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Modeling of next generation digital learning environments : complex systems theory
The emergence of social networks, OpenCourseWare, Massive Open Online Courses, informal remote learning and connectivist approaches to learning has made the analysis and evaluation of digital learning environments more complex. Modelling these complex systems makes it possible to transcribe the phenomena observed and facilitates the study of these processes with the aid of specific tools. Once this essential step is taken, it then becomes possible to develop plausible scenarios from the observation of emerging phenomena and dominant trends. This book highlights the contribution of complex systems theory in the study of next generation digital learning environments.
Book
Using Exaggerated Feedback in a Virtual Reality Environment to Enhance Behavior Intention of Water-Conservation
Taiwan has long been categorized as a country suffering from water shortages. The acquisition of knowledge and development of the concept of water conservation, and the development water conservation habits, are considered a civic responsibility of the citizens. The purpose of the present study was to utilize an immersive virtual environment technology (IVET) to create virtual experiences that expose individuals to vivid information with personal relevance and immediacy in hopes of increasing the behavior intention to conserve water. A mediated virtual experience was provided in the form of an experiential learning game, in which participants were situated in a virtual bathroom and asked to repeatedly use a 600-milliliter bottle to fill a specific water tank to flush a toilet and take a one-minute shower. While consuming the water resources, participants received exaggerated feedback (EF) to intensify the negative consequences of water consumption (direct EF) and/or environmental damage (ambient EF) that emphasized personal affective responses. A total of 165 players, separated into four groups according to the ambient or/and direct EF conditions, experienced the game activities. ANOVA was used to examine the effects of the experimental intervention. The results showed that the immersive virtual reality game in this study caused significant changes in cognition and behavior intention. This study contributes a novel persuasive technology specific to water resources.
Journal Article
Navigating cultural landscapes: a thematic analysis of home faculty experiences in transborder simulation curriculum development and adaptation
Background
The increasing globalization of medical education necessitates effective strategies for transnational curriculum adaptation and transfer, particularly in simulation-based education (SBE). This study explores the process of adapting SBE curricula across different cultural contexts, emphasizing the need for cultural competence and a socio-constructivist approach. By synthesizing the Campinha-Bacote Model of Cultural Competence and Kern’s Six Step Approach to curriculum design, we propose a framework for transborder simulation curriculum adaptation.
Methods
This study adopts an exploratory qualitative approach, conducting a thematic analysis of data gathered by in-depth semi-structured interviews with faculty and simulation staff from various institutions actively participating in transborder curriculum partnerships.
Results
Nine themes crucial for successfully adapting health professions curricula containing SBE were identified. These themes were Cultural Humility, Communication and Interaction, Relationship Building, Faculty Development, Customization and Inclusivity, Psychological Safety, Educational Norms, Professional Expectations, and Implementation Strategies.
Discussion
Our findings highlight the importance of cultural humility, relationship building, and customized educational strategies in the transborder transfer of SBE curricula. The study underscores the significance of cultural considerations in SBE curriculum transfer. Furthermore, faculty development was understood as crucial, emphasizing the need for bi-directional training to navigate cultural differences and foster understanding between contexts. Customization and inclusivity were highlighted as essential for tailoring curricula to fit the cultural and practice environments of the host context.
Conclusion
This study provides a comprehensive framework integrating socio-cultural considerations into the curriculum adaptation process. By leveraging existing models of cultural competency and curriculum design, educators can navigate the complexities of transborder curriculum partnerships more effectively, leading to enhanced educational outcomes and cultural competence among healthcare providers.
Journal Article
The impact of simulation-based learning on the knowledge, attitude and performance of physiotherapy students on practice placement
Background
Practice placement is a crucial part of pre-registration physiotherapy education worldwide. However, educators face challenges in finding practice sites for students to undertake placement. The use of simulation-based (SBL) learning has the potential to replace some traditional placement, thereby increasing placement capacity, but the benefits have not been fully explored. This study aimed to assess the impact of SBL placement on students’ knowledge, attitude, and performance during practice placements with external providers.
Methods
This study utilised an exploratory qualitative research design using a semi-structured interview to collect data from Year 2 students of a 2-year MSc pre-registration physiotherapy programme in the UK. To be eligible to be included in the study, students must have participated in the 4-week simulation placement and have completed all their practice placements with external providers. All the interviews were conducted virtually in a 1:1 setting and recorded. The interviews lasted an average of 45 min. An inductive thematic analysis based on Braun and Clarke’s approach was utilised in this study.
Results
Twelve students consented to participate in this study. The 56 codes generated from the data were categorised into 5 themes; [
1
] Working together, [
2
] Working with Service Users, [
3
] Professionalism, [
4
] Profession-specific practical skills and [
5
] Generic practical skills. Participants unanimously expressed a positive view on working in groups, and they believe that engaging with service users who acted as patients enhanced the authenticity of the simulation placement. Subjective and objective assessments were considered important profession-specific skills gained during the simulation. Despite the benefits derived from the simulation placement, some participants felt that the learning experience would have been enriched by periodically changing the groups they were working in and having the opportunity for more 1:1 feedback throughout the four weeks.
Conclusions
SBL has the potential to be a valuable educational experience for physiotherapy students. It may assist in better preparing students for successful integration into the dynamic healthcare environment. To enhance and improve the authenticity of this type of placementour recommendations include recruiting more service users, incorporating and encouraging more intervention-based elements, and increasing the practice educators’ and students’ contact time.
