TY - JOUR
T1 - Simulation-based education for novices
T2 - complex learning tasks promote reflective practice
AU - Tremblay, Marie-Laurence
AU - Leppink, Jimmie
AU - Leclerc, Gilles
AU - Rethans, Jan-Joost
AU - Dolmans, Diana H. J. M.
N1 - Funding Information:
we are grateful for the help of research assistants Sabrina Iannone, Faculty of Pharmacy, Laval University, Quebec, Quebec, Canada, and Audrey Thibault, Department of Information and Communication, Faculty of Literature and Human Sciences, Laval University, Quebec, Quebec, Canada. We are also thankful for the support of the programme director of the Faculty of Pharmacy at Laval University in authorising this research. We would like to thank the staff at the Apprentiss Simulation Centre (Pharmacy) for supervising the technical aspects of this study. Finally, we want to thank Gilles Chiniara, Department of Anestesiology and Intensive Care, Faculty of Medicine, Laval University, Quebec, Quebec, Canada, and Marie-Claude Boivin, Faculty of Pharmacy, Laval University, Quebec, Quebec, Canada, for their feedback on the learning tasks.
Publisher Copyright:
© 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education
PY - 2019/4
Y1 - 2019/4
N2 - Context Simulated clinical immersion (SCI), in which clinical situations are simulated in a realistic environment, safely and gradually exposes novices to complex problems. Given their limited experience, undergraduate students can potentially be quite overwhelmed by SCI learning tasks, which may result in misleading learning outcomes. Although task complexity should be adapted to the learner's level of expertise, many factors, both intrinsic and extraneous to the learning task, can influence perceived task complexity and its impact on cognitive processes. Objectives The purpose of this mixed-methods study was to understand the effects of task complexity on undergraduate pharmacy students' cognitive load, task performance and perception of learning in SCI. Methods A total of 167 second-year pharmacy students were randomly assigned to undertake one simple and one complex learning task in SCI consecutively. Participants' cognitive load was measured after each task and debriefing. Task performance and time on task were also assessed. As part of a sequential explanatory design, semi-structured interviews were conducted with students showing maximal variations in intrinsic cognitive load to elucidate their perceptions of learning when dealing with complexity. Results Although the complex task generated significantly higher cognitive load and time on task than the simple task, performance was high for both tasks. Qualitative results revealed that a lack of clinical experience, an unfamiliar resource in the environment and the constraints inherent to SCI, such as time limitations, hindered the clinical reasoning process and led to poorer self-evaluation of performance. Simple tasks helped students gain more self-confidence, whereas complex tasks further encouraged reflective practice during debriefings. Conclusions Although complex tasks in SCI were more cognitively demanding and took longer to execute, students indicated that they learned more from them than they did from simple tasks. Complex tasks constitute an additional challenge in terms of clinical reasoning and thus provide a more valuable learning experience from the student's perspective.
AB - Context Simulated clinical immersion (SCI), in which clinical situations are simulated in a realistic environment, safely and gradually exposes novices to complex problems. Given their limited experience, undergraduate students can potentially be quite overwhelmed by SCI learning tasks, which may result in misleading learning outcomes. Although task complexity should be adapted to the learner's level of expertise, many factors, both intrinsic and extraneous to the learning task, can influence perceived task complexity and its impact on cognitive processes. Objectives The purpose of this mixed-methods study was to understand the effects of task complexity on undergraduate pharmacy students' cognitive load, task performance and perception of learning in SCI. Methods A total of 167 second-year pharmacy students were randomly assigned to undertake one simple and one complex learning task in SCI consecutively. Participants' cognitive load was measured after each task and debriefing. Task performance and time on task were also assessed. As part of a sequential explanatory design, semi-structured interviews were conducted with students showing maximal variations in intrinsic cognitive load to elucidate their perceptions of learning when dealing with complexity. Results Although the complex task generated significantly higher cognitive load and time on task than the simple task, performance was high for both tasks. Qualitative results revealed that a lack of clinical experience, an unfamiliar resource in the environment and the constraints inherent to SCI, such as time limitations, hindered the clinical reasoning process and led to poorer self-evaluation of performance. Simple tasks helped students gain more self-confidence, whereas complex tasks further encouraged reflective practice during debriefings. Conclusions Although complex tasks in SCI were more cognitively demanding and took longer to execute, students indicated that they learned more from them than they did from simple tasks. Complex tasks constitute an additional challenge in terms of clinical reasoning and thus provide a more valuable learning experience from the student's perspective.
KW - COGNITIVE LOAD THEORY
KW - INSTRUCTIONAL-DESIGN
KW - PERFORMANCE
KW - AUTHENTICITY
KW - ENVIRONMENT
KW - IMPACT
U2 - 10.1111/medu.13748
DO - 10.1111/medu.13748
M3 - Article
C2 - 30443970
SN - 0308-0110
VL - 53
SP - 380
EP - 389
JO - Medical Education
JF - Medical Education
IS - 4
ER -