example, no peers used prescribed instructional strategies. ...
Introduction:
There is growing evidence that instruction and guidance during simulation
engagement can enhance explicit and subtle procedural knowledge and skills,
medical knowledge, situation awareness and organization, and observation
and reflection. However, instruction and guidance to scaffold learners during
simulation engagement receive limited attention in published peer-reviewed
literature, simulation practice guidelines and instructional design practices.
This scoping review aimed to identify specific instruction or guidance strategies
used to scaffold learners during simulation engagement, who or what provided
support and guidance, who received instruction or guidance, and for what
reasons.
Methods:
Guided by Reiser and Tabak’s perspectives on scaffolding, we conducted a
scoping review following JBI Guidance. Included databases were PubMed,
CINAHL, Embase, PsycINFO and Web of Science. No date boundary was
set. All languages were eligible. Hand searching included six healthcare
simulation journals, yielding 9232 articles at the start. Using Covidence, two
reviewers independently screened all articles (title and abstract, full-text). Two
independent reviewers extracted every third article. The content analysis enabled
categorization and frequency counts.
Results:
Ninety articles were included. A human or computer tutor or a combination
of human and computer tutors provides instruction and guidance. Strategies
employed by human tutors were verbal guidance, checklists, collaboration scripts,
encouragement, modelling, physical guidance and prescribed instructional strategies (e.g., rapid cycle deliberate practice). Strategies employed by computer
tutors were audio prompts, visualization, modelling, step-by-step guides,
intelligent tutoring systems and pause buttons. Most studies focused on prelicensure and immediate post-graduate learners but continuing professional
development learners were also represented. The most common reason for
including instruction and guidance was to enhance learning without specific
language regarding how or what aspects of learning were intended to be
enhanced.
Conclusion:
Although less prominent than pre- and post-simulation instructional
strategies (e.g., pre-briefing, debriefing), there is a growing body of literature
describing instruction and guidance for scaffolding learners during simulation
engagements. Implications for practice, professional guidelines and terminology
are discussed.
... specifically, social cognitive theory explains that the learning process occurs in a social context where dynamic and reciprocal interactions occur between individual personal factors, the environment, and their behaviour (Bandura, 1986). one of the basic principles of social cognitive theory is that individuals will develop or adjust their judgments and opinions about something through observation and by learning from the experiences of other people in their environment, in addition to through the individual's direct experience (Bandura, 1986(Bandura, , 2001stegmann et al., 2012). social cognitive theory emphasises our ability to learn without direct experience. ...
... specifically, social cognitive theory explains that the learning process occurs in a social context with dynamic and reciprocal interaction between an individual's personal factors, environment, and behaviour (Bandura, 1986). one of the basic principles of social cognitive theory is that individuals will develop or adjust their judgments and opinions about something through observation and learning from the experiences of others in their environment, in addition to their own direct experiences (Bandura, 1986(Bandura, , 2001stegmann et al., 2012). using the perspective of social cognitive theory, this research also examined the influence of individuals' internal and external characteristics on digital literacy, which we identified as an outcome of the learning process in this study. ...
... in this study, social capital is an external factor contributing to the development of digital literacy possessed by business actors, including small businesses. this is in line with one of the basic principles of the social cognitive theory that individuals will form views, opinions, and understandings of something through observation and learning from the experiences of others in their environment, in addition to the direct experiences of the individual concerned (Bandura, 1986(Bandura, , 2001stegmann et al., 2012). therefore, based on the explanation of the relationship between locus of control, need for achievement, social capital, and their relationship with digital literacy, the hypotheses developed in this research proposal are: hypothesis 1: 'the locus of control held by small business owners/managers has a significant influence on the digital literacy of small business owners/managers' . ...
Technological disruption and the COVID-19 pandemic have challenged SMEs to adapt to digital consumer behaviour, necessitating digital transformation. This study examines the impact of digital literacy on digital transformation, exploring the antecedent factors shaping digital literacy and the government’s role in providing IT infrastructure. A survey method was undertaken for this study with a total sample of 293 small businesses in East Java, Indonesia. This study employed structural equation modeling through PLS-SEM for the data analysis. The research results show that locus of control, need for achievement, and social capital significantly and positively influence digital literacy. Digital literacy has been proven to significantly and positively impact digital business transformation. IT infrastructure does not significantly affect the moderation between digital literacy and digital transformation. The findings of this research will assist in overcoming technology usage challenges faced by SMEs in East Java, particularly those exacerbated by the COVID-19 pandemic. Business actors can leverage the Indonesian government’s efforts in business incubation and facilitating access to technology and the internet to enhance their social capital. SMEs should consider joining sectoral organisations or associations to build relationships with other business actors and engage in training and capacity-building initiatives.
... Observation in simulation-based medical education may be effective [4][5][6][7][8][9][10][11][12][13][14] but a recent meta-analysis suggests that learning is more limited for an observer than for an active participant [5]. To increase the educational effects of simulation training when the learner is in the role of observer, some authors have proposed to use an observer tool (OT) allowing observers to analyse the progress of the task performed by their colleagues [4,[15][16][17][18]. OT are checklists in which key points to be achieved are listed in a consecutive manner. ...
... The attention boost effect [30] is a theory that suggests that when two actions are performed simultaneously (in the present study, observing the other student and filling out the OT), attention is increased, and this would be even more true when the different elements to observe are frequent [31]. However, the available literature regarding the use of tools to increase observer learning is limited, heterogeneous and controversial, making interpretation still uncertain [8,[15][16][17][18]. Some studies have indeed shown a beneficial effect [15,16]. ...
... However, the available literature regarding the use of tools to increase observer learning is limited, heterogeneous and controversial, making interpretation still uncertain [8,[15][16][17][18]. Some studies have indeed shown a beneficial effect [15,16]. One randomised study [16] howed an increased acquisition of medical knowledge and skills of anaesthesia residents when using an OT based on cognitive aids (i.e., emphasizing technical skills and medical knowledge). ...
Background
Simulation training in cardiopulmonary resuscitation (CPR) is effective but active practice time is limited given the large number of students and the learning effect size remains small. To improve learning during observation, the use of an observer tool (OT) has been advocated. The aim was to assess the value of OT to improve medical students' learning outcomes during CPR simulation training.
Methods
This prospective, randomized study took place during CPR training of medical students. The workshop targeted recognition of unconsciousness, absence of breathing, call for help, cardiac massage and defibrillation. Students practicing in dyads were randomized to use an OT (i.e., a checklist summarizing CPR skills and step-by-step actions) (OT +) or not (OT-) when observing others. At the end of the training, the global performance of the dyad was assessed by an evaluator using the OT checklist (primary outcome). The non-technical skills (NTS), chest compression quality, perceived improvement in knowledge and skills and knowledge score (MCQ) were also recorded.
Results
The student dyads were included (OT + : n = 40 and OT-: n = 41). Immediately after training, the global performance was similar between the two groups: OT + : 24 [23—25] and OT-: 23 [21—24] (out of 25), p = 0.052. However, better learning of breathing assessment and cardiac massage performance, as well as a better knowledge score, were found in the OT + group. No significant difference was observed for NTS or perceived improvement in knowledge and skills. Satisfaction was higher in the OT- group.
Conclusions
The use of an OT during CPR simulation did not show any pedagogical benefit on the global performance of medical students. However, a potential benefit was found for several important secondary outcomes. Further studies are needed to confirm these positive results.
... To increase the positive effects of simulation training when the learner is in the role of observer, some authors have proposed the use of an observer tool (OT) allowing observers to analyze the progress of the task performed by their colleagues [3,[14][15][16]. OTs are checklists describing key points to be achieved. ...
... As learning from observing is likely more limited than active participation during simulation sessions [4], some studies have tried to improve learning outcomes by using an OT [7,14,3,24,25]. OT is believed to allow more active learning by reinforcing attention during training [26]. This is based on [27] a theory suggesting that when two actions are performed simultaneously (in the present study observing the other resident and filling out the form), attention is increased, and even more so when the different elements to observe are frequent (in our study, the procedure was observed 6 times on average) [28]. ...
... The post-test evaluation, which was carried out using a questionnaire based on non-technical skills, showed no difference in the average score. The study by Stegmann et al. [14] studied the impact of an OT in 200 medical students trained with a mock patient with rectal bleeding and abdominal pain. The observers used or not a checklist targeting technical skills (performing a digital rectal examination) and non-technical skills (patient information, doctor-patient relationship). ...
Background
Central venous catheter (CVC) insertion using simulation is an essential skill for anesthesiologists. Simulation training is an effective mean to master this skill. Given the large number of residents and the limited duration of training sessions, the active practice time is limited and residents remain observers of their colleagues for much of the session. To improve learning during observation periods, the use of an observer tool (OT) has been advocated but its educational effectiveness is not well defined.
Methods
Incoming anesthesia residents were randomized to use an OT (i.e. procedural skill-based checklist) (OT+) or not (OT-) when observing other residents during a simulation bootcamp. The primary outcome was a composite score (total 60 points) evaluating CVC procedural skills rated immediately after the training. This score covers theoretical knowledge explored by multiple choice questions (MCQs) (/20), perceived improvement in knowledge and skills (/20), perceived impact on future professional life (/10) and satisfaction (/10). Measurements were repeated 1 month later. Residents in each group recorded the number of CVCs placed and their clinical outcomes (attempts, complications) during the first month of their clinical rotation using a logbook.
Results
Immediately after training, the composite score was similar between the two groups: 45.3 ± 4.2 (OT+, n = 49) and 44.4 ± 4.8 (OT-, n = 42) (p = 0.323). Analysis of sub-items also showed no difference. Results at 1 month were not different between groups.
Analysis of the logbook showed no difference between groups. No serious complications were reported.
Conclusions
The use of a procedural task-based OT by incoming anesthesia residents and used during CVC insertion simulation training was not associated with better learning outcomes, neither immediately after the session nor when re-evaluated 1 month later. The training at least once on simulator of all residents could limit the impact of OT. Further studies are necessary to define the place of OT in simulation training.
... [2][3][4][5] Observation in simulation seems to promote students' learning, particularly in the area of patient assessment and communication. 6,7 However, some learners do not perceive these observations as meaningful learning opportunities and even find them uninteresting. 2 When using an observing guide during simulation, Norman and colleagues 8 have demonstrated that students are more satisfied with their learning experience than those who observe the simulation without guidance, although no differences in learning outcomes were detected. Experiential learning theories support the use of observation in simulation to promote learning, 9 but evidence on how best to foster attention and motivation during the observational phase remains scarce. ...
... Other instructional guidance to promote observers' engagement such as collaboration scripts have been proven useful to increase learning in the context of simulation. 6,17 Collaboration or observation scripts are sets of scaffolds that help structure the learning process of observers during collaborative learning activities. As opposed to checklists, such scripts not only set the focus on specific observable content, they also promote interactions between learners. ...
... This 5-minute discussion was used in other study contexts to highlight the main observations to be discussed in the debriefing. 6,17 Students were instructed to discuss together both positive and negative actions regarding a specific aspect of the task. For example, one observer would focus on observing and reporting all positive actions concerning data collection, whereas the other participant in the same subgroup would focus on elements that could be improved regarding data collection (ie, positive and negative observers). ...
Introduction:
In simulation, students often observe their peers perform a task. It is still unclear how different types of instructional guidance can turn the observational phase into an active learning experience for novices. This mixed-method study aims to understand similarities and differences between use of collaboration scripts and checklists by observers in terms of cognitive load and perception of learning.
Methods:
Second-year pharmacy students (N = 162) were randomly assigned to 1 of 4 conditions when observing a simulation: collaboration scripts (heuristic to analyze in dyads while observing), checklists, both, or no guidance. We measured observers' intrinsic and extraneous cognitive load and self-perceived learning and conducted focus group interviews.
Results:
Intrinsic cognitive load was significantly lower for checklists (M = 3.6/10) than for scripts (M = 4.7/10) or scripts and checklists combined (M = 4.7/10). Extraneous cognitive load was significantly lower for checklists (M = 1.5/10) than for scripts combined with checklists (M = 2.6/10) or no guidance (M = 1.8/10). There was no statistical difference between conditions for self-perceived learning. Coding of focus group interviews revealed 6 themes on observers' perception of learning under different conditions of instructional guidance. Students explained that collaboration scripts felt more complex, whereas checklists were perceived as a simple fact-checking exercise. Observing the simulation, regardless of guidance, was a meaningful learning experience.
Conclusions:
With or without guidance, observers are actively engaged with the simulation, but their effort differed depending on instructions. When choosing between checklists or collaboration scripts, educators should be guided by the type of simulation task.
... Some studies have therefore sought to elucidate the formative value of observation-based learning with OT in different simulation contexts and with different types of tools [17,25,26,34]. The randomised cross-over study of Stegmann et al. [34] found a beneficial effect on learning However, contrary to these previous positive results, the current study did not show any added value when using a non-technical OT for NTS learning in anaesthesia residents observing simulated crisis management. ...
... Some studies have therefore sought to elucidate the formative value of observation-based learning with OT in different simulation contexts and with different types of tools [17,25,26,34]. The randomised cross-over study of Stegmann et al. [34] found a beneficial effect on learning However, contrary to these previous positive results, the current study did not show any added value when using a non-technical OT for NTS learning in anaesthesia residents observing simulated crisis management. Theoretically, the use of an OT enables more active learning by increasing attention and improving learning thanks to the attention boost effect [35]. ...
Background
The use of an observer tool (OT) has been shown to improve learning of technical skills through observation in simulation. The objective was to assess the impact of a non-technical OT on anaesthesia residents’ learning of non-technical skills (NTS) during simulation.
Methods
After consent, residents were randomised into 2 groups: OT+ (with an OT based on NTS to be systematically completed during observation of others) and OT- (without OT). Both groups observed a high-fidelity simulation of crisis management (with or without OT), then were asked to perform actively another simulation. The primary outcome was NTS performance, assessed by an evaluator using the Anaesthesia Non-Technical Skills score (ANTS score out of 16) on video recording. Secondary outcomes were results of score items, satisfaction, team performance, and professional impact.
Results
No significant difference was found between OT + group (n = 33) and OT- group (n = 30) for the ANTS score (OT + 12 [9.5–12.5], OT- 10.5 [8.75–12]/16 (p = 0.13)). Among sub-items of the ANTS score, decision-making was significantly better in the OT + group (3 [2–3] versus 2 [2–3], p = 0.01). Satisfaction, team performance and perception of professional impact were not significantly different between groups.
Conclusions
This study showed no significant difference in learning of observational anaesthesia resident’s NTS whether or not they were provided a non-technical OT during crisis management simulation. Decision-making was better with an OT. Further work is necessary to define the place of OT in observer-based learning.
... The remaining group of students observed the simulations (OP). Previous studies have provided evidence, that APs and OPs benefit similarly from such simulations (Bong et al., 2017;Stegmann et al., 2012), so it can be assumed that in the present study APs and OPs benefit similarly from communication training. Owing to restrictions during the COVID-19 pandemic, the training took place in a digital meeting room. ...
... The preceding results on APs and OPs indicated that both benefited similarly from biology-specific communication training with regard to the utility value and fear, supporting previous empirical evidence (e.g. Stegmann et al., 2012). However, these results are inconsistent with previous results of a pilot study where APs rated the increase of perceived utility value significantly higher than OPs. ...
... Furthermore, when it comes to mastering authentic professional tasks, it is assumed that learners not only use acquired action routines when coping with the task but also specific conceptual knowledge (Chi et al., 1989). Thus, such authentic learning experiences might support the elaboration of conceptual knowledge by encouraging learners to reflect and restructure acquired knowledge against the background of central aspects of practice (Lane et al., 2008;Lane & Rollnick, 2007;St-Onge et al., 2013;Stegmann et al., 2012). ...
... However, increasing functional correspondence might make it more difficult to sustain physical correspondence. Role-plays, for example, are a widespread type of simulation, in medical programs at universities (Lane et al., 2008;Lane & Rollnick, 2007;Stegmann et al., 2012) or, via microteaching approaches with a long tradition in teacher education programs (Brown, 1975;He & Yan, 2011), but also in initial approaches as highly standardized simulated learning environments (Gartmeier et al., 2015;Marczynski, 2022;Seidel et al., 2015). In role-plays, learners typically take over a role (e.g., that of a teacher) and act with others when enacting a professional task. ...
To support professional competence development in teacher education, learning environments should allow learners to engage with professional tasks. It is crucial for knowledge and skill transfer in such learning environments to real-life context that preservice teachers perceive the task as authentic. However, due to a lack of prior knowledge, novices may have difficulties in recognizing relevant elements of practice. It is thus assumed that different factors may guide their perception of task authenticity independently of the task that has to be mastered. Such factors could be, for example, overt design features of the learning environments on a physical level or the familiarity with the learning context and learning prerequisites, which act as important links for knowledge acquisition. In this study, preservice teachers' perception of task authenticity is contrasted between two implementation types (video vs. role-play) of the same simulation aiming to foster diagnostic competence. The two types differ in approximating real-life practice concerning the professional task that has to be mastered. In an experimental, longitudinal study, N = 119 mathematics preservice teachers participated online in one type of the simulation four times during one semester (n = 66 video, n = 53 role-play). Perceived task authenticity was higher for the video simulation type and increased with repeated participation in the simulation independently of the implementation type. Further, preservice teachers' task utility value positively influenced their perception of task authenticity. The results illustrate the role of learning prerequisites as well as familiarity with the task for novices' perception. Also, they could be an initial indication that, depending on the level of learners' professional development, the way of approximating real-life practice in simulations might influence the perception of task authenticity.
... In domains such as teacher and medical training (e.g. Korucu-Kış, 2021, Stegmann et al. 2012), vicarious experiences have been shown to be as effective for developing the skills to respond to real patients or students as actual direct experience. For example, trainees may observe others undertake procedures on simulated patients, or they may reflect on critical incidents and dilemmas in online settings. ...
... For example, trainees may observe others undertake procedures on simulated patients, or they may reflect on critical incidents and dilemmas in online settings. Across the board, combining vicarious and "hands-on" experience was found to be the most effective approach (Stegmann et al. 2012). ...
At a time when wildfires and severe floods are challenging human society in unprecedented ways, we examine how immersive virtual environments can be used to enhance community preparedness for, and engagement with, disaster scenarios. Drawing on research from the fields of interaction design and participatory design, we explore the capacity of three-dimensional (3D) immersive virtual environments to foster increased situational awareness and risk perception among diverse communities—from first responders to local populations. Investigating tangible interfaces and interaction schemas applied to spatialised settings, we demonstrate how immersive environments can support effective scenario testing and rehearsal of responses to hazardous situations. Application of the described methods can equip users with response strategies that may prove productive in augmenting risk perception and deliberation.
... There is growing evidence that students can acquire communication skills and practice behaviors, typically acquired by firsthand participation, through observing the experience of others; this process is known as vicarious learning [54,55]. In the external role, the learner is listening/watching, but not directly participating in the simulated patient encounter [56]. ...
... Our PPE positioned students in the observer role, in which the learner is not directly participating in the simulated patient encounter [56]. As such, in our PPE, the student observed the roles of both the pharmacist and the standardized patient (SP), learning through a process known as vicarious learning [54,55]. To maximize benefit in the vicarious learning environment, we provided the learner observer tools (e.g., explanations of the learning activities and expectations) and a postactivity debriefing reflection exercise to process the learning [56,57]. ...
Purposefully developed professional identity formation (PIF) learning activities within the didactic curriculum provide crucial groundwork to complement PIF within authentic settings. The aim of this didactic exercise was to explore the impact upon student pharmacists’ PIF after viewing, analyzing, and reflecting upon a simulated pharmacist–patient encounter (PPE). A 12 min role-play video was created, featuring a pharmacist counseling a standardized patient on a new medication regimen; foundational principles of medication safety, health literacy, social determinants of health, empathic communication, and motivational interviewing were included in the counseling, with some aspects intentionally performed well, others in need of improvement. Also included were the patient’s varied reactions to the counseling. Students assumed the observer role and learned vicariously through viewing the PPE. Postactivity debriefs included justifying a foundational principle performed well by the pharmacist, and another in need of improvement, and a self-reflection essay expressing the impact of viewing the PPE on their PIF, from which extracts were thematically analyzed for impact. The main themes of the impact included increased awareness of counseling techniques, patient-friendly medical jargon, patient perspectives/empathy, positive and negative pharmacist role-modeling, and the value of the observer role. This PPE exercise enhanced PIF in terms of students thinking, acting, and feeling like a pharmacist, based on students’ self-reflections, which most often referenced effective pharmacist–patient communication and enacting optimal patient care.
... Noticing is, after all, recognized as crucial in models of clinical judgment (Tanner 2006). This takes up the potential of observation as a vicarious experience (Stegmann et al. 2012) but recognizes that it requires an approach that avoids a sense among observers that they are secondary and missing out on the key benefits of simulation. ...
... In more distant observation setups where the live facilitator support is not available, the key is to scaffold learners' noticing in different ways. Observation scripts have been advocated (Zottmann et al. 2018;Stegmann et al. 2012) but remain in need of further development. Asking students to spot examples from a list of practices or comment on what went well or not appears insufficient to breach the double distance and leaves students with scope to disengage in the hope that others observing more attentively will contribute in the debrief (Rooney et al. 2015). ...
... Derartige Simulationen sind in der medizinischen Ausbildung bereits gängige Praxis (z. B. Lane, Hood & Rollnick, 2008;Stegmann, Pilz, Siebeck & Fischer, 2012), aber auch für die universitäre Lehrerbildung wird ihnen großes Potential zugeschrieben (Grossman et al., 2009). In solchen Settings wird es Studierenden ermöglicht, verschiedene Rollen (z. ...
