Operationalising elaboration theory for simulation instruction design: a Delphi study.

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Title: Operationalising elaboration theory for simulation instruction design: a Delphi study.
Authors: Haji, Faizal A, Khan, Rabia, Regehr, Glenn, Ng, Gary, Ribaupierre, Sandrine, Dubrowski, Adam
Source: Medical Education. Jun2015, Vol. 49 Issue 6, p576-588. 13p. 4 Charts.
Subjects: Delphi method, Lumbar puncture, Medical teaching personnel, Medical simulation, Clinical medicine, Teaching methods research, Professional education, Medical students, Research funding, School environment, Decision making in clinical medicine, Task performance, Education theory, Data analysis software, Descriptive statistics
Abstract: Objective The aim of this study was to assess the feasibility of incorporating the Delphi process within the simplifying conditions method ( SCM) described in elaboration theory ( ET) to identify conditions impacting the complexity of procedural skills for novice learners. Methods We generated an initial list of conditions impacting the complexity of lumbar puncture ( LP) from key informant interviews ( n = 5) and a literature review. Eighteen clinician-educators from six different medical specialties were subsequently recruited as expert panellists. Over three Delphi rounds, these panellists rated: (i) their agreement with the inclusion of the simple version of the conditions in a representative ('epitome') training scenario, and (ii) how much the inverse (complex) version increases LP complexity for a novice. Cronbach's α-values were used to assess inter-rater agreement. Results All panellists completed Rounds 1 and 2 of the survey and 17 completed Round 3. In Round 1, Cronbach's α-values were 0.89 and 0.94 for conditions that simplify and increase LP complexity, respectively; both values increased to 0.98 in Rounds 2 and 3. With the exception of 'high CSF (cerebral spinal fluid) pressure', panellists agreed with the inclusion of all conditions in the simplest (epitome) training scenario. Panellists rated patient movement, spinal anatomy, patient cooperativeness, body habitus, and the presence or absence of an experienced assistant as having the greatest impact on the complexity of LP. Conclusions This study demonstrated the feasibility of using expert consensus to establish conditions impacting the complexity of procedural skills, and the benefits of incorporating the Delphi method into the SCM. These data can be used to develop and sequence simulation scenarios in a progressively challenging manner. If the theorised learning gains associated with ET are realised, the methods described in this study may be applied to the design of simulation training for other procedural and non-procedural skills, thereby advancing the agenda of theoretically based instruction design in health care simulation. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: <searchLink fieldCode="JN" term="%22Medical+Education%22">Medical Education</searchLink>. Jun2015, Vol. 49 Issue 6, p576-588. 13p. 4 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Delphi+method%22">Delphi method</searchLink><br /><searchLink fieldCode="DE" term="%22Lumbar+puncture%22">Lumbar puncture</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+teaching+personnel%22">Medical teaching personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+simulation%22">Medical simulation</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+medicine%22">Clinical medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Teaching+methods+research%22">Teaching methods research</searchLink><br /><searchLink fieldCode="DE" term="%22Professional+education%22">Professional education</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+students%22">Medical students</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22School+environment%22">School environment</searchLink><br /><searchLink fieldCode="DE" term="%22Decision+making+in+clinical+medicