Perspectives on the use of instructional design guidelines for health simulation: a literature review
DOI:
https://doi.org/10.15448/1980-6108.2018.1.28852Keywords:
models, educational, simulation, instructional technology, transfer of learning, instructional design guidelines.Abstract
AIMS: This article had two main objectives: to present a brief summary of introductory cognitive concepts on learning and instruction for simulation, including instructional design guidelines; and provide an overview of the current available evidence on the instructional perspectives on healthcare simulation training effectiveness, in particular with regards to simulation formats, fidelity and simulation site.
METHODS: We searched for articles at MEDLINE/PubMed, Embase, Cochrane, ERIC, LILACS and SciELO databases, using the keywords "instructional design guidelines", "healthcare simulation", "simulation training", "simulation effectiveness", "complex learning", and "transfer of learning". No specific beginning date of publication was specified and last date of search was September 19th 2017. All articles in English and Portuguese were considered for inclusion with no specific exclusion criteria. A few articles were purposefully selected in search of introductory concepts on learning and instruction.
RESULTS: Our search retrieved 3196 articles in the different databases. After preliminary title, abstract and content analysis, we selected 56 articles. Additionally, nine traditional articles and one book were included to present the best available evidence, reviews, reflections and critiques on simulation instructional perspectives, resulting in 66 references consulted in detail for this review.
CONCLUSIONS: Simulation offers the opportunity for active learning for health professionals by providing a complex learning environment with integration of knowledge, skills and attitudes. With potential impact on the different levels of learning, behavior and results, special attention should be given to the instructional format of the simulation. Among the instructional design guidelines, authenticity stands out as one of the elements of fundamental relevance for learning. Other instructional elements, such as increasing complexity, proper training location, debriefing, self-assessment opportunity, and other forms of assessment, also have positive influence and should be used in planning different simulation instructional designs.
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References
– Norman G. Simulation comes of age. Adv in Health Sci Educ. 2014;19(2):143-6. https://doi.org/10.1007/s10459-014-9507-7
– Gaba DM. The future vision of simulation in health care. Qual Saf Health Care. 2004;13(Suppl 1):i2-10. https://doi.org/10.1136/qshc.2004.009878
– Fox R, Walker J, Draycott T. Medical simulation for professional development—science and practice. BJOG. 2011;118(Suppl.3):1-4. https://doi.org/10.1111/j.1471-0528.2011.03173.x
– Ilgen JS, Sherbino J, Cook DA. Technology-enhanced simulation in emergency medicine: A systematic review and meta-analysis. Acad Emerg Med. 2013;20(2):117-27. https://doi.org/10.1111/acem.12076
- Zendejas B, Wang AT, Brydges R, Hamstra SJ, Cook DA. Cost: The missing outcome in simulation-based medical education research: A systematic review. Surgery. 2013;153(2):160-76. https://doi.org/10.1016/j.surg.2012.06.025
– Gordon M, Darbyshire D, Baker P. Non-technical skills training to enhance patient safety: a systematic review. Med Educ. 2012;46(11):1042-54. https://doi.org/10.1111/j.1365-2923.2012.04343.x
– Cook DA, Hamstra SJ, Brydges R, Zendejas B, Szostek JH, Wang AT, Erwin PJ, Hatala R. Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis. Med Teach. 2013;35(1):e867-98. https://doi.org/10.3109/0142159X.2012.714886
– Schaefer III JJ, Vanderbilt AA, Cason CL, Bauman EB, Glavin RJ, Lee FW, Navedo DD. Literature Review Instructional Design and Pedagogy Science in Healthcare Simulation. Sim Healthc. 2011;6:S30-41. https://doi.org/10.1097/SIH.0b013e31822237b4
– Issenberg SB, McGaghie WC, Petrusa ER, Gordon DL, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005;27(1):10-28. https://doi.org/10.1080/01421590500046924
– Salas E. Reporting guidelines for health care simulation research: Where is the learning? Sim Healthc. 2016;11(4):249. https://doi.org/10.1097/SIH.0000000000000187
– McGaghie WC, Draycott TJ, Dunn WF, Lopez CN, Stefanidis D. Evaluating the impact of simulation on translational patient outcomes. Simul Healthc. 2011;6(Suppl):S42-7. https://doi.org/10.1097/SIH.0b013e318222fde9
– McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003–2009. Med Educ. 2010;44(1):50-63. https://doi.org/10.1111/j.1365-2923.2009.03547.x
– Chauvin S. Applying educational theory to simulation-based training and assessment in surgery. Surg Clin N Am. 2015;95(4):695-715. https://doi.org/10.1016/j.suc.2015.04.006
– Salas E, Tannenbaum SI, Kraiger K, Smith-Jentsch KA. The science of training and development in organizations: What matters in practice. Psychol Sci Public Interest. 2012;13(2):74-101. https://doi.org/10.1177/1529100612436661
– Kirkpatrick DL. Techniques for evaluating training programmes. Train Dev J. 1979;33(6):78-92.