... Insgesamt wird simulationsbasierten Lernumgebungen das Potential zugesprochen, die Elaboration konzeptuellen Wissens zu unterstützen (z. B. Lane et al., 2008;Stegmann et al., 2012), indem erworbenes Wissen vor dem Hintergrund praktischer Handlungsfelder reflektiert und neu strukturiert wird. Weiterhin stellen simulierte Rollenspiele aufgrund ihrer vergleichsweise ökonomischen Realisierbarkeit für die hochschulische Lehrerbildung eine wichtige, ökologisch valide Lernressource für den Aufbau professioneller Kompetenzen dar. ...
... Vicarious learning can be more effective with structured observational guidelines and explicit, collaborative feedback. Stegmann et al. (2012) found that with a collaborative learning scenario and scripted feedback, participants demonstrated learning, but cautioned that if the observation situation is complex, students should be told where to place their focus. Katz et al. (2017) used vicarious learning to demonstrate social work skills to MSW level social work students. ...
... Participants also noted the experiential grounding of skills acquisition as opposed to learning skills through discussion and then performing themselves without having seen the skills demonstrated. Stegmann et al. (2012) found that vicarious learning more directly contributed to participants' skill development than learning independently. In their study, two hundred medical students were randomly assigned to participate in 2 separate, 30-minute simulated sessions, followed by collaborative, peer feedback. ...
While direct client experience is the optimal environment for social work students to learn interviewing skills, vicarious learning, or learning through observing peers or an instructor in a simulated client encounter, also affords students the opportunity for personal growth and reflection. To explore students’ experiences of vicarious learning this study involved Year 4 BSW students who observed the course instructor conduct 10, 1-hour, live simulated client interviews over the period of a two-semester course. Data for this study included a course assignment on the simulated sessions, and written responses to reflection questions, following the last simulated session. Thematic analysis surfaced salient themes which included the following: 1) benefits of live simulation: application of theory to practice and authenticity; 2) challenges of live simulation: logistical and experiential concerns; 3) application of empathy and active listening; 4) focus of attention; 5) maintaining attention and self-awareness; 6) reactions to simulated sessions; and 7) improved theoretical understanding and application. The article offers implications for social work educators to maximize vicarious learning in the social work classroom.
... Aunque es deseable que todo el grupo pueda actuar en algún momento como profesional en simulaciones complejas, el rol de observador también se asocia con un aprendizaje, pues es una manera de aproximación parcial a la tarea (Heitzmann et al. 2019). De hecho, algunas investigaciones han encontrado que estudiantes que solo han observado durante las simulaciones han mejorado las competencias entrenadas (Stegmann et al. 2012). ...
En este libro presentamos parte del trabajo elaborado en tres proyectos de innovación docente de la Universidad Complutense de Madrid (UCM) sobre el uso de la simulación como metodología docente en el contexto universitario.
Está dividido en dos partes, que se corresponden con sus dos objetivos principales.
En la primera, ofrecemos una breve introducción teórica sobre la aplicación de la simulación en la universidad, que puede servir para conocer los conceptos y los recursos básicos necesarios para emplear esta metodología. En la segunda, incluimos una serie de escenarios de simulación desarrollados en distintas asignaturas de grados y posgrados de las facultades de Medicina, Educación y Psicología de la UCM. Estos pueden ser utilizados como aparecen en este libro o adaptarse para crear casos nuevos. Todos los escenarios están enfocados a la atención psicopedagógica, educativa, social y psicosanitaria y, por tanto, no incorporan tecnología ni equipamiento propio específico.
... En effet, la littérature supporte l'apprentissage par l'observation des pairs pour diverses aptitudes et contexte clinique. [9][10][11][12] Comme O'Regan & al. l'ont mentionné dans leur revue systématique, l'observation des pairs est bénéfique pour l'apprentissage du RC lorsque l'EO observe de façon engagée. 7 L'utilisation d'un formulaire post-interaction dans l'étude actuelle force les étudiants à observer l'entrevue de façon active sans y participer eux-mêmes. ...
Contexte
Dans le cadre des séances de simulation de raisonnement clinique (RC) à la faculté de médecine de l’Université d’Ottawa, les étudiants de pré-externat sont jumelés en dyade afin d’augmenter le nombre de cas cliniques pratiques avant l’externat. Un étudiant joue le rôle du clinicien (EC) et l’autre est observateur (EO) en alternance. Cette étude descriptive quantitative vise à comparer la génération d’hypothèses diagnostiques des EO à celles des EC pour soutenir l’utilité de l’observation engagée des pairs comme stratégie d’apprentissage du RC en contexte de simulation clinique.
Méthodes
Suivant un entretien avec un patient simulé, les EC et les EO ont été invités à générer deux hypothèses diagnostiques dans un formulaire électronique. Les réponses ont été compilées, catégorisées et comparées en termes d’hypothèses diagnostiques équivalentes au sein d’une même dyade. La différence de distribution de fréquences des hypothèses équivalentes a été analysée statistiquement à l’aide d’un calcul du chi-carré.
Résultats
Le pourcentage de dyades avec au moins une hypothèse diagnostique équivalente varie entre 83 à 100% selon le scénario. Le nombre d’hypothèses équivalentes entre les EO et les EC est statistiquement significatif (p<0.01).
Conclusion
Les EO semblent pouvoir générer des hypothèses diagnostiques semblables aux EC. Les résultats soutiennent l’utilisation de l’observation engagée des pairs comme stratégie d’apprentissage du RC en contexte de simulation clinique au pré-externat de médecine.
... Simulated cases may be preferable to real-life practice as the complexity and unpredictability of real situations potentially overwhelm learners, especially in beginning stages of knowledge acquisition or training (Stegmann et al., 2012;Grossman et al., 2009). Another advantage of simulations is that learners can be guided to (repeatedly) practice specific parts of a task ( van Merriënboer & Kirschner, 2017). ...
Teachers routinely observe and interpret student behavior to make judgements about whether and how to support their students’ learning. Simulated cases can help pre-service teachers to gain this skill of diagnostic reasoning. With 118 pre-service teachers, we tested whether participants rate simulated cases presented in a serial-cue case format as more authentic and become more involved with the materials compared to cases presented in a whole case format. We further investigated whether participants with varying prior conceptual knowledge (what are symptoms of ADHD and dyslexia) gain more strategic knowledge (how to detect ADHD and dyslexia) with a serial-cue versus whole case format. We found that the case format did not impact authenticity ratings but that learners reported higher involvement in the serial-cue case format condition. Bayes factors provide moderate evidence for the absence of a case format effect on strategic knowledge and strong evidence for the absence of an interaction of case format and prior knowledge. We recommend using serial-cue case formats in simulations as they are a more authentic representation of the diagnostic reasoning process and cognitively involve learners. We call for replications to gather more evidence for the impact of case format on knowledge acquisition. We suggest a further inquiry into the relationship of case format, involvement, and authenticity but think that a productive way forward for designing authentic simulations is attention to aspects that make serial-cue cases effective for diverse learners. For example, adaptive feedback or targeted practice of specific parts of diagnostic reasoning such as weighing evidence.
... RPs are used in small or larger groups where students usually prepare for their part with a script (Joyner & Young, 2006) and play the role of doctor, patient, or observer. Although the distinction between an active (doctor, patient) and a passive (observer) role has been made, observers are engaged and benefit from actively assessing the situation, especially by means of instructional support, such as an observational script or protocol (Stegmann et al., 2012). Hence, we suggest the terms interactive (doctor, patient) and observational. ...
Authenticity in simulation-based learning is linked to cognitive processes implicated in learning. However, evidence on authenticity across formats is insufficient. We compared three case-based settings and investigated the effect of discontinuity in simulation on perceived authenticity. In a quasi-experiment, we compared formats of simulation in the context of medical education. All formats simulated anamnestic interviews with varying inter-actant and task representations using highly comparable designs. Interactants (patients) were simulated by (a) live actors (standardized patients), (b) live fellow students (role-plays), or (c) question menus and videoclips (virtual patients). The continuity of simulations varied. We measured perceived authenticity with three subscales: Realness, Involvement , and Spatial Presence. We employed confirmatory factor analysis (CFA) to assess measurement invariance across settings and analysis of variance on authenticity ratings to compare the effects of setting and discontinuous simulation. CFA supported the assumption of invariance. Settings differed in Realness and Spatial Presence but not Involvement. Discontinuous simulations yielded significantly lower ratings of authenticity than continuous simulations. The compared simulation modalities offer different advantages with respect to their perceived authenticity profiles. Lower levels of interactivity and reduced subtask representation do not necessarily lead to lower ratings of perceived authenticity. Spatial Presence can be as high for media-based simulation as for roleplays. Discontinua-tion of simulations by offering scaffolding impairs perceived authenticity. Scaffolds may be designed to avoid discontinuation of simulation to uphold perceived authenticity.
... Im medizinischen Bereich sind diese bereits gängige Praxis in der Ausbildung (u. a. Lane et al., 2008;Stegmann et al., 2012), aber auch im Bereich der universitären Lehrkräftebildung wird sich ein Mehrwert von ihnen versprochen (Grossman et al., 2009). In einem Rollenspiel können Studierende verschiedene Rollen (z. ...
Im Artikel wird mit KOSI – Kognitiv aktivierende Gespräche im Mathematikunterricht digital simulieren ein Projekt vorgestellt, dass durch digitale Selbstlerneinheiten Grundschullehramtsstudierende auf eine kognitiv aktivierende Gesprächsführung vorbereiten möchte. Kern der Selbstlerneinheiten bilden Dialogsimulationen, die als interaktive Übung ein echtes Gespräch mit einem Kind nach-ahmen. Im Folgenden werden ausgehend von Herausforderungen einer kognitiv aktivierenden Gesprächsführung im Unterricht das Projekt und der erwartete Mehrwert vorgestellt. Das Projekt wird im Rahmen des Programms „Fellowship für Innovationen in der digitalen Hochschullehre“ durch den Stifterverband und das Thüringer Wissenschaftsministerium gefördert.
... As Bruner (1987) noted, many of our experiences with the world are not direct, suggesting that we can learn through mechanisms other than firsthand experience. Stegmann et al. (2012) found that vicarious learning can be unexpectedly more effective than learning by doing. In addition, vicarious learning can play a role in students' acquisition of professional skills (Tufford et al., 2021), and has been found to be helpful in online language learning (Pleines, 2020). ...
Virtual Reality (VR) is increasingly recognized as a promising tool to enhance learning, yet research on the use of VR instructional approaches for online learning remains limited. The present study aims to address this research gap by examining the effects of VR instructional approaches and textual cues on learning. We conducted an educational VR study using a 2 × 2 + 1 between-subjects design involving 67 secondary vocational students. Participants learned computer assembly online and were exposed to either vicarious experience or direct manipulation instructional approaches, with or without textual cues. A control group received traditional online instruction using slides. We collected retention, transfer learning outcomes, cognitive load, and learning experience of students. The findings indicated that while vicarious VR had no effects on long-term retention, transfer, and learning experience, there were significant positive effects on the immediate acquisition of knowledge. Textual cues did not affect learning in general. However, for immediate knowledge gain, they did provide a positive boost to learning in VR involving direct manipulation, while they were unnecessary in vicarious VR experiences. This study contributes to how the cueing principle can be extended to educational VR contexts and expands the knowledge of vicarious VR learning.
