Student's experiences of simulation based education vs. problem based learning in emergency medical care training

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Date
2017
Authors
Rowland, Mugsien
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University of the Free State
Abstract
English: An in-depth study was done into Simulation Based Education (SBE) and Problem Based Learning (PBL) with a view to understanding which method of education is best suited to paramedic education. The researcher performed a survey of students who were studying towards becoming a paramedic at the Free State College of Emergency Care in Bloemfontein. Paramedic education requires the educator to understand a variety of teaching skills and an understanding to support the needs of the students. As such, the educator’s role is critical for learning to occur in the classroom and it requires the educator to have sound knowledge about different teaching strategies, as well as an understanding of which strategies work best with the specific discipline content information. This study sought to bridge the gap created by the absence of guidelines by the Health Professions Council of South Africa (HPCSA) for curriculum deployment in emergency medical care (EMC) training. With the recent shift from vocationally-based training to higher education in paramedic education a dire need exists to explore student paramedics’ perception of the curriculum that is being used in EMC training. Simulation is currently being used as a summative assessment instrument to measure students’ competency, but it does not integrate educational methods which are being used in emergency medicine and in other allied health care education. Universities and other institutions use outcomes-based education and training as set out by the requirements of the South African Qualifications Authority (SAQA). Countries such as the United States and Australia make use of integration of PBL and SBE or Case-based learning (CBL) and SBE. SBE and PBL studies were used to frame and focus the study. This study is situated in the field of Health Professions Education and focused on the profession of EMC. The research methods comprised analysis of documents that contextualise the use of clinical simulation by emergency care education programmes in South Africa. A review of scholarship provided a conceptual framework for understanding health care simulation as an educational methodology and its use as an instrument of assessment in EMC. Literature on PBL was also sought in EMC and since no articles could be found locally, articles from Australia, the United States and medicine were used to draw conclusions. Limited articles could be found internationally and even less information was found when the researcher looked within the South African EMC system with regard to different curriculums in use for paramedic education. A quantitative descriptive design was employed and a questionnaire survey was used as the method of data collection for the empirical phase of the study. All participants was first introduced to SBE and PBL prior the completion of the questionnaire survey. This ensured that each participant knew exactly how each method of education works. Data from questionnaire survey was analysed and interpreted in conjunction with the ICT Department University Free State, and the experience of the researcher, to examine which method of education is preferred by paramedic students’ which was the main unit of analysis, and the subunits, namely, how students experienced SBE and PBL. The data collected from the questionnaire survey was analysed and a description and discussion of the research findings were documented. Based on the literature review and the responses to the questionnaire, several prominent conclusions were reached. One of the key issues identified is that simulation is employed as a tool of assessment only, and not as an integration of an educational method. PBL also received favourable feedback from students who had never encountered PBL before this session. These research findings can assist with decisions as to whether future (more comprehensive and potentially more costly) research projects are justified. Both SBE and PBL prepare the paramedic with knowledge, skills and competence to treat a patient safely and with quality care. SBE should be seen as a method of education that can be integrated with other methods of education such as lectures, PBL and bedside teaching. Understanding the competence of paramedics is an important resource. They transport millions of people to hospitals each year and consequently, the need to measure how they learn is an important task. The study serves to frame the breadth, depth and scope of SBE and PBL in paramedic education in South Africa.
Afrikaans: 'n Dieptestudie na simulasiegebaseerde onderwys en probleemgebaseerde leer is uitgevoer met die doel om te verstaan watter onderwysmetode die geskikste is vir paramediese onderwys. Die navorser het 'n opname gedoen onder studente terwyl hulle in Bloemfontein, by die Free State College of Emergency Care, studeer het om paramedici te word. Paramediese onderwys vereis dat die opvoeder begrip het van 'n verskeidenheid onderrigvaardighede, en verstaan hoe om die studente se behoeftes te ondersteun. Gevolglik speel die opvoeder 'n noodsaaklike rol om leer in die lesingsaal te laat plaasvind. Dit vereis doeltreffende onderrig en kennis van 'n verskeidenheid onderrigstrategieë, sowel as 'n begrip van watter strategieë die beste werk vir spesifieke inhoudsinligting van die dissipline. Die studie het gepoog om die gaping, wat geskep is deur 'n gebrek aan riglyne deur die Gesondheidsberoepe Raad van Suid-Afrika (GBRSA) vir die toepassing van kurrikulum vir noodsorgopleiding, te oorbrug. Met die onlangse klemverskuiwing van beroepsgerigte opleiding na hoër onderwys in paramediese onderwys het 'n ernstige behoefte ontstaan om die persepsies van student-paramedici ten opsigte van die kurrikulum wat vir noodsorgopleiding gebruik word, te ondersoek. Simulasie word tans gebruik as 'n instrument vir summatiewe evaluering van studente se vaardigheid, maar dit integreer nie onderrigmetodes wat in noodgeneeskunde en ander, verwante gesondheidsorgonderwys gebruik word nie. Universiteite en ander instellings gebruik uitkomsgebaseerde onderwys en opleiding soos dit deur die vereistes van die Suid- Afrikaanse Kwalifikasiegesag (SAQA) uitgeengesit is. Lande soos die Verenigde State en Australië gebruik onderrigmetodes wat probleemgebaseerde leer en simulasiegebaseerde onderwys, of gevat-gebaseerde leer en simulasiegebaseerde onderwys integreer. Hierdie definisies is gebruik om die studie te omskryf en te fokus. Hierdie studie is geleë in die veld van gesondheidsorgprofessie-onderwys en het gefokus op die professie van nood- mediese sorg. Die navorsingsmetodes wat aangewend is, het die analise van dokumente wat die gebruik van kliniese simulasie in noodsorg-onderwysprogramme kontekstualiseer, behels. 'n Oorsig van vakgeleerdheid het 'n konseptuele raamwerk verskaf vir 'n begrip van simulasie in gesondheidsorg as 'n opvoedkundige metodologie, en die aanwending daarvan as 'n assesseringsinstrument in noodsorg. 'n Soektog na navorsing oor probleemgebaseerde leer in noodsorg is onderneem, maar aangesien geen artikels plaaslik opgespoor kon word nie, is artikels uit Australië en die Verenigde State, en van geneeskunde, gebruik om gevolgtrekkings te maak. 'n Beperkte aantal artikels is in die buiteland gevind, maar nog minder inligting was beskikbaar toe die navorser ondersoek ingestel het na verskillende kurrikula wat in die Suid-Afrikaanse noodsorgstelsel vir paramediese opleiding gebruik word. 'n Kwantitatiewe beskrywende ontwerp is aangewend, en 'n vraelysopname is gebruik as metode om data in te samel en vir die empiriese fase van die studie. Voordat hulle die vraelys voltooi het, is alle deelnemers eers aan simulasiegebaseerde onderwys en probleemgebaseerde leer bekend gestel. Dit het verseker dat elke deelnemer presies geweet het hoe elke onderrigmetode werk. Data van die vraelysopname is ontleed en geïnterpreteer in samewerking met die IKT Department van die Universiteit van die Vrystaat en aan die hand van die navorser se ervaring, om te ondersoek watter onderwysmetode in noodsorg verkies word - dit was die hoof- eenheid van ontleding - en hoe studente simulasiegebaseerde onderwys en probleemgebaseerde ervaar, wat die subeenhede was. Die data wat deur die vraelysopame versamel is, is ontleed en 'n beskrywing en bespreking van die navorsingsbevindinge is aangeteken. Verskeie duidelike gevolgtrekkings is aan die hand van die literatuuroorsig en die response op die vraelyste bereik. Sleutelkwessies wat geïdentifiseer is, is dat simulasie net as 'n assesseringshulpmiddel aangewend is, en nie as 'n geïntegreerde opvoedkundige hulpmiddel nie. Probleemgebaseerde leer is gunstig deur studente, wat dit nog nie voor hierdie sessie teëgekom het nie, beoordeel. Hierdie navorsingsbevindinge kan help met besluite oor of toekomstige (meer omvattende en potensieel duurder) geregverdig is. Sowel SBE en probleemgebaseerde leer berei die paramedikus voor met kennis, vaardighede en bevoegdhede om 'n pasiënt veilig en met gehalte sorg te behandel. SBE moet beskou word as 'n onderwysmetode wat met ander onderwysmetodes, soos lesings, probleemgebaseerde leer en onderrig langs die siekbed, geïntegreer kan word. Begrip van die paramedikus se bevoegdheid is 'n belangrike hulpbron. Paramedici vervoer jaarliks miljoene mense na hospitale; gevolglik is dit belangrik om paramedici se bevoegdheid te verstaan en te meet, en te weet hoe hulle leer. Hierdie studie dien om die breedte, diepte en omvang van simulasiegebaseerde onderwys en probleemgebaseerde leer in noodsorgopleiding in Suid-Afrika te beskryf.
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Keywords
Simulation Based Education, Problem Based Learning, Emergency Medicine, Emergency Care, Paramedic, Simulation, Pedagogy, Dissertation (M.HPE. (Health Professions Education))--University of the Free State, 2017
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