1,721,030 research outputs found
Advancing Theory in Healthcare Simulation Instructional Design: The Effect of Task Complexity on Novice Learning and Cognitive Load
Get PDFDramatic changes to healthcare systems globally have led to increased use of simulation as a pedagogical tool in health professions education. An impressive evidence base has accrued in support of simulation-based education and training, leaving little doubt that ‘it works’. As a result, scholarship in the field is shifting toward clarifying the features of simulation instructional design that optimize learning outcomes. Many scholars advocate for the use of established instructional frameworks to advance this agenda.
In this dissertation, the author employed Cognitive Load Theory (CLT) and related instructional frameworks to investigate the relationship between task complexity, cognitive load (CL), and learning among novices engaged in simulation-based procedural skills training. Phase one of this research program established the sensitivity of two CL measures (subjective ratings of mental effort and secondary task performance) to predicted differences in load related to learners’ proficiency with a procedural skill and simulation training task complexity. As a result, these measures may be used to track changes in CL during simulation training and distinguish between the CL imposed by different instructional designs.
Phase two operationalized Elaboration Theory (ET) to identify the task-conditions that impact training complexity of a prototypical procedural skill (lumbar puncture). The results of this phase demonstrate the methodological and theoretical advantages of combining a structured instructional design framework with expert consensus (via the Delphi technique) when developing healthcare simulation curricula.
The final phase examined the competing effects of task complexity and context similarity on novices’ skills transfer. The results demonstrate that higher task complexity increases load during training, which may impede initial learning and subsequent transfer of skills ‘peripheral’ to the task (e.g. sterility). However, the findings also suggest that other variables (i.e. context or information processing specificity and learners strategies to manage load) may have important effects on these learning outcomes.
At a broader level, the systematic, multi-phased approach employed in this dissertation provides a framework to guide future research in simulation instructional design. Furthermore, the application of CLT in this work exposes strengths and shortcomings in the theory that educators and researchers should be aware of, and highlights avenues for future inquiry.Ph.D
Development of a novel consensus-building methodology to design valid simulation-based medical education-supporting technologies
Get PDFIndustry 4.0 has introduced new combinations of technologies that have the potential to revolutionize the way in which medical education, more specifically healthcare simulation, is delivered. However, the integration of these technologies into healthcare simulation requires an interdisciplinary team to ensure that design meets the needs of medical community, from both a content and technical standpoint. The process to design simulation-supporting technologies needs to offer space for creativity due to the diverse perspectives that need to be involved while offering content validity in the final design to be deemed acceptable by the medical community. To address this, we have engineered a constraints-ideation-consensus approach based on the design-based research framework to design valid simulation-supporting technologies and have applied it to two tests cases to demonstrate how it could work, highlight strengths and weaknesses, and propose next steps.University of Ontario Institute of Technolog
The perceived effectiveness of various forms of feedback on the acquisition of technical skills by advanced learners in simulation-based health professions education
Get PDFSimulation-based health professions education is valuable for healthcare professionals to develop technical skills. However, little research has explored the effectiveness of augmented versus intrinsic feedback for advanced learners. This thesis aimed to determine what feedback type is perceived to be most effective by advanced care paramedics airing intraosseous access skills using simulation. Following the Design- Based Research framework, design-thinking and Delphi methods were used to generate a list of augmented feedback. In the test phase, paramedics received the augmented feedback and compared it to their intrinsic feedback while using the simulator, and in the evaluate phase, they ranked the feedback types. The results indicate that knowledge of performance was perceived as most effective, followed by intrinsic, and knowledge of results was perceived as least effective. This research provides insights into augmented and intrinsic feedback in simulation-based health professions education, but further work is needed to assess their actual learning effects.University of Ontario Institute of Technolog
Bridging the gap: a competency framework for non-clinical simulation technicians
Get PDFHealthcare simulation-based education is essential for developing clinical skills in a risk-free environment, relying heavily on simulation technicians for the operation and maintenance of simulation technologies. However, a shortage of qualified technicians, compounded by rapid technological advancements, limits the expansion of SBE across healthcare disciplines. This study addresses this gap by developing a competency framework for undergraduate students aspiring to become simulation technicians.