... There are a few limitations to the study. There were a small number of residents who were the lead residents of the SPE compared to the observing residents, and we were unable to compare the survey results of the lead resident to the results of the observing residents, though there is evidence that vicarious learning can be as effective as learning by doing [15]. Additionally, this specific SPE was only run at a single institution, therefore limiting its generalizability, though it was run three times with many learners overall and with two different languages. ...
Background: Pediatricians can cultivate a more trusting relationship with their non-English speaking patients by emphasizing the importance of upholding patient confidentiality in the presence of an interpreter. We designed a case for pediatric residents to increase comfort when conducting an adolescent interview using a medical interpreter, emphasizing the importance of upholding patient confidentiality, specifically when discussing sensitive health topics.
Methods: We developed a standardized patient encounter (SPE) for pediatric residents at a large academic institution that focused on exploring sensitive health topics with an adolescent, non-English speaking female patient using an interpreter. A validated survey was administered upon completion of the case, prompting participants to reflect on their comfort and skills with specific activities before and after the case, and was analyzed using paired t-tests.
Results: Eighty-nine residents participated; 66 were interns and 23 were in their second year of residency. The mean scores of all paired survey items significantly increased after the case (p<0.01), indicating perceived personal growth in all educational objective categories. The majority of the participants (97%, N=86) agreed that they built skills in understanding cultural humility and caring for future patients (mean Likert scores: 4.91 and 5.10, respectively).
Conclusions: Upon completion of the case, residents reported increased comfort and skills using a medical interpreter for non-English speaking patients within the context of patient-centered care, discussing various sensitive health topics, emphasizing the importance of upholding patient confidentiality, and demonstrating skills in adolescent interviewing. Both medical confidentiality and cultural humility education can be integrated into simulation-based medical education to improve the quality of care for diverse patient populations.
... Additionally, learners can be assigned the role of an observer. Results on acquiring diagnostic competences in the role of an observer are still lacking, but Stegmann et al. (45) showed that communication skills can be acquired effectively in this role. ...
The health care system in Germany and in many other countries is facing fundamental challenges due to demographic change, which require new integrated care concepts and a revision of the collaboration between health care professions in everyday clinical practice. Internationally, several competency framework models have been proposed, but a framework that explicitly conceptualizes collaborative activities to improve interprofessional problem-solving competency in health care is still missing. Such a framework should define contextual, person-related, process-related, and outcome-related variables relevant to interprofessional problem solving in health care. Against this background, we present a conceptual framework to improve interprofessional collaboration in health education and care (FINCA) developed with scientific consideration of empirical data and various theoretical references. FINCA reflects an interprofessional learning and interaction process involving two persons from different health care professions and with different individual learning prerequisites. These two initially identify a problem that is likely to require interprofessional collaboration at some point. FINCA acknowledges the context of interprofessional learning, teaching, and working as well as its action-modifying context factors. We follow the reasoning that individual learning prerequisites interact with the teaching context during learning activities. At the heart of FINCA are observable collaborative activities (information sharing and grounding; negotiating; regulating; executing interprofessional activities; maintaining communication) that can be used to assess individuals' cognitive and social skills. Eventually, the framework envisages an assessment of the outcomes of interprofessional education and collaboration. The proposed conceptual framework provides the basis for analysis and empirical testing of the components and variables it describes and their interactions across studies, educational interventions, and action-modifying contexts. FINCA further provides the basis for fostering the teaching and learning of interprofessional problem-solving skills in various health care settings. It can support faculty and curriculum developers to systematize the implementation and improvement of interprofessional teaching and learning opportunities. From a practical perspective, FINCA can help to better align curricula for different health professions in the future. In principle, we also see potential for transferability of the framework to other areas where different professions collaborate.
... Qualitative data further contextualized this finding, indicating that participating as an observer decreased learning and made effective rubric-based scoring more difficult. This is in contrast to research which reported that the observer roles have been shown to contribute to similar knowledge gains as measured by forced response questions, qualitative data and rating scales [37][38][39][40][41]. ...
Simulation-based activities (SBAs) research has explored the perceived and actual impact of SBAs on nursing education. The current study compares the perceived efficacy and transferability of nursing simulation to clinical practice from the point of view of simulation facilitators (SFs), course professors (CPs) and students.
A one-time online survey was administered to SFs, CPs and students regarding SBA effectiveness. Quantitative data were analysed using descriptive analysis.
Student participants (especially those in years 2 and 3) perceived simulation to be a poorer (relative to course professors and SFs) reflection of their capabilities and means of developing clinical skills. Participants (including students, CPs and SFs) who reported that simulation group sizes as ideal were better prepared for SBAs, able to engage in clinical roles and to more effectively incorporate feedback. Qualitatively, CPs identified low-quality SBA facilitation as a barrier to learning effectiveness, and SFs described multiple approaches to simulation that influence transferability to clinical practice.
We conclude that a misalignment between the strengths and weaknesses of SBAs by CPs, SFs and students may challenge improvement efforts. Group size, less positive student attitudes and a lack of confidence in SFs should be specifically addressed.
... Fig. 1 Thematic analysis. Implementing breast ERAS protocols were not necessarily connected to trainees understanding the principles behind breast ERAS but being a believer in ERAS principles can help to bridge that gap between learning and doing The informal learning within the breast surgery service is not novel, as both medical education and data management literature has shown that learners can acquire knowledge by watching others complete a task instead of completing the task themselves [11,12]. Frequently, this informal learning occurred from patient encounters. ...
PurposeBreast enhanced recovery after surgery (ERAS) protocols emphasize multimodal analgesia to expedite home recovery, but variable implementation remains. This study examines how residents learn and use ERAS protocols, how they conceptualize pain management, and what influences breast surgery patients’ same-day discharges.Methods
Interviews were conducted with surgical residents following their breast surgery rotation using an interview guide adapted from existing pain management literature. Interviews were transcribed, de-identified, and independently inductively coded by two researchers. A codebook was developed and refined using the constant comparative method. Codes were grouped into categories and explored for thematic analysis.ResultsTwelve interviews were completed with plastic and general surgery residents. Ultimately, 365 primary codes were organized into 26 parent codes, with a Cohen’s kappa of 0.93. A total of six themes were identified. Three themes described how participants learn through a mixture of templated care, formal education, and informal experiential learning. Two themes delineated how residents would teach breast surgery ERAS: by emphasizing buy-in and connecting the impetus behind ERAS with daily workflow implementation. One theme illustrated how a patient-centered culture impacts postoperative management and same-day discharges.Conclusions
Residents describe learning breast surgery ERAS and postoperative pain management by imitating their seniors, observing patient encounters, completing templated orders, and translating concepts from other ERAS services more so than from formal lectures. When implementing breast ERAS protocols, it is important to consider how informal learning and local culture influence pain management and discharge practices. Ultimately, residents believe in ERAS and often request further educational tools to better connect the daily how-to of breast ERAS pathways with the why behind the enhanced recovery principles.
... Although the benefits for the student practicing their skills is evident, the research literature explored social learning theory with regard to the observer role in nursing education role-play scenarios. There is also evidence in the health professions, that observers are capable of learning skills like interviewing and counseling through observation alone (Davys-Beddoe, 2015;Roberts, 2010;Stegmann et al., 2012). ...
The longstanding use of the peer-to-peer role-play offers social work students an introduction to developing their skills of intervention in a simulated client encounter. This experiential exercise permits students to practice the generalist skills involved in engaging, assessing, intervening, and terminating with clients in distress. Although the student social worker is the central player of this exercise, the client and observer have integral roles. To explore Bachelor of Social Work students’ (N = 18) perceptions of the client and observer roles, focus groups were conducted. Thematic analysis revealed the following themes for the client role: 1) Helping the student social worker; 2) Increased empathy for the character; 3) Increased vulnerability; 4) The need for feedback; and 5) Coping with triggers. The themes for the observer role include: 1) Learning through observing; and 2) Placement of observers. Implications for social work educators who use the peer-to-peer role-play are offered.
... Both the on-off approach among squads and the rotation of leadership within squads facilitated two modes of experiential learning: handson learning and vicarious learning. There is evidence that students can learn as much, if not more, by observing their peers perform tasks (vicarious learning) than through their own learning by doing (hands-on learning) [29], although students often prefer the hands-on approach [30]. ...
Wildland fire literacy is the capacity for wildland fire professionals to understand and communicate fundamentals of fuel and fire behavior within the socio-ecological elements of the fire regime. While wildland fire literacy is best developed through education, training, and experience in wildland fire science and management, too often, development among early-career professionals is deficient in one or more aspects of full literacy. We report on a hands-on prescribed fire methods workshop designed to provide training and experience in measuring and conducting prescribed fire, with a focus on grassland ecosystems. The workshop was held in March 2022 at The Nature Conservancy’s Dunn Ranch Prairie in northern Missouri. It consisted of hands-on training and experience in measuring fuels, fire weather, and fire behavior. Prescribed fire operations training facilitated both hands-on learning and vicarious learning by rotating squad roles among several small sub-units on the first day of live fire exercises. Participants then gained experience as crew members for two larger prescribed burns (60 and 200 ha). We report here on the successes and lessons learned from the perspectives of both participants and the instructor cadre for what was widely regarded as a successful workshop.
... Meanwhile, social learning theories and the GLM posit that personal behaviours are greatly influenced by the environment (Bandura and McClelland 1977;Buckley and Anderson 2006). People can efficiently learn by observing the behaviours of others and their consequences, known as vicarious learning, and be guided in action by expediency in the absence of strong countervailing internalised standards or prevailing social standards (Bandura 1986;Stegmann et al. 2012). Since prevailing social standards have generally not been established for the virtual world, the behaviour of other people in the immediate environment becomes a dominant source of social influence for gamers (Wu and Chen 2013). ...
Despite the substantial attention paid to the effects of game violence and game addiction, insufficient research has been conducted on other moral risks of gaming behaviour. Drawing upon the General Learning Model and the Differential Susceptibility to Media Effects Model, the current study utilised a survey approach to investigate the effect of online gameplay on emerging adults’ real-life unethical decision-making. The mediation analyses showed no direct effect of gaming intensity on unethical decision-making, but revealed two significant indirect effects: the specific indirect effect through game cheating and the serial indirect effect through game cheating and moral disengagement. Both the indirect effects were contingent upon the moderator of peer cheating. Specifically, the relationship between gaming intensity and unethical decision-making was positively significant at low levels of peer cheating and negatively significant at high levels. In addition to contributing to a broader view of the effects of online gameplay, this study also contributes to the literature on divergent gaming behaviours and online ethics.
... Previous studies have shown that observing doctors communicating with their patients can enhance knowledge on effective doctor-patient communication strategies amongst medical students [21]. Vicarious experiences of this kind can help learners believe they can match the accomplishments of their peers, and impact on students is directly correlated with the extent to which they relate to the model being observed. ...
