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Making the implicit explicit: Theories informing simulation-based - - PowerPoint PPT Presentation

Nov 10, 2023 39 likes •660 views

Making the implicit explicit: Theories informing simulation-based education #simtheory October 18 Introduction: Debra Nestel Theory #1: Gabriel Reedy Theory #2: Peter Dieckmann November 10 Theory #3: Nancy McNaughton Theory #4: Walter

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Making the implicit explicit: Theories informing simulation-based education

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October 18

Introduction: Debra Nestel Theory #1: Gabriel Reedy Theory #2: Peter Dieckmann

November 10

Theory #3: Nancy McNaughton Theory #4: Walter Eppich Theory #5: Ryan Brydges

#simtheory

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Simulation education and…

Cognitive Load Theory Installation Theory

November 10

Critical Theory Cultural-Historical Activity Theory Normative Theory

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World views

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World views

Positivism & post-positivism

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World views

Positivism & post-positivism Interpretivism

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World views

Positivism & post-positivism Interpretivism Critical theory

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Behavioural

Constructivist

Social constructivist

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Theories can be seen as frameworks of ideas… are complex and contestable

Nestel D, Bearman M. Theory and simulation-based education: definitions, worldviews and applications. Clinical Simulation in Nursing. 2015;11:349-54.
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Theories are nets cast to catch what we call ‘the world’; to rationalize, to explain and to master it. We endeavor to make the mesh ever finer and finer.

Popper K. 1959, The Logic of Scientific Discovery, New York

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Theories to illuminate

Bordage G. Conceptual frameworks to illuminate and magnify. Medical Education. 2009;43:312-9.

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Theories to magnify

Bordage G. Conceptual frameworks to illuminate and magnify. Medical Education. 2009;43:312-9.

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Theories as lenses

Bordage G. Conceptual frameworks to illuminate and magnify. Medical Education. 2009;43:312-9.
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Theories as liquids

Not fixed in time, constantly changing, not fixed in space…

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  • Skills-based
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Source: www.hellenic.simulations.com

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SLIDE 17 January 14-16, 2016 IMSH 2016 - DISCOVER|SHARE|LEAD

Source: Michelle Kelly

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Source: Debra Nestel

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October 18

Introduction: Debra Nestel Theory #1: Gabriel Reedy Theory #2: Peter Dieckmann

November 10

Theory #3: Nancy McNaughton Theory #4: Walter Eppich Theory #5: Ryan Brydges

#simtheory

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Cognitive Load Theory and Simulation Education

Gabriel Reedy PhD King’s College London Simulation and Interactive Learning Centre at Guy’s and St Thomas’ NHS Foundation Trust

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Information Processing Model

  • How many items are you faced with?
  • How are the items related to each other and to what you

already know?

  • What rules (schemata) in your long-term memory can help you

process them?

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Intrinsic Load

  • How difficult is the

task for the learner?

– Contextual to task, situation, learner – What is the learner’s previous experience with this or similar tasks – Cannot be lowered, as such – but it can be mitigated and must be considered

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Extraneous Load

  • Not inherent or

necessary to complete a task

  • Based on the design
  • f the task or

experience

  • Adds to intrinsic load
  • Can potentially
  • verload working

memory

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Germane Load

  • Sometimes the task is richly

difficult, but working through it can help the learner progress – it is germane to the learning.

  • Part of intrinsic load
  • Helps to create schemata in

working memory to help learner be successful in the long term with other tasks

  • Be judicious and thoughtful
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Using Cognitive Load in Simulation

  • Goal-free learning allows for more specific and appropriate learning
  • pportunities

– Learner-defined goals – Safe to make mistakes

  • Setting up the simulation tasks appropriately can make for a more

effective learning environment

– Set learners up for success – lower the extraneous cognitive load by reminding participants of protocols and previous knowledge – Use confederates judiciously to lower the extraneous cognitive load

  • Start with simple tasks and move towards more complex ones

– Develop learners over time, lower intrinsic load by preparing learners

  • Develop higher fidelity as learners progress

– Too much detail can overwhelm novice learners and is unnecessary

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Peter Dieckmann PhD, Dipl-Psych

Installation Theory

by Saadi Lahlou, LSE

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Why

do people do, what they do?