– Kirkpatrick DL. Great ideas revisited: Revisiting Kirkpatrick's four-level model. Train Dev J. 1996;50(1):54-9.
– Van Merriënboer JJG, Kester L, Paas F. Teaching complex rather than simple tasks: Balancing intrinsic and germane load to enhance transfer of learning. Appl. Cognit. Psychol. 2006;20(3):343-52. https://doi.org/10.1002/acp.1250
– Van Merriënboer JJG, Kirschner PA. Ten steps to complex learning: A systematic approach to four-component instructional design. New York: Routledge; 2013.
– Oswald A, Czupryn J, Wiseman J, Snell L. Patient-centered education: what do students think? Med Educ. 2014;48(2):170-80. https://doi.org/10.1111/medu.12287
– Schwartzstein RM, Roberts DH. Saying goodbye to lectures in medical school — paradigm shift or passing fad? NEJM. 2017;377(7):605-7. https://doi.org/10.1056/NEJMp1706474
– De Bruin ABH, Merriënboer JJG. Bridging cognitive load and self-regulated learning research: A complementary approach to contemporary issues in educational research. Learning and Instruction. 2017;5:1-9. https://doi.org/10.1016/j.learninstruc.2017.06.001
– Durning SJ, Gruppen LD. Learning and instruction: the world inside the head or the head inside the world? Med Educ. 2015;49(4):351-4. https://doi.org/10.1111/medu.12674
– Brydges R, Manzone J, Shanks D, Hatala R, Hamstra SJ, Zendejas B, Cook DA. Self-regulated learning in simulation-based training: a systematic review and meta-analysis. Med Educ. 2015;49(4):368-78. https://doi.org/10.1111/medu.12649
– Edozien LC. Situational awareness and its application in the delivery suite. Obstet Gynecol. 2015;125(1):65-9. https://doi.org/10.1097/AOG.0000000000000597
– Atkinson RC, Shiffrin RM. Human memory: a proposed system and its control processes. Psychol Learn Motiv. 1968;2:89-195. https://doi.org/10.1016/S0079-7421(08)60422-3
– Miller GA. The magical number seven, plus or minus two: Some limits on our capacity for processing information. Psychol Rev. 1955;101(2):343-52. https://doi.org/10.1037/0033-295X.101.2.343
– Sweller, J. Cognitive load theory, learning difficulty and instructional design. Learning and Instruction. 1994;4:295-312. https://doi.org/10.1016/0959-4752(94)90003-5
– Van Merriënboer JJ, Sweller J. Cognitive load theory in health professions education: design principles and strategies. Med Educ. 2010;44(1):85-93. https://doi.org/10.1111/j.1365-2923.2009.03498.x
– Santos LMA, Tarouco LMR. A importância do estudo da teoria da carga cognitiva em uma educação tecnológica. RENOTE. 2007;5(1):1-9 [Internet]. [Cited 2017 December 20]. Available from: http://seer.ufrgs.br/renote/article/viewFile/14145/8082
– van Merriënboer JJG, Sluijsmans DMA. Toward a synthesis of cognitive load theory, four-component instructional design, and self-directed learning. Educ Psychol Rev. 2009;21(1):55-66. https://doi.org/10.1007/s10648-008-9092-5
– Sweller J, Merrienboer JJG, Paas FGWC. Cognitive architecture and instructional design. Educ Psychol Rev. 1998;10(3):251-96. https://doi.org/10.1023/A:1022193728205
– Merriënboer JJG, Sweller J. Cognitive load theory and complex learning: Recent developments and future directions. Educ Psychol Rev. 2005;17(2):147-77. https://doi.org/10.1007/s10648-005-3951-0
– Merrill MD. First principles of instruction. ETR&D. 2002;50(3):43-59. https://doi.org/10.1007/BF02505024
– van Merriënboer JJG, Clark RE, Croock MBM. Blueprints for complex learning: The 4C/ID Model. ET&RD. 2002;50(2):39-61. https://doi.org/10.1007/BF02504993