Background:
Existing literature on cardiopulmonary resuscitation (CPR) training focuses on the knowledge and skill components while the attitudinal component is rarely addressed. There is a need to explore how peer interaction, learning atmosphere, and communication influence learning effectiveness during CPR training. Therefore, this study's objective was to evaluate how a senior student (near peer) sharing their real-life experience of performing CPR would influence medical students' learning and readiness to perform CPR.
Methods:
The present study involved 250 newly enrolled undergraduate medical students. The Solomon's four-group study design was used to evaluate the influence of both pretesting and peer interaction. Students belonging to two groups initially completed a pre-training knowledge test (pretest) and a questionnaire on readiness to perform CPR. Students from all four groups then participated in instructor-led hands-on skills training, after which the two intervention groups interacted with their senior, who shared their life experiences of performing CPR. Finally, all four groups underwent skills evaluation, immediate and delayed post-tests, and completed a questionnaire to assess readiness to perform CPR. The students also provided their feedback on the experience of interacting with a peer during the training.
Results:
Post-test scores were significantly higher than pretest scores (Kruskal-Wallis test, p < 0.05). Scores were significantly higher in pretested intervention groups than in the non-pretested non-intervention group (p < 0.05). Delayed post-test scores were slightly but not significantly lower than the immediate post-test scores with no significant difference observed in the scores among the groups. The pretested groups showed more readiness to perform CPR and the pretested intervention group were least concerned about acquiring infection during CPR. Students in all groups were confident of performing chest compressions correctly, and found it inspiring and motivating listening to and discussing real-life experiences with a near peer.
Conclusions:
Hearing from peers about real-life CPR experience during CPR training sessions significantly impacted learning, enhanced student motivation to learn and may be an effective strategy to consider in routine CPR training. However, the positive effects of pretesting and peer interaction on knowledge were not sustained, highlighting a need for repeat training.
... "L'outillage" du rôle d'observateur nous parait en faveur du renforcement de l'apprentissage vicariant du fait d'une observation plus active. Cette pratique est encouragée depuis plusieurs années (Hober & Bonnel, 2014 ;O'Regan et al., 2016) et semble produire, outre un engagement dans les échanges et une orientation des analyses fournies, des effets sur l'amélioration des compétences non-techniques (Lau et al., 2001 ;Stegmann et al., 2012). ...
La formation par simulation interprofessionnelle s’est imposée ces dernières années avec pour perspective le développement des compétences relatives à la sécurité des patients. Néanmoins, l’incidence des événements indésirables liés aux soins concerne encore un patient hospitalisé sur dix. Cette thèse contribue à éclairer le rapport travail- formation, plus précisément le rapport entre la configuration didactico-pédagogique et le potentiel d’apprentissage organisationnel. Elle s’appuie sur une méthode mixte intégrée, combinant un ensemble d’analyses qui traite des composantes de l’acte éducatif, de la pluralité des situations professionnelles qui en constitue la référence, de l’évolution des compétences perçues qui en découlent. Le dispositif étudié est caractérisé par un mode transmissif davantage qu’interactif, par un faible partage de la réflexivité de la part des apprenants, et par des débats centrés très largement sur des éléments favorables à un apprentissage simple boucle plutôt que double boucle. Le suivi en quatre temps de l’évolution des compétences perçues montre un développement limité dans le temps de la plupart des domaines de compétences relatives à la sécurité des patients. Exploiter le potentiel d’apprentissage organisationnel en simulation interprofessionnelle et renforcer les compétences relatives à la sécurité des patients par leur ampleur et leur durée, impliquent une consolidation de l’articulation entre le travail et la formation, d’une part en soutenant le positionnement des apprenants à partir de leurs richesses d’expérience, d’autre part en abordant l’environnement de simulation comme un lieu de réflexivité sur l’activité, propice à la transformation des pratiques.
... While AoPs in teacher education have strongly focused on the use of video cases (e.g., Seidel et al. 2011;van Es and Sherin 2008), the field of medical education has a long tradition of investigating the use of simulations and simulated patients (Lane and Rollnick 2007). In particular, the use of roleplay-based simulations with actors as patients has been investigated (e.g., Lane et al. 2008;Stegmann et al. 2012), as these simulations allow for interpersonal interaction, portray the natural behavior of participants and allow them to make their own decisions. Paralleling this development, research in teacher education has started to investigate roleplay-based live simulations, such as teacher-parent communication (Gartmeier et al. 2011) or diagnostic one-on-one interviews with students (Marczynski et al. 2022). ...
The acquisition of diagnostic competences is an essential goal of teacher education. Thus, evidence on how learning environments facilitate pre-service teachers’ acquisition of corresponding competences is important. In teacher education, approximations of practice (such as simulations) are discussed as being learning environments that can support learners in activating acquired knowledge in authentic situations. Simulated diagnostic interviews are recommended to foster teachers’ diagnostic competences.
The conceptualization of diagnostic competences highlights the importance of cognitive and motivational characteristics. Motivational learning theories predict that the activation of acquired knowledge in learning situations may be influenced by motivational characteristics such as individual interest. Although teachers’ diagnostic competences constitute an increasing research focus, how cognitive and motivational characteristics interact when shaping the diagnostic process and accuracy in authentic learning situations remains an open question.
To address this question, we report on data from 126 simulated diagnostic one-on-one interviews conducted by 63 pre-service secondary school mathematics teachers (students simulated by research assistants), studying the combined effects of interest and professional knowledge on the diagnostic process and accuracy. In addition to the main effect of content knowledge, interaction effects indicate that participants’ interest plays the role of a “door-opener” for the activation of knowledge during simulation-based learning. Thus, the results highlight the importance of both, cognitive and motivational characteristics. This implies that simulation-based learning environments should be designed to arouse participants’ interest to support their learning or to support less interested learners in activating relevant knowledge.
... According to the self-efficacy theory [33,34], one's self-efficacy increases not only through positive personal experiences but also by seeing others succeed. There has been an increasing awareness and understanding of learning from others within higher education [35,36] and various professions that require clinical practice [32,37,38]. However, this learning approach has not been well-described in the social work learning literature. ...
Background:
Information and communication technology (ICT) use may enhance social work practice and continuous professional development. Under the Hong Kong Jockey Club SMART Family-Link Project, we developed an innovative web-based training, learning, and sharing platform (i-TLS) to support not only ICT and other learning needs of Hong Kong social workers but also their practice.
Objective:
We developed i-TLS with 3 major components (i-Training, i-Learning, and i-Sharing) and assessed its acceptability and impact on facilitating ICT use in family services.
Methods:
We described the i-TLS development based on a 4-phase model and evaluated i-TLS using the platform database, Google Analytics, a self-administered survey, and individual phone interviews 1 year after launching.
Results:
i-TLS was launched in 12 nongovernmental organizations on July 1, 2019. The COVID-19 outbreak in December 2019 limited face-to-face services, which galvanized digital transformation in social work practice. By July 31, 2020, 313 social workers had registered with i-TLS. Approximately 79.6% (249/313) of users accessed i-TLS at least once in the past 28 days, averaging 3.2 (SD 1.35) platform visits per day and viewing 4.8 (SD 1.42) pages per visit. i-Training provided 41 mini-modules on applying ICT to family services, with 730 enrollments. Approximately 70% (511/730) of users completed the mini-modules and obtained digital mini-certificates. i-Learning provided 112 items of learning resources centered on ICT use in family services, with nearly 4000 page views. i-Sharing had 25 discussion threads with 59 posts. Approximately 53.7% (168/313) of users completed the 1-year evaluation survey, including 7.1% (12/168) who were phone interviewed. The mean i-TLS satisfaction score (out of 10) increased from light (4.99, SD 1.54) to occasional (6.15, SD 1.34) and frequent (6.31, SD 2.29) users. Frequent users showed higher scores (out of 10) than light users for an increase in knowledge (5.84, SD 1.34 vs 4.09, SD 1.74; P<.001), self-efficacy (5.23, SD 1.92 vs 3.96, SD 1.77; P=.02), and knowledge application (6.46, SD 1.33 vs 1.91, SD 1.40; P<.001). Interviewees reported increased ICT use in services and considered i-TLS an acceptable and supportive tool for learning and practice, especially during the pandemic.
Conclusions:
i-TLS is acceptable to social workers and enhances their learning and use of ICT in family services. This was achieved through access to self-directed and collaborative learning and sharing of experiences within their practice. Further research on enhancing web-based platforms is needed to expand participation and capacity building among social workers and other health and social care professionals.
... A third tool would be to let learners take on different roles. Switching from the perspective of the person who conducts the diagnosis to the perspective of an observer or even the patient or student might lead to new insights about diagnostic errors (Stegmann et al., 2012). The presented simulations will not only allow us to see whether explicitly presented information on concepts and procedures as well as scaffolding is helpful, but also which version of this information is most beneficial. ...
This final chapter starts with an overview of the simulations presented throughout the book. All of the simulations are tools to test and foster diagnostic competences. The simulations differ regarding diagnostic modes, sources of information, domains, and topics. The chapter then revisits the four overarching research questions from the introduction and lies out potential avenues for future research: (1) Diagnostic activities are a promising concept to explore the processes that are central for generating learning outcomes. (2) Optimal means of supporting learners in simulations might include the presentation of information, prompts, reflection phases, and role-taking. (3) Various characteristics of the learners, such as their expertise level, as well as the simulation, such as its authenticity, could mediate the effects of instructional support. (4) If simulations are adaptable, between learners or within the same simulation, they might increase the learning potential even further. The chapter then gives examples for how the projects presented in this book will address these four topics. The outlook ends with a call for interdisciplinary research.
... Meta-analytic findings indicate that simulation-based learning conveys diagnostic competences effectively if adequate instructional support is offered to learners (Cook et al., 2010(Cook et al., , 2013. Instructional support measures such as reflection phases and roletaking seem promising for fostering diagnostic competences in history-taking situations because they are beneficial for acquiring complex skills in other contexts within medical training (Stegmann et al., 2012;Mamede et al., 2008). Presently, however, only limited empirical findings are available concerning facilitating diagnostic competences in history-taking simulations via these two instructional support measures (Keifenheim et al., 2015). ...
History-taking is an essential diagnostic situation and has long been an important objective of medical education in European countries and beyond. Thus, the research project presented here investigates facilitating diagnostic competences in live and video history-taking simulations. In this chapter, the theoretical background and the design, development, and validation process of the learning environment for this research project are described. In the first section, an overview of history-taking models is provided, the concept of diagnostic competences for history-taking is specified, and a summary of research on simulation-based learning and assessment of history-taking is given. The second section reports on the creation of knowledge tests and the live and video simulations. In the third section, results from a pilot study and an expert workshop are disclosed and findings from a validation study are provided. These findings indicate that the created simulations and knowledge tests measure separate but related aspects of diagnostic competences reliably and validly and may be used for assessment. In the final section, a summary is provided and future questions for research are presented with a focus on the adaptivity of scaffolds and simulation-based learning from atypical cases.
