From simulation to reality - breaking down the barriers

Smith, Barry

doi:10.1111/j.1743-498x.2006.00103.x

Cited by 13 publications

(26 citation statements)

References 6 publications

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“…Because of their limited clinical experience pre-clinical students need intense supervision (Haffling et al 2001;Smith 2006). Students, patients and their supervisors should experience a safe setting during the teaching and learning process.…”

Section: Discussionmentioning

confidence: 99%

“…Skills laboratory staff is fully devoted to education, whereas hospital staff will prioritize patient care over teaching. Moreover, training with manikins and simulated patients cannot fully mimic hospital practice, and experiences gained in the laboratory setting may be neglected by the students in clinical contacts with patients (Nielsen et al 2003;Smith 2006). The resulting ''clinical culture shock'' may negatively impact on students' motivation for learning (Prince et al 2005).…”

Section: Introductionmentioning

confidence: 99%

“…Skills laboratories usually avail of manikins, medical equipment and simulated patients to train students' clinical skills (Van Dalen et al 2001;Smith 2006). A systematic review by Lynagh et al (2007) has confirmed that clinical skills performance of medical students improves by skills training in skills laboratories.…”

Section: Introductionmentioning

confidence: 99%

“…Such ''early clinical experiences'' may promote the learning behavior of pre-clinical students by exposing them to clinical role models, improving their clinical skills, and eventually reducing the stress of meeting patients (Dornan et al 2006). Early clinical experiences have been shown to give students more confidence to interact with patients in their first clerkships (Hampshire 1998;Smith 2006).…”

Section: Introductionmentioning

confidence: 99%

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Effects of partial substitution of pre-clinical skills training by attachments to primary health care centers: An experimental study

2011

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Background: Recent studies indicate that students may encounter problems when they have to apply clinical skills learned in a skills laboratory to patients. To facilitate this transition, it has been advised to include patient contacts early in the pre-clinical curriculum. Objective: To compare clinical skills performance and level of preparedness for entering the clerkships between students who were prepared exclusively in a skills laboratory and peers for whom part of their skills training program was substituted by training in a primary health care (PHC) center. Methods: Pre-clinical students either trained clinical skills exclusively in a skills laboratory while their peers attended a mixed program of laboratory trainings and practice in PHC centers. Students' perception of preparedness for the clerkships was explored through the Preparation for Hospital Practice Questionnaire. Students' clinical skills were assessed by an Objective Structured Clinical Examination (OSCE) and by supervisors in PHC centers. Results: Students following the mixed program felt better prepared for their clerkships than skills lab-trained peers. Students' perceptions were supported by assessments by their supervisors. However, mean OSCE scores of both groups did not differ significantly. Conclusion: PHC centers can be involved to better prepare pre-clinical students for their clerkships.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of partial substitution of pre-clinical skills training by attachments to primary health care centers: An experimental study

2011

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“…En ellos los estudiantes y los profesionales médicos o sanitarios pueden aprender diferentes tipos de habilidades en un entorno no estresante, bajo la supervisión de profesores o de forma autónoma e independiente. Además, es posible repetir, tantas veces como se desee, la técnica o habilidad concreta; el error está permitido, el estudiante recibe de forma continua feed-back sobre su actuación, y puede ser evaluado de forma objetiva [55][56][57][58] . Como dice Amitai Ziv, Director del Israel National Simulation Center, Chaim Sheva Medical Center, "la educación médica basada en simulaciones es hoy día un imperativo ético.…”

Section: Los Entornos Educativosunclassified

Retos de la formación médica de grado

Palés

Castro

2006

Educ. méd.

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INTRODUCCIÓNLas Facultades de Medicina españolas han iniciado un nuevo proceso de reforma curricular en el marco de la implantación del Espacio Europeo de Educación Superior (EEES). Este proceso constituye, sin duda, una nueva oportunidad, quizás la últi-ma en mucho tiempo, para llevar a cabo de una vez por todas la reforma en profundidad que nuestra formación de grado requiere. Los retos que se nos plantean son muchos y nada fáciles de afrontar. En este artículo vamos a discutir cuáles son estos retos y cómo deberíamos alcanzarlos. Para saber hacia dónde hemos de ir es imprescindible saber de dónde partimos y sobre todo dónde estamos. Por ello dividiremos nuestra exposición en tres períodos: el primero, que engloba el siglo XX desde 1930 a 1990, es un período en el que a pesar de su dilatada extensión apenas se producen cambios substanciales en nuestra formación de grado; el segundo, que se extiende desde finales del siglo XX a los principios del siglo actual (concretamente desde 1990 al 2003), abarca nuestro presente actual; y el tercero a partir del 2004, en el que comienzan a surgir los retos que el futuro nos depara. I. EL SIGLO XX De 1929 a 1990En este período la formación médica de grado en nuestro país no experimenta importantes modificaciones ni cambios radicales y en aquellos limitados casos en que se producen, éstos son aislados u obedecen a iniciativas individuales que en un plazo más o menos corto acaban por fracasar. Sólo se suceden cambios de planes de estudios caracterizados por modificaciones esencialmente de tipo estructural. De hecho, no se produce una reforma de cierta envergadura hasta 1990 que, por desgracia, como analizaremos posteriormente, no es bien aprovechada.Sin embargo, este período no puede considerarse totalmente plano desde el punto de vista educativo y en él se pueden distinguir algunos hechos de cierta relevancia. En 1929 el fisiólogo Juan Negrín 1 reorganiza el currículum preclínico en consonancia con los avances científicos de la época. Poco después, en 1933, surge la experiencia de la primera Universitat Autònoma de Barcelona. En ella, y por lo que hace referencia a la enseñanza de la Medicina, se proponen algunas reformas interesantes, como la desaparición de la enseñanza masificada y la supresión de las clases magistrales y su substitución por el méto-do inductivo u objetivo o de autoaprendizaje, con observación directa del hecho biológico. La asistencia a las clases prácticas se hace indispensable, así como el seguimiento de historias clínicas y la presencia en intervenciones quirúrgicas y en necropsias. Se intenta, además, paliar la pobreza de medios materiales y de recursos humanos. La experiencia se ve truncada por nuestra guerra civil. 2Hasta la década de los sesenta, el modelo de los años treinta se mantiene prácticamente igual. En 1962 y en 1966, otro fisiólogo eminente, el profesor Antonio Gallego, publica en el Journal of Medical Education sendos artículos, en los que realiza un diagnóstico certero de la situación de la educación médica en nuestro país, analizando...

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Minding the gap between communication skills simulation and authentic experience

2013

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CONTEXT Concurrent exposure to simulated and authentic experiences during undergraduate medical education is increasing. The impact of gaps or differences between contemporaneous experiences has not been adequately considered. We address two questions. How do new undergraduate medical students understand contemporaneous interactions with simulated and authentic patients? How and why do student perceptions of differences between simulated and authentic patient interactions shape their learning?METHODS We conducted an interpretative thematic secondary analysis of research data comprising individual interviews (n = 23), focus groups (three groups, n = 16), and discussion groups (four groups, n = 26) with participants drawn from two different year cohorts of Year 1 medical students. These methods generated data from 48 different participants, of whom 17 provided longitudinal data. In addition, data from routinely collected written evaluations of three whole Year 1 cohorts (response rates 88%, n = 378) were incorporated into our secondary analysis dataset. The primary studies and our secondary analysis were conducted in a single UK medical school with an integrated curriculum.RESULTS Our analysis identified that students generate knowledge and meaning from their simulated and authentic experiences relative to each other and that the resultant learning differs in quality according to meaning created by comparing and contrasting contemporaneous experiences. Three themes were identified that clarify how and why the contrasting of differences is an important process for learning outcomes. These are preparedness, responsibility for safety, and perceptions of a gap between theory and practice.CONCLUSIONS We propose a conceptual framework generated by reframing common metaphors that refer to the concept of the gap to develop educational strategies that might maximise useful learning from perceived differences. Educators need to 'mind' gaps in collaboration with students if synergistic learning is to be constructed from contemporaneous exposure to simulated and authentic patient interactions.The strategies need to be tested in practice by teachers and learners for utility. Further research is needed to understand gaps in other contexts.

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From simulation to reality - breaking down the barriers

Cited by 13 publications

References 6 publications

Effects of partial substitution of pre-clinical skills training by attachments to primary health care centers: An experimental study

Effects of partial substitution of pre-clinical skills training by attachments to primary health care centers: An experimental study

Retos de la formación médica de grado

Minding the gap between communication skills simulation and authentic experience

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