– Cheng A, Eppich W, Grant V, Sherbino J, Zendejas B, Cook DA. Debriefing for technology-enhanced simulation: a systematic review and meta-analysis. Med Educ. 2014;48(7):657-66. https://doi.org/10.1111/medu.12432
– Levett-Jones T, Lapkin S. A systematic review of the effectiveness of simulation debriefing in health professional education. Nurse Educ Today.2014;34(6):e58-63. https://doi.org/10.1016/j.nedt.2013.09.020
– Hatala R, Cook DA, Zendejas B, Hamstra SJ, Brydges R. Feedback for simulation-based procedural skills training: a meta-analysis and critical narrative synthesis. Adv in Health Sci Educ. 2014;19(2):251-72. https://doi.org/10.1007/s10459-013-9462-8
– Ameh CA, van den Broek N. Making It Happen: Training health-care providers in emergency obstetric and newborn care. Best Pract Res Clin Obstet and Gynaecol. 2015;29(8):1077-91. https://doi.org/10.1016/j.bpobgyn.2015.03.019
– Sørensen JL, Løkkegaard E, Johansen M, Ringsted C, Kreiner S, Mcaleer S. The implementation and evaluation of a mandatory multi-professional obstetric skills training program. Acta Obstet Gynecol. 2009;88(10):1107-17. https://doi.org/10.1080/00016340903176834
– Holton III EF. The flawed four-level evaluation model. Hum Res Dev Rev. 1996;7(1):5-21. https://doi.org/10.1002/hrdq.3920070103
– Yardley S, Dornan T. Kirkpatrick's level and education "evidence". Med Educ. 2012;46(1):97-106. https://doi.org/10.1111/j.1365-2923.2011.04076.x
– Brandão CFS, Collares CF, Marin HF. A simulação realística como ferramenta educacional para estudantes de medicina. Sci Med. 2014;24(2):187-92. https://doi.org/10.15448/1980-6108.2014.2.16189
– Ilgen JS, Ma IWY, Hatala R, Cook DA. A systematic review of validity evidence for checklists versus global rating scales in simulation-based assessment. Med Educ. 2015;49(2):161-73. https://doi.org/10.1111/medu.12621
– McGaghie WC. When I say . . . mastery learning. Med. Educ. 2015;49:558-9. https://doi.org/10.1111/medu.12679
– Barsuk JH, Cohen ER, Wayne DB, Siddall VJ, McGaghie WC. Developing a simulation-based mastery learning curriculum lessons from 11 years of advanced cardiac life support. Sim Healthcare. 2016;11(1):52-9. https://doi.org/10.1097/SIH.0000000000000120
– Cook DA, Brydges R, Zendejas B, Hamstra SJ, Hatala R. Mastery Learning for Health Professionals Using Technology-Enhanced Simulation: A systematic review and meta-analysis. Acad Med. 2013;88(8):1178-86. https://doi.org/10.1097/ACM.0b013e31829a365d
– Eppich W, Howard V, Vozenilek J, Curran I. Simulation-based team training in healthcare. Sim Healthc. 2011;6:S14-9. https://doi.org/10.1097/SIH.0b013e318229f550
– Weaver SJ, Dy SM, Rosen MA. Team-training in healthcare: A narrative synthesis of the literature. BMJ Qual & Saf. 2014;0:e1-14. https://doi.org/10.1136/bmjqs-2013-001848
– Onwochei DN, Halpern S. Teamwork assessment tools in obstetric emergencies a systematic review. Sim Healthc. 2017;12(3):165-76. https://doi.org/10.1097/SIH.0000000000000210
– Fung L, Boet S, Bould MD, Qosa H, Perrier L, Tricco A, Tavares W, Reeves S. Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review. J Interprof Care. 2015;29(5):433-44. https://doi.org/10.3109/13561820.2015.1017555
– Salas E, Wilson KA, Burke CS, Wightman. Does crew resource management training work? An update, an extension, and some critical needs. Hum Factors. 2006;48(2):392-412. https://doi.org/10.1518/001872006777724444