... Active engagement is important for simulation-based learning 36,37 and is a significant factor in observational learning. [38][39][40][41][42] However, emotional activation can be both positive (excitement) and negative (stress). A meta-analysis concluded that although stress is related to an individual's resources and situational appraisal, it can be expected to impede performance in tasks requiring recall, working memory, divided attention, and decision making. ...
Introduction:
The degree of emotional activation required for optimal learning in either hands-on or observer roles is unclear, as is the level of stress that impedes learning. Measuring emotional activation is time-consuming, and many scales measure threat or anxiety without considering pleasurable activation. This study examined emotional activation in the observer and hands-on roles in 2 different scenario designs.
Methods:
This study was a 2-cohort, parallel study of graduate nurses and doctors completing 2 different courses in managing the deteriorating patient. We examined emotional activation by role across 2 scenario designs. We measured emotional activation on 3 anchored measures scales: the State Trait Anxiety Inventory, Cognitive Appraisal Index, and the Affect Grid with data analysis using analysis of variance and repeated measures.
Results:
Hands-on learners experienced higher anxiety, threat, and arousal levels and less pleasure than observers in both scenario designs. There were no differences in pre-emotional and postemotional activation in immersive scenarios for either role and increased arousal and decreased threat and anxiety in the hands-on role in the pause-and-discuss scenario design.
Conclusions:
Hands-on learners were more emotionally activated than observers in both scenario designs. There was significant perceived anxiety, threat, and pleasurable arousal in both roles and both scenario designs. Pause-and-discuss scenarios demonstrated similar levels of activation as the immersive scenario design. The Affect Grid provided a quick subjective view of arousal and pleasure in simulation participants, potentially providing educators with an indication of whether emotional activation is positive (excitement) or negative (stressful) and may be helpful in educational planning and future research.
... In the current global context, SBLE allows educators to continue the vital education and development of psychologists, addressing some of the barriers associated with placement loss. SBLE provides several additional opportunities (detailed below), both as an educational approach and a framework for competency-based assessment (McNaughton et al., 2008;Butler et al., 2009;Kameg et al., 2010;Maas and Flood, 2011;Stegmann et al., 2012;Milkins et al., 2014;Nestel et al., 2017). ...
In training to become a registered psychologist in Australia, as with many other countries, there is a requirement for students to attend placements, where they work with clients in an apprenticeship model under the guidance of qualified supervisors. In the context of COVID-19, tertiary sector psychology educators responsible for facilitating these placements, which typically require face-to-face client work, have been challenged to arrange or maintain practica. During the pandemic, across Australia, most placements have been affected through cancellation, postponement, or modification (e.g., using telehealth, supported by the Australian Federal Government). In this paper we describe a collaborative initiative by members of the psychology profession across 15 providers of Australian postgraduate professional training programs. The initiative aimed to identify ways in which to develop and innovate psychological placement offerings, specifically using simulation-based learning. Although simulation-based learning in psychology training programs in Australia is a widely employed pedagogy for the scaffolding of theory into psychological practice, there is paucity of clear and comprehensive guidelines for the use of simulation to both optimize competency-based training and ensure public and student safety. The overarching aim of the group, and the focus of this paper, is to provide standardized guidelines for the inclusion of simulation-based learning in psychology training in Australia both during and post-COVID 19. Such guidelines may be equally valuable for psychology training programs globally.
Recruiting and retaining research participants is challenging because it often requires overcoming structural barriers and addressing how histories of mistrust and individuals’ lived experiences affect their research engagement. We describe a pilot workshop designed to educate clinical research professionals on using empathy skills to recognize and mitigate bias to improve recruitment and retention. In a post-workshop survey (22/31 participants completed), 94% agreed the workshop helped them practice perspective-taking, recognize implicit bias, and identify opportunities for empathy. Participants reported increased confidence in key recruitment and retention skills ( p < 0.05). Future studies will evaluate whether this translates into improved recruitment.
Vicarious learning is obtaining knowledge through seeing the activities and results of others. One can acquire new knowledge, abilities, and habits without necessarily experiencing them firsthand. Vicarious learning is a very successful method of education that can occur in a variety of contexts, including the classroom, business, and daily life. An individual observes the conduct of others and learns from the repercussions of their actions without engaging in the behavior themselves. By examining and assessing the activities of others, students can improve their problem-solving and critical thinking skills through observation. By observing the behaviors and emotions of others, students can learn how to manage their emotions and interact with others in a positive and productive manner. Students can gain essential social skills such as empathy, collaboration, and cooperation, which are essential for success in both academic and non-academic settings. To gather information, a test instrument has been constructed by the researcher. A sample of (40) students divided into two groups (experimental and control one), from the English Department at the College of Education for Humanities / University of Diyala of the academic year (2023). K E Y W O R D S Vicarious Learning, Effectiveness, Engagement, Classroom
Nursing is an art and a science; these words perhaps ring most true for mental health nursing. Mental health nursing (MHN) is a specialty where therapeutic human interaction and engagement are strongly aligned to positive consumer outcomes. The more engaging and therapeutic a mental health nurse is, the more likely this will result in a positive experience for the consumers. This does not always come naturally for many nurses, and these skills have to be learned in a safe environment. This makes MHN an ideal nursing specialty for educational experiences that incorporate working with simulated participants (SP). This chapter will explore the use of simulation in the specialty area of mental health nursing by providing best-practice examples and how to successfully integrate simulation into MHN undergraduate curricula. Including a sample case will be used as a guiding tool for the development or redevelopment of MHN simulation. These constructs should give readers a sound foundation to develop a successful MHN simulation program where students become practice ready.
The importance of the field of digital forensics (DF) is growing, where digital evidence is increasingly recognized as a crucial part of many investigations. As a result, criminal justice systems rely on DF practitioners to conduct robust investigations of digital devices and their data, and interpret and present these results in a way that can be relied upon. Undertaking this task appropriately requires a practitioner to have a range of skills; however, focus is often placed on the need for and importance of technical competency. Technical skills are vital in this role, that cannot be in dispute; however, this work discusses the need for practitioners to also have an “investigative mindset.”
This article is categorized under: Digital and Multimedia Science > Cybercrime Investigation
The current study examined the use of immersive technology as a way to improve access to high-quality interpersonal breastfeeding interactions in an undergraduate clinical lactation course. In particular, we investigated the impact of immersive consultation videos and related activities on student self-efficacy, motivational beliefs, and perceived skill level. Results indicate that usability was high, with participants rating videos, interactives, and activities positively. Students did report a significant increase in self-efficacy and their perceived ability to meet the course learning objectives; no significant changes in the level of interest or perceived skill were found. Our results demonstrate that high-quality immersive videos can be an important learning tool for teaching clinical skills when access to direct patient care is limited or absent.
Background
Simulation in healthcare education is becoming increasingly popular. However, there is limited evidence of simulation in post registration education or in neurological practice. This article reports on the introduction of simulation into a neurological course for registered nurses and the value of this from the learner perspective.
Aim
To explore the experiences of nurses who participated in a neurological simulation activity.
Methods
A phenomenological research design was used to explore the experiences of 10 registered nurses using semi-structured interviews.
Findings
A total of four key themes were generated from the analysis: being in the spotlight, reality of simulation, theory to practice interface, and learning and working with others.
Conclusion
The lived experience of the participants of this study has shown that neuro-simulation is valued as a teaching strategy to consolidate learning, with low-fidelity simulation receiving the most positive feedback owing to its authentic nature. A review of the high-fidelity session, where the simulation should become more realistic and use smaller, interprofessional groups, needs to be considered.
Tolerancija stresa jedna je od karakteristika otpornih pojedinaca, a dugoročna izloženost stresu na radnome mjestu dovodi do sindroma profesionalnog izgaranja. Vikarijska trauma je ishod kontinuirane izloženosti traumi korisnika i vezana je uz direktan rad s ljudima. I dok se profesionalno izgaranje može pojaviti u svim područjima rada, za vikarijsku traumu specifično je da se pojavljuje samo kod praktičara čiji su korisnici žrtve ili rjeđe počinitelji nasilja. U radu su prikazani rizični i zaštitni čimbenici te mehanizmi koji pomažu predvidjeti koji će pojedinci biti podložniji simptomima vikarijske traume, o kojoj se nedovoljno sluša u programima osposobljavanja socijalnih radnika za rad s ranjivim skupinama korisnika. Ti čimbenici mogu biti osobni ili organizacijski. Zajedničko im je to da narušavaju produktivnost socijalnih radnika, njihovu predanost i zadovoljstvo poslom te sposobnost suosjećanja, a posljedice mogu utjecati i na njihov obiteljskih život. Ključne riječi: socijalni rad, vikarijska trauma, sekundarna trauma, izgaranje, stres
Les professionnels de santé sont particulièrement impactés par les problèmes liés au stress. Ceux qui exercent en anesthésie réanimation ont un risque majoré. Le secteur de la santé et la santé des individus sont au cœur du changement (Rhéaume, 2002 ; Bedin, 2013 ; Marcel, 2014). La formation des praticiens a évolué pour une approche par les compétences et intègre la simulation comme méthode de développement de ces compétences. Dans ce contexte, nous avons essayé de mettre en évidence l’impact de la simulation pleine échelle de situations critiques (Pastré, 2010) sur le stress, l’anxiété, l’épuisement professionnel et in fine sur la qualité de vie au travail des participants. Pour cela, nous avons réalisé, dans le cadre d’une démarche quasi-expérimentale, une phase exploratoire, avec 50 étudiants en soins infirmiers, pour tester trois échelles relatives à l’anxiété et au burn out. Lors de la phase 2, nous avons assisté à des séances de simulation auprès de soignants exerçant en anesthésie réanimation pendant un an et testé 209 professionnels. Ils ont renseigné les échelles avant et après la séance de simulation. Enfin, dans la phase 3, nous avons cherché à mettre en évidence l’effet de la simulation sur le stress clinique de 215 étudiants en soins infirmiers. Nous montrons les effets positifs que semble avoir la simulation sur le stress, l’épuisement professionnel, l’anxiété et les traits de personnalité anxieux des participants. D’autre part, il semblerait que la simulation puisse permettre une diminution du stress clinique des étudiants en soins infirmiers et que cet effet soit stable quatre mois après la séance de simulation. La simulation aurait ainsi un effet préventif sur le stress. Ces résultats permettent d’appuyer des propositions de développement de cette méthode pédagogique en formation initiale et continue.
Purpose
Nurses’ lack of competence to be caring affects patients’ health and patients describe a desire for more individual and compassionate care. Nursing education tends, however, to focus less on the caring approach in nursing practice and more on developing knowledge in psychomotor skills. The aim of this study was to describe nursing students’ experiences of simulating caring and uncaring encounters founded on the caritative perspective at a Clinical Training Centre (CTC).
Method
A qualitative, inductive approach using a qualitative latent content analysis. Written reflections of 49 students were analysed.