Through a review of existing literature and expert consultation, the research identifies the key competencies needed for entry-level technicians. The proposed framework offers a standardized model for training and certification, aligning workforce development with industry standards. This study also contributes to the application of competency-based education in healthcare technology roles, providing a structured approach to curriculum development and improving job readiness for non-clinical graduates. Ultimately, the findings aim to enhance workforce preparedness, support international standardization, and improve the scalability of simulation-based education
Development and initial testing of a virtual simulation training module to teach microtomy
Get PDFBackground: Microtomy is a procedure that medical laboratory technologists (MLTs) use to cut tissue samples. The aim of this thesis is to use the think-aloud protocol to develop a virtual simulation training module for students to learn microtomy.
Methods: A think-aloud protocol was conducted with an MLT expert to generate the steps of the microtomy procedure. Eight experts rated the criticalness and provided feedback on the steps. Once the module was developed, nine undergraduate students completed the module and provide feedback.
Results: The think-aloud protocol generated 10 steps for the microtomy procedure and experts concluded that all ten steps are critical. Students who completed the module provided a positive response and considered the module as a useful tool to practice microtomy.
Conclusions: The 10 steps of the microtomy procedure have been validated by MLT experts. Students completed the virtual simulation training module and viewed it as a user-friendly tool for learners of the medical laboratory sciences program.University of Ontario Institute of Technolog
Advancing Theory in Healthcare Simulation Instructional Design: The Effect of Task Complexity on Novice Learning and Cognitive Load
No full textDramatic changes to healthcare systems globally have led to increased use of simulation as a pedagogical tool in health professions education. An impressive evidence base has accrued in support of simulation-based education and training, leaving little doubt that ‘it works’. As a result, scholarship in the field is shifting toward clarifying the features of simulation instructional design that optimize learning outcomes. Many scholars advocate for the use of established instructional frameworks to advance this agenda.
In this dissertation, the author employed Cognitive Load Theory (CLT) and related instructional frameworks to investigate the relationship between task complexity, cognitive load (CL), and learning among novices engaged in simulation-based procedural skills training. Phase one of this research program established the sensitivity of two CL measures (subjective ratings of mental effort and secondary task performance) to predicted differences in load related to learners’ proficiency with a procedural skill and simulation training task complexity. As a result, these measures may be used to track changes in CL during simulation training and distinguish between the CL imposed by different instructional designs.
Phase two operationalized Elaboration Theory (ET) to identify the task-conditions that impact training complexity of a prototypical procedural skill (lumbar puncture). The results of this phase demonstrate the methodological and theoretical advantages of combining a structured instructional design framework with expert consensus (via the Delphi technique) when developing healthcare simulation curricula.
The final phase examined the competing effects of task complexity and context similarity on novices’ skills transfer. The results demonstrate that higher task complexity increases load during training, which may impede initial learning and subsequent transfer of skills ‘peripheral’ to the task (e.g. sterility). However, the findings also suggest that other variables (i.e. context or information processing specificity and learners strategies to manage load) may have important effects on these learning outcomes.