– Baldwin T, Ford JK. Transfer of training: A review and directions for future research. Pers Psychol. 1988;41(1):63-105. https://doi.org/10.1111/j.1744-6570.1988.tb00632.x
– Facteau JD, Dobbins GH, Russell JEA, Ladd RT, Kudisch JD. The influence of general perceptions of the training environment on pretraining motivation and perceived training transfer. J Manag. 1995;21(1):1-25. https://doi.org/10.1177/014920639502100101
– Cook DA, Artino Jr AR. Motivation to learn: An overview of contemporary theories. Med Educ. 2016;50(10):997-1014. https://doi.org/10.1111/medu.13074
– Dybowski C, Sehner S, Harendza S. Influence of motivation, self-efficacy and situational factors on the teaching quality of clinical educators. BMC Med Educ. 2017;e1-8. doi: 10.1186/s12909-017-0923-2. https://doi.org/10.1186/s12909-017-0923-2
– Melo BCP, Falbo AR, Muijtjens AMM, van der Vleuten CPM, van Merriënboer JJG. The use of instructional design guidelines to increase effectiveness of postpartum hemorrhage simulation training. Int J Gynecol Obstet. 2017;137:99-105. https://doi.org/10.1002/ijgo.12084
– Naismith LM, Cavalcanti R. Validity of cognitive load measures in simulation-based training: A systematic review. Acad Med. 2015;90(11Suppl):S24-35. https://doi.org/10.1097/ACM.0000000000000893
– Cook, DA. If you teach them, they will learn: why medical education needs comparative effectiveness research. Adv in Health Sci Educ. 2012;17(3):305-10. https://doi.org/10.1007/s10459-012-9381-0
– Hamstra SJ, Brydges R, Hatala R, Zendejas B, Cook DA. Reconsidering fidelity in simulation-based training. Acad Med. 2014;89(3):387-392. https://doi.org/10.1097/ACM.0000000000000130
– Grierson LEM. Information processing, specificity of practice, and the transfer of learning: considerations for reconsidering fidelity. Adv in Health Sci Educ. 2014;19:281-9. https://doi.org/10.1007/s10459-014-9504-x
– Sørensen JL, Østergaard D, LeBlanc V, Ottesen B, Konge L, Dieckmann P, Van der Vleuten C. Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation. BMC Med Educ. 2017;17:20. https://doi.org/10.1186/s12909-016-0838-3
– Sørensen JL, Van der Vleuten C, Lindschou J, Gluud C, Østergaard D, LeBlanc V, Johansen M, Ekelund K, Albrechtsen CK, Pedersen BW, Kjærgaard H, Weikop P, Ottesen B. 'In situ simulation' versus 'off site simulation' in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for a randomized controlled trial. Trials. 2013;14:220. https://doi.org/10.1186/1745-6215-14-220
– Sørensen JL, van der Vleuten C, Rosthøj S, Østergaard D, LeBlanc V, Johansen M, Ekelund K, Starkopf L, Lindschou J, Gluud C, Weikop P, Ottesen B. Simulation-based multiprofessional obstetric anaesthesia training conducted in situ versus off-site leads to similar individual and team outcomes: a randomised educational trial. BMJ Open. 2015 Oct 6;5(10):e008344. https://doi.org/10.1136/bmjopen-2015-008344
– Maran NJ, Glavin RJ. Low- to high-fidelity simulation – a continuum of medical education? Med Educ. 2003;37(Suppl. 1):22-8. https://doi.org/10.1046/j.1365-2923.37.s1.9.x
– Schoenherr JR, Hamstra SJ. Beyond Fidelity: Deconstructing the seductive simplicity of fidelity in simulator-based education in the health care professions. Sim Healthc. 2017;12:117-23. https://doi.org/10.1097/SIH.0000000000000226
– Norman G, Dore K, Grierson L. The minimal relationship between simulation fidelity and transfer of learning. Med Educ. 2012;46(7):636-47. https://doi.org/10.1111/j.1365-2923.2012.04243.x
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