Findings
By intertwining reflection with acting and observation, the students experienced that they achieved an open mind and gained an understanding of how important it was to treat the patient based on a caring approach. To act, first uncaring and thereafter caring, gave them an awakening. The students were touched and an overwhelming feeling of suddenly understanding human uniqueness and vulnerability appeared.
Conclusions
To simulate caritative caring and uncaring encounters at the CTC enhanced students’ knowledge and understanding about caring and strengthened their prerequisites to acquire a caritative ontological basic view and attitude which in the long run may lead to an increased feeling of patient well-being in the encounter.
As virtual reality (VR) technologies have been increasingly adopted in the educational field, careful consideration and evaluation of instructional modes to support learning with VR are needed. This study focuses on evaluation of two instructional modes: direct interaction and manipulation of the VR learning environment; and the vicarious approach of observing how a novice peer and an expert learn with VR. An experimental design was utilized with two comparison conditions: direct VR interaction (n=72) and the vicarious approach (n=69). Participants’ knowledge and emotional engagement were evaluated via self-report questionnaires. Results showed that though learning with the direct VR condition was associated with more intense emotional engagement, there was no significant difference in knowledge gains between the two study conditions. The findings suggest that each of the two instructional modes has specific instructional affordances and that the cognitive and emotional components of learning via VR should be further explored. Since learning vicariously through observing the dialogue between an expert and a peer can have immediate knowledge gains comparable to the direct VR interaction, there is an effective and more accessible opportunity for VR-based learning. Future research should evaluate this instructional effect on knowledge retention.
Mathematical argumentations and proofs cause difficulties for secondary school students (Healy and Hoyles, 2000). Teachers’ diagnostic skills are essential for adapting their teaching to students’ specific needs in order to facilitate students’ understanding of proofs (Südkamp and Praetorius, 2017). We developed a video-based simulation to investigate and promote pre-service teachers’ diagnostic skills. Participants encountered a diagnostic task with short, scripted video clips showing simulated students working on a geometry proof with a teacher. Observing student-teacher interactions served as the basis for the pre-service teacher participants’ diagnoses of students’ individual argumentation skills. This simulation is first used to investigate pre-service teachers’ diagnostic performance and the quality of their diagnoses and diagnostic processes. In a second step, the simulation will be expanded into a learning environment to investigate how pre-service teachers’ diagnostic skills can be supported through different kinds of scaffolds.
The introductory chapter provides a brief overview of the existing research strands on simulation-based learning and the notion of diagnostic competences. We believe that the domains of medical and teacher education can learn a lot from each other, especially when it comes to designing learning environments to promote professional development. We therefore emphasize the need for finding similarities across disciplines and instructional design features that can be effectively transferred between domains. This chapter also introduces the three-level coherence framework used throughout the other chapters of this book to enable comparisons between the presented approaches to simulation-based learning. This chapter ends with an overview of the chapters in the book.
One-on-one diagnostic interviews with school students have been proposed as learning opportunities to acquire diagnostic competences. Moreover, role-play-based simulations have proved promising to foster interactive competences similar to diagnosis during early phases of teacher and medical education. Thus, we developed a role-play-based simulation of diagnostic interviews on the topic of decimal fractions for mathematics pre-service teachers. During the role-play, participants either take on the role of a sixth grader, a teacher interviewing a sixth grader, or an observer watching the interview. Based on cognitive labs addressing criteria such as authenticity and immersion in the teacher’s diagnostic task in the role-play, we analyze the feasibility of the chosen simulation approach to measure and foster mathematics pre-service teachers’ diagnostic competences.
Purpose
This study aims to identify the roles that privacy experiences and social media use play in influencing privacy-protection behaviors. As social media use expands in terms of the number of users and functionality; it is important to understand social media user privacy-protection behaviors and the users’ psychological underpinnings driving those behaviors. Among these, perceptions are the users’ evaluation of their privacy concerns and data sharing benefits inherent in social media use which influence the users’ behaviors to protect their privacy.
Design/methodology/approach
To research these issues, a theoretical model and hypotheses were developed, based on self-efficacy theory. The theoretical model was empirically tested using 193 questionnaire responses collected from students enrolled in business courses at a medium-sized university in the western USA. All the respondents reported that they routinely use social media. The empirical analysis was performed using structural equations modeling in PC SAS version 9.4, procedure Calis.
Findings
The estimation of the paths in the structural model indicates that privacy concerns positively influence social media users’ protection behaviors while the perceived benefits of data sharing negatively influence protection behaviors. Privacy experience positively influences privacy concerns. Alternatively, social media use positively influences social media self-efficacy and perceived usefulness, which, in turn, have meaningful influences on data sharing benefits.
Originality/value
Previous findings about the effect of self-efficacy on protection behaviors has been inconclusive. This study adds some clarity. Specifically, the findings suggest that the effect depends upon the foci of self-efficacy. While higher self-efficacy with respect to using privacy-related features of a specific technology tends to lead to greater privacy concerns, higher self-efficacy with respect to the more general technology (e.g. social media, computer) seems to affect protection behaviors through perceived benefits. Further, the results of this study offer conclusions about the roles that privacy experiences, social media use and perceived social media benefits play in affecting protection behaviors.
Introduction:
The growing number of learners implies that all of them cannot play an active role during high-fidelity scenarios. Studies suggest a positive educational value when learners are observers only, but it remains uncertain whether learning outcomes might be improved by using an observer tool (OT).
Methods:
Eighty-nine anesthesia residents were randomized to use an OT (n = 44, OT+; based on a cognitive aid) or not (n = 45, OT-) when not role-playing. The main outcome parameter was the learning outcomes assessed by comparing the change (before-after) in the response score to a questionnaire dedicated to medical knowledge obtained in the OT+ and OT- groups. The impact of using the OT was also assessed by measuring the perceived stress level and the change of the Anesthetists' Non-Technical Skill items values.
Results:
At the end of the session, the mean medical knowledge score (mean ± SD) was higher in the OT+ group than in the OT- group (11.4 ± 2.7 vs. 9.6 ± 2.4, respectively, P = 0.0008). The mean Anesthetists' Non-Technical Skill score and level of stress perceived did not differ between groups. Trainees rated similarly the learning value and satisfaction related to the simulation course.
Conclusions:
This study suggests that observing high-fidelity simulation scenarios using an OT based on a cognitive aid increases the medical knowledge gain when compared with that seen in passive observers. This study suggests that the use of an OT improves the educational value of simulation.
This research used vicarious-learning procedures in an attempt to increase students' knowledge of the domain and enhance the quality of their questions in an intelligent tutoring- system involving computer-controlled animated agents. Students who overheard a dialogue in which a virtual tutee asked a virtual tutor questions during acquisition wrote significantly more in free recall and asked significantly more questions in a transfer task than those who overheard a monologue. Students in the monologue condition asked significantly more shallow questions that require short answers than those in the dialogue condition. Students in the dialogue condition asked significantly more deep-level reasoning questions of the kind that were modeled by the virtual tutee during acquisition. It was concluded that modeling a brief dialogue involving question asking at the outset of a first learning session on an intelligent tutor system could enhance both the structure of the subsequent dialogue and knowledge acquisition.
Knowledge, although seemingly available, is often not used for problem solving. That means it remains "inert." Three types of explanations exist for this phenomenon. Metaprocess explanations assume that the relevant knowledge is available, but it is not used because of disturbed access processes (e.g., lacking metacognitive control). Structure deficit explanations suppose that the deficit is rooted in the structure of the knowledge itself (i.e., the knowledge is not available in a form that allows for its application). In situatedness explanations, the traditional concepts of knowledge and transfer are questioned. One basic assumption of this perspective is that knowledge is fundamentally situated (i.e., context-bound). In the last decade, instructional models have been developed that try to remedy the inert knowledge problem and take into account important aspects that have been raised by the different explanations.
Simulation is used widely in medical education. The simulation methodologies used at the present time range from low technology to high technology. This article describes how role play, standardized patients, computer, videotape, and mannequin simulations are integrated into the educational curricula for medical students and physicians. Advantages and disadvantages of simulation and barriers to the use of simulation are discussed. Simulation is an integral part of today's undergraduate, postgraduate, and continu-ing medical education curricula. It has been recognized for some time that simulation is a valuable and necessary adjunct to the educational experience because opportuni-ties to learn essential clinical skills in the real clinical setting may be inadequate. To be competent, a medical student must master a basic skill set by the time of graduation, continue to master new skills during further training, and pursue lifelong learning skills once formal training is completed. Skills needed by physicians may be divided into three distinct areas: (a) patient-centered skills, (b) process-centered skills, and (c) environment-centered skills. Patient-centered skills are those related to the direct care of an individual patient and include data-gathering skills (history taking and physical examination), communica-tion skills, interpersonal skills, and technical skills. Implementation of these skills combined with a sound knowledge base and clinical reasoning ability generally results in successful diagnosis and management of a patient. Process-centered skills are those that allow physicians to practice successfully in their local environment and include information management skills, teamwork skills, patient advocacy skills, and self-directed learning skills. Environment-centered skills are those that enable the physician to be successful in the culture of medicine and the wider medical practice AUTHORS' NOTE: We would like to thank Sybil Fullard for her help with the preparation of the article and Ruth Gottlieb and Kenneth Green for their support and advice.
The present study examined the effectiveness of (a) peer feedback for learning, more specifically of certain characteristics of the content and style of the provided feedback, and (b) a particular instructional intervention to support the use of the feedback. A quasi-experimental repeated measures design was adopted. Writing assignments of 43 students of Grade 7 in secondary education showed that receiving ‘justified’ comments in feedback improves performance, but this effect diminishes for students with better pretest performance. Justification was superior to the accuracy of comments. The instructional intervention of asking assessees to reflect upon feedback after peer assessment did not increase learning gains significantly.
It is hypothesized that learning and retention of unfamiliar but meaningful verbal material can be facilitated by the advance introduction of relevant subsuming concepts (organizers). 2 groups of 40 undergraduate Ss each were equated for sex, field of specialization, and ability to learn unfamiliar scientific material. Experimental Ss studied a 500-word-passage that supplied the subsuming concepts. Control Ss studied traditional type historical material of equal length. The learning material was then presented. Comparison of mean retention scores of the 2 groups unequivocably supported the hypothesis. From Psyc Abstracts 36:01:1CI67A. (PsycINFO Database Record (c) 2006 APA, all rights reserved).
The goals of this study are to evaluate a relatively novel learning environment, as well as to seek greater understanding of why human tutoring is so effective. This alternative learning environment consists of pairs of students collaboratively observing a videotape of another student being tutored. Comparing this collaboratively observing environment to four other instructional methods-one-on-one human tutoring, observing tutoring individually, collaborating without observing, and studying alone-the results showed that students learned to solve physics problems just as effectively from observing tutoring collaboratively as the tutees who were being tutored individually. We explain the effectiveness of this learning environment by postulating that such a situation encourages learners to become active and constructive observers through interactions with a peer. In essence, collaboratively observing combines the benefit of tutoring with the benefit of collaborating. The learning outcomes of the tutees and the collaborative observers, along with the tutoring dialogues, were used to further evaluate three hypotheses explaining why human tutoring is an effective learning method. Detailed analyses of the protocols at several grain sizes suggest that tutoring is effective when tutees are independently or jointly constructing knowledge: with the tutor, but not when the tutor independently conveys knowledge.
Roger Schank's influential book, Dynamic Memory, described how computers could learn based upon what was known about how people learn. Since that book's publication in 1982, Dr Schank has turned his focus from artificial intelligence to human intelligence. Dynamic Memory Revisited contains the theory of learning presented in the original book, extending it to provide principles for teaching and learning. It includes Dr Schank's important theory of case-based reasoning and assesses the role of stories in human memory. In addition, it covers his ideas on non-conscious learning, indexing, and the cognitive structures that underlie learning by doing. Dynamic Memory Revisited is crucial reading for all who are concerned with education and school reform. It draws attention to how effective learning takes place and provides instruction for developing software that truly helps students learn.
This unique and ground-breaking book is the result of 15 years research and synthesises over 800 meta-analyses on the influences on achievement in school-aged students. It builds a story about the power of teachers, feedback, and a model of learning and understanding. The research involves many millions of students and represents the largest ever evidence based research into what actually works in schools to improve learning. Areas covered include the influence of the student, home, school, curricula, teacher, and teaching strategies. A model of teaching and learning is developed based on the notion of visible teaching and visible learning. A major message is that what works best for students is similar to what works best for teachers - an attention to setting challenging learning intentions, being clear about what success means, and an attention to learning strategies for developing conceptual understanding about what teachers and students know and understand. Although the current evidence based fad has turned into a debate about test scores, this book is about using evidence to build and defend a model of teaching and learning. A major contribution is a fascinating benchmark/dashboard for comparing many innovations in teaching and schools.
Feedback is one of the most powerful influences on learning and achievement, but this impact can be either positive or negative. Its power is frequently mentioned in articles about learning and teaching, but surprisingly few recent studies have systematically investigated its meaning. This article provides a conceptual analysis of feedback and reviews the evidence related to its impact on learning and achievement. This evidence shows that although feedback is among the major influences, the type of feedback and the way it is given can be differentially effective. A model of feedback is then proposed that identifies the particular properties and circumstances that make it effective, and some typically thorny issues are discussed, including the timing of feedback and the effects of positive and negative feedback. Finally, this analysis is used to suggest ways in which feedback can be used to enhance its effectiveness in classrooms.
Using the design of Learning by Design (LBD) for illustration and results of its enactments as evidence, I make an argument
about the roles Schank and Abelson’s (1977) kind of scripts can play in promoting collaborative discourse and present a way
of promoting the kind of script learning that results in productive collaborative discourse. LBD’s way of promoting script
learning has three parts to it: (i) a set of scripted activity structures and sequences (classroom scripts) that promote productive
and appropriate participation in classroom practices (including collaborative discourse), (ii) an approach to instruction
that focuses on repeated, deliberative practice of each of these classroom scripts, and (iii) an approach to getting started
through launcher units that introduce the scripted activity structures, their sequencing, and how to participate in each. I argue that scripts students
learn for participating in classroom practices can play three roles in promoting collaboration and collaborative learning:
(i) they help students participate in whole-class discussions and in discursive practices by proposing sequencing for their
discourse, (ii) they help students participate in whole-class discussions and discursive practices by proposing content for
their discourse, and (iii) they provide focus for small group discourse as students aim their discussion toward fulfilling
a script’s expectations in order to be able to participate in the script later. Learning by Design is a design-based approach
to science learning.
This study explores the relation between argumentation in online discussions, cognitive elaboration, and individual knowledge acquisition. In a one-factorial experimental design with 48 participants we investigated the effect of an argumentative computer-supported collaboration script (with vs. without) on the formal quality of argumentation, cognitive elaboration, and individual knowledge acquisition in online discussions. Furthermore, we examined the relation between the formal quality of argumentation, cognitive elaboration, and individual knowledge acquisition. Empirical evidence was found that a computer-supported collaboration script can foster formal quality of argumentation as well as corresponding cognitive elaboration. Construction of formally sound arguments is positively related to both deep cognitive elaboration and individual acquisition of knowledge on argumentation.
Students often face process losses when learning together via text-based online environments. Computer-supported collaboration scripts can scaffold collaborative learning processes by distributing roles and activities and thus facilitate acquisition of domain-specific as well as domain-general knowledge, such as knowledge on argumentation. Possibly, individual learners would require less additional support or could equally benefit from computer-supported scripts. In this study with a 2 × 2-factorial design (N = 36) we investigate the effects of a script (with versus without) and the learning arrangement (individual versus collaborative) on how learners distribute content-based roles to accomplish the task and argumentatively elaborate the learning material within groups to acquire domain-specific and argumentative knowledge, in the context of a case-based online environment in an Educational Psychology higher education course. A large multivariate interaction effect of the two factors on learning outcomes could be found, indicating that collaborative learning outperforms individual learning regarding both of these knowledge types if it is structured by a script. In the unstructured form, however, collaborative learning is not superior to individual learning in relation to either knowledge type. We thus conclude that collaborative online learners can benefit greatly from scripts reducing process losses and specifying roles and activities within online groups.
The study investigated the effects of cooperative learning on junior high school students who worked in structured or unstructured cooperative groups. Two hundred and twenty-three junior high school students participated in the study and worked in three or four-person, mixed gender and achievement groups. The results show that the children in the structured groups were more willing to work with others on the assigned tasks and they provided more elaborate help and assistance to each other than their peers in the unstructured groups. Furthermore, as the children in the structured groups had more opportunities to work together, they developed a stronger perception of group cohesion and social responsibility for each other’s learning than their peers in the unstructured groups.
Video-based observational practice can extend simulation-based learning outside the training space. This study explores the value of collaborative feedback provided during observational practice to the acquisition of clinical skills.
Nursing students viewed a video demonstrating the proper ventrogluteal injection technique before performing a videotaped pre-test trial on a simulator. They were then assigned randomly to one of three observational practice groups: a group that observed the expert demonstration (EO group); a group that viewed the expert demonstration, self-assessed their individual pre-test and contrasted their self-assessments with expert feedback (ESO group), and a group that observed the expert demonstration, self-assessed and contrasted their assessments with those of an expert, and formed a community that engaged in peer-to-peer feedback (ESPO group). The observation of all videos, the provision of assessments and all networking occurred via an Internet-mediated network. After 2 weeks, participants returned for post-tests and transfer tests.
The pre-test-post-test analyses revealed significant interactions (global rating scale: F((2,22)) =4.00 [p =0.033]; checklist: F((2,22)) =4.31 [p =0.026]), which indicated that post-test performance in the ESPO group was significantly better than pre-test performance. The transfer analyses revealed main effects for both the global rating scale (F((2,23)) =6.73; p =0.005) and validated checklist (F((2,23)) =7.04; p =0.004) measures. Participants in the ESPO group performed better on the transfer test than those in the EO group.
The results suggest that video-based observational practice can be effective in extending simulation-based learning, but its effectiveness is mediated by the amount of time the learner spends engaged in the practice and the type of learning activities the learner performs in the observational practice environment. We speculate that increasing collaborative interactivity supports observational learning by increasing the extent to which the educational environment can accommodate learners' specific needs.
textlessptextgreaterEffective collaboration in computer-mediated settings among spatially distributed people is a precondition for success in many new learning and working contexts but it is hard to achieve. We have developed two instructional approaches to improve collaboration in such settings by promoting people's capabilities to collaborate in a fruitful way and furthering their understanding of what characterizes good collaboration. The rationale is that strategies necessary for a good and effective computer-mediated collaboration may be conveyed to people by exposing them to an elaborated worked-out collaboration example (observational learning) or by giving them the opportunity to learn from scripted collaborative problem-solving. An experimental study was conducted that compared learning from observing a worked-out collaboration example with the learning effects of scripted collaborative problem-solving, the effects of unscripted collaborative problem-solving, and a control condition without a learning phase. The experimental design provided clearly separated phases for the instructional treatments (learning phase) and for applying and testing the acquired skills (application phase). Both observing a worked-out collaboration example and collaborating with a script during the learning phase showed positive effects on process and outcome of the second collaboration in the application phase.
Undergraduate medical curricula are often deficient in teaching physical examinations in intimate zones, such as the rectal examination. Student inhibition is assumed to substantially hamper both the acquisition of knowledge and the performance of these examinations in practice.
The two present studies examined the effects of low-fidelity (LFS) and high-fidelity (HFS) simulation on the acquisition of the necessary knowledge and inhibition about carrying out the rectal examination. In addition, we investigated the effects of the different sequencing of the two simulations (HFS-LFS versus LFS-HFS).
A manikin for the rectal examination was used to implement the LFS. Standardised patients (SPs) were used to implement the HFS. Study samples consisted of 41 (Study 1) and 188 (Study 2) female and male undergraduate medical students. Each student participated in two individual sessions of 30 minutes each. Half the students participated first in the HFS and then in the LFS and the other half participated in the simulations in the opposite order. Outcome measures were self-rated inhibition and knowledge tests.
In both studies, HFS was found to reduce inhibition significantly more than LFS. Furthermore, in Study 2, a marginal effect of the sequence of simulation was found. In both studies, both types of simulation were found to facilitate the acquisition of knowledge. There was no sequence effect for the acquisition of knowledge.
Teaching the rectal examination with the help of SPs, who represent an HFS, can help medical undergraduate students to overcome inhibition about this examination. Standardised patient simulation is far more effective than that achieved using a manikin, which represents an LFS. Both types of simulation support the acquisition of knowledge.
The study investigated the effects of cooperative learning on junior high school students who worked in structured or unstructured cooperative groups. Two hundred and twenty-three junior high school students participated in the study and worked in three or four-person, mixed gender and achievement groups. The results show that the children in the structured groups were more willing to work with others on the assigned tasks and they provided more elaborate help and assistance to each other than their peers in the unstructured groups. Furthermore, as the children in the structured groups had more opportunities to work together, they developed a stronger perception of group cohesion and social responsibility for each other’s learning than their peers in the unstructured groups.
To contribute to reforming the medical education system in Japan, we visited overseas medical schools and observed the methods utilized in medical education.
We visited 28 medical schools and five institutes in the United States, Europe, Australia and Asia in 2008. We met deans and specialists in medical affairs and observed the medical schools' facilities.
Among the several effective educational methods used in overseas medical schools, simulation-based learning was being used in all that we visited. Simulation-based learning is used to promote medical students' mastery of communication skills, medical interviewing, physical examination and basic clinical procedures. Students and tutors both recognize the effectiveness of simulation-based learning in medical education.
In contrast to overseas medical schools, simulation-based learning is not common in Japan. There remain many barriers to introduce simulation-based education in Japan, such as a shortage of medical tutors, staff, mannequins and budget. However, enhancing the motivation of tutors is likely the most important factor to facilitate simulation-based education in Japanese medical schools to become common place.