At a broader level, the systematic, multi-phased approach employed in this dissertation provides a framework to guide future research in simulation instructional design. Furthermore, the application of CLT in this work exposes strengths and shortcomings in the theory that educators and researchers should be aware of, and highlights avenues for future inquiry.Ph.D
Development and user experience assessment of a VR resource for lactation latching
Get PDFBreastfeeding is essential for infants and mothers. However, low breastfeeding rates have become a major health problem despite the use of electronic health resources used in videos, websites, and online video calls that lack spatial interactions. Existing VR breastfeeding research focuses on gathering technological acceptance, general information, and relationship with virtual infants by providing a first-person immersive experience, although lacking user experience and educational value assessments. This thesis develops a Virtual Reality (VR) breastfeeding experience focused on latching and compares user experience and educational value using head and eye tracking interactions. The preliminary results with 10 participants, five women, and five men volunteered to participate in a within subjects study indicate that eye tracking improved education value despite the nuances of artifacts caused by sudden eye movement and blinking. Future work will focus on a larger study, migration to a system with better support for hand and eye tracking, and increased realism.University of Ontario Institute of Technolog
A Phase 1 Study of a Kolb-influenced, High Fidelity Simulation Intervention Implemented to Improve Nursing Students' Use of a Conflict Resolution Skill
Get PDFInterpersonal task-related conflict that arises within nursing practice can contribute to issues regarding patient safety. Exposure to conflict within practice occurs as soon as the undergraduate nursing student’s first clinical placement. Yet studies have shown that students, as well as practitioners, are not utilizing a conflict management style conducive to safe patient care. Few educational interventions have incorporated the teaching of conflict resolution skills to nursing students. Therefore, a high fidelity simulation intervention (two scenarios, each followed by a debriefing session) was developed and refined to teach the two-challenge rule to Year 2 nursing students. The Medical Research Council Framework informed the intervention’s design and refinement strategy, while Kolb’s Experiential Learning Theory provided the foundation to implement the entire, refined intervention.
A Phase 1 study with two successive components, refinement and single-group post-test, was conducted to determine the feasibility for a future randomized controlled trial (RCT) of this high fidelity simulation intervention. Forty eligible Year 3 nursing students participated in the refinement phase during a 2-week period. For the single-group post-test component, 35 Year 2 nursing students participated in the entire, refined high fidelity simulation intervention which included a 5-week spacing period.
The refinement strategy improved the high fidelity simulation intervention’s overall design features. For Scenario 1, the Simulation Design Scale (SDS) mean score reached a high on Day 5 of 4.86 (SD = 0.14) in contrast to a score of 3.45 (SD = 0.17) on Day 1. For Scenario 2, the SDS specific mean score was 4.75 (SD = 0.16) on Day 5, which represented a mean score increase of 1.01 from the score on Day 1.
Of the Year 2 students who participated in the refined intervention, 88.7% rated its quality at 4 or higher on the Educational Practices Questionnaire. Year 2 nursing students (82.9%) also rated their satisfaction and self-confidence after participating in the entire refined intervention at 4 or higher on the Satisfaction and Self-Confidence in Learning scale. Additionally, the Year 2 students utilized the two-challenge rule 74.3% of the time after participating in the second high fidelity simulation scenario. Overall, the results of the Phase 1 study were favourable and will contribute to planning a future RCT.Ph.D
Using the evidence-development-validation-consensus (EDVC) approach to develop an online training program for healthcare professionals and laypeople to provide outside-hospital cardiac arrest care in rural and remote places
Get PDFIntroduction: The COVID-19 pandemic exacerbated challenges in delivering cardiac arrest (CA) courses in remote and rural (R&R) areas and affected training for laypeople (LP) and healthcare professionals (HCPs). Due to the combined issues, medical education suffered, including the suspension of basic life support and defibrillation (BLSD) training.
Materials and Methods: In this study, researchers developed an online training program via evidence-development-validation-consensus (EDVC) approach using a learning management system (LMS) model.
Results: A comprehensive online training program should encompass cognitive, affective, and psychomotor learning domains, addressing various skills and knowledge aspects in BLSD training.
Conclusion: The study presents the EDVC approach used to develop an online training program, enabling effective out-of-hospital CA care courses in R&R places. The program incorporates expert feedback and improves knowledge and techniques in automated external defibrillator (AED) delivered by drones use.University of Ontario Institute of Technolog
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