Journal Article
Developing a learning tool for advanced life support and resuscitation: Performance Reflection Model for Resuscitation (PRM-Resus)
Background
Acquiring proficiency in advanced life support (ALS) can pose challenges for novice learners. Simulation-based training (SBT) is widely used to address this, offering learners opportunities to practise and receive feedback during debriefing. However, existing performance tools often lack the clarity, behavioural specificity, and educational scaffolding required to support deep reflective learning. This study aimed to develop and evaluate the Performance Reflection Model for Resuscitation (PRM-Resus) and to integrate it with the ALS Team Model and structured video exemplars as a comprehensive learning package to enhance ALS training.
Methods
The study involved four phases. Phase 1 created the ALS Team Model to clarify individual roles. Phase 2 focused on co-designing PRM-Resus, using team expertise and the Team Model to create behaviourally anchored performance descriptors. In Phase 3, video scenarios were produced to represent ALS team performance at varying proficiency levels. Phase 4 evaluated the PRM-Resus through expert think-aloud studies. Qualitative content analysis was used alongside Cronbach’s alpha to assess internal consistency and its use for SBT.
Results
The PRM-Resus comprises four domains—clinical skills, clinical knowledge, team management, and leadership—each defined by behavioural descriptors across three performance levels. The participating experts endorsed the tool’s clarity, structure, and educational value for novice learners. Internal consistency was high (α > 0.95). When used alongside the ALS Team Model and video exemplars, PRM-Resus facilitated deeper performance analysis, which had potential for enhancing post-simulation reflection and supporting faculty development.
Conclusions
This study presents a novel, interdisciplinary framework that integrates PRM-Resus, the ALS Team Model, and video exemplars to support reflective learning in ALS simulation. Together, these tools help novice learners build a concrete understanding of effective team performance and enable educators to deliver more structured feedback. Further research should explore its impact on learner development and potential translation into improved clinical outcomes.
Journal Article
Evaluation of Nursing Students' Experiences in an Interprofessional Simulated Disaster Exercise
Background:
Disaster simulation exercises provide a unique opportunity for nursing students to experience interprofessional collaboration. The limited study of interprofessional education using disaster simulation has focused on two to three health disciplines. In reality, teams comprise members from multiple disciplines in health care and emergency management.
Method:
A simulated disaster was held at a community college in Toronto, Canada. A total of 121 nursing students participated in the event, alongside students and providers from six health care and emergency management professions. A survey was used to evaluate nursing students' experiences.
Results:
Nursing students (n = 78) reported a high level of satisfaction, and 90% reported the simulation demonstrated the importance of inter-professional practice. Two themes arose from participants' comments: communicating with patients and collaborating with health care and emergency management providers.
Conclusion:
There is a need for follow-up to evaluate the impact of this event on nursing students' future practice. [J Nurs Educ. 2021;60(8):445–448.]
Journal Article
An assessment of the simulated performance of basic clinical procedures by junior doctors during the first year of clinical practice
Background
Upon entering the healthcare system, junior doctors may lack the skills required to care for patients, and feel unprepared for their role, with considerable variation in the level of proficiency in the performance of particular clinical procedures.
Objective
To compare the performance and proficiency (self-report and observed) of the performance of nine basic clinical procedures.
Methods
Seventeen interns were observed performing nine clinical procedures in a simulated setting in June 2021 (Assessment 1) and January 2022 (Assessment 2). The observers identified whether each step in the procedure was performed correctly, and provided an overall assessment of proficiency. The participants also rated their own level proficiency.
Results
At Assessment 1 the number of steps performed correctly ranged from a mean of 41.9–83.5%. At Assessment 2 the number of steps performed correctly ranged from a mean of 41.9–97.8%. The most common median proficiency rating for Assessment 1 was ‘close supervision’, and was ‘indirect supervision’ at Assessment 2. There was a significant and large effect size in the improvement in performance from Assessment 1 to Assessment 2. Low correlations were found between observer and self-reported proficiency in performance of the procedures.
Conclusions
The large improvement in performance across the two assessments is encouraging. However, there is a need to address the variability in performance on graduation from medical school, and to ensure that any assessment of proficiency is not only reliant on self-report.
Journal Article
An Innovative Remote Simulation Approach for Acute Care Clinical Hour Replacement
A camera view from the bedside nurse perspective was not available through the on-site audio-visual equipment. [...]one faculty member simply strapped an iPad® onto another faculty member's chest with bandage material, and the simulation continued with the mantra of “the show must go on.” [...]in one of the reported studies in the aforementioned systematic review, the active participants' learning outcomes were significantly better than the outcomes of the observing learners among nursing and medical students. The simulation session objectives were to perform a focused patient assessment, determine priorities of care, and implement nursing actions according to an individualized plan of care.
Journal Article
Simulation-Based Learning in Higher Education: A Meta-Analysis
Simulation-based learning offers a wide range of opportunities to practice complex skills in higher education and to implement different types of scaffolding to facilitate effective learning. This meta-analysis includes 145 empirical studies and investigates the effectiveness of different scaffolding types and technology in simulation-based learning environments to facilitate complex skills. The simulations had a large positive overall effect: g = 0.85, SE = 0.08; CIs [0.69, 1.02]. Technology use and scaffolding had positive effects on learning. Learners with high prior knowledge benefited more from reflection phases; learners with low prior knowledge learned better when supported by examples. Findings were robust across different higher education domains (e.g., medical and teacher education, management). We conclude that (1) simulations are among the most effective means to facilitate learning of complex skills across domains and (2) different scaffolding types can facilitate simulation-based learning during different phases of the development of knowledge and skills.
Journal Article