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Person(ality) Situation

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Person(ality) Situation

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Person(ality) Situation

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Person(ality) Situation

Jung Adler Kelly Lave & Wenger Goffman Lewin

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Kurt Lewin

(1890 – 1947)

The whole as starting point Dynamic of situations Psychological aspects

http://www.tavinstitute.org/

  • P. Dieckmann, DIMS
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B=f(P,E)

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P

Wishes Knowledge Perception Anticipation Memories Habits

erson

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Life Space

+

P

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Life Space

+

+

+

+ +

  • Affordances describe the value of elements

for a person in the life space

  • P. Dieckmann, DIMS

P

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Life Space

+

+

+ +

  • +

Not all is achieveable (easily) Borders have different strengths

  • P. Dieckmann, DIMS

P

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Material Aspects Social and Organisational Aspects

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Installation Material Layer Embodied Competence Societal and

  • rganisational control

Saadi Lahlou

  • P. Dieckmann, CAMES
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Installation Material Layer Embodied Competence Societal and

  • rganisational control

Saadi Lahlou

  • P. Dieckmann, CAMES

P E E

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Installation ML EC SC

Saadi Lahlou

  • P. Dieckmann, CAMES

Compensations

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Installation ML EC SC

Saadi Lahlou

  • P. Dieckmann, CAMES

Compensations

Declining Eyesight

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Installation ML EC SC

Saadi Lahlou

  • P. Dieckmann, CAMES

Compensations

Declining Eyesight Extend Arm Increase Light Reluctance to buy glases

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Installation ML EC SC

Saadi Lahlou

  • P. Dieckmann, CAMES

Compensations

Software Bugs Ask your colleague Restart Computer Inform programmer Find workaround

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Installation ML EC SC

Saadi Lahlou

  • P. Dieckmann, CAMES

Compensations

„Unworkable“ Guidelines “Violations“ Hide Folders Feedback to designers Block implementation Complain to colleagues

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ML EC SC Clinical Practice ML EC SC Simulation / Educational Practice

Connection

  • P. Dieckmann, CAMES

Work as imagined / Work as done.

(Erik Hollnagel)

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Formula for Impact

Medical

Science Educational Efficiency Local Organization Safety Quality of care

Adapted from Resuscitation 59 (2003) 11-43

Human Factors Ergonomics Process sceience …

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  • P. Dieckmann, CAMES
  • P. Dieckmann, CAMES

Standardized Teaching Variable Learning Variable Teaching “Standardized” Learning

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Thank you

Peter Dieckmann Peter.dieckmann@regionh.dk @pdieckmann

  • P. Dieckmann, CAMES
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Making the implicit explicit: Theories informing simulation-based education

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October 18

Introduction: Debra Nestel Theory #1: Gabriel Reedy Theory #2: Peter Dieckmann

November 10

Theory #3: Nancy McNaughton Theory #4: Walter Eppich Theory #5: Ryan Brydges

#simtheory

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Simulation education and…

Cognitive Load Theory Installation Theory

November 10

Critical Theory Cultural-Historical Activity Theory Normative Theory

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Thank you

Debra Nestel AMEE Simulation Committee

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Further reading (DN)

  • Battista, A., Activity theory and analyzing learning in simulations. Simulation and Gaming,
  • 2015. 46(2): p. 187-196.
  • Battista, A., & Nestel, D. (In press). Simulation in medical education. In T. Swanwick (Ed.),
Understanding Medical Education: Wiley.
  • Bearman, M., N. McNaughton, and D. Nestel, Theories informing healthcare simulation
practice, in Healthcare Simulation Education: Evidence, Theory & Practice, D. Nestel, et al., Editors. 2018, John Wiley & Sons Ltd.: Chichester. p. 9-15.
  • Eppich, W. and A. Cheng, Cultural historical activity theory (CHAT) - informed debriefing for
interprofessional teams. Clinical Simulation in Nursing, 2015. 11: p. 383-389.
  • Fenwick, T. and M.A. Dahlgren, Towards socio-material approaches in simulation-based
education: lessons from complexity theory. Med Educ, 2015. 49(4): p. 359-67.
  • Husebo, S., S. O'Regan, and D. Nestel, Reflective practice and its role in simulation.
Clinical Simulation in Nursing, 2015: p. 368-375.
  • Kneebone, R., Simulation in surgical training: educational issues and practical implications.
Medical Education, 2003. 37(3): p. 267-77.
  • Nestel, D. and M. Bearman, Theory and simulation-based education: definitions,
worldviews and applications. Clinical Simulation in Nursing, 2015. 11: p. 349-354.
  • Reedy, G., Using cognitive load theory to inform simulation design and practice. Clinical
Simulation in Nursing, 2015. 11: p. 350-360.
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gabriel.reedy@kcl.ac.uk weppich@gmail.com ryan.brydges@utoronto.ca nmcnaughton@michener.ca mail@peter-dieckmann.de debra.nestel@monash.edu dnestel@unimelb.edu.au

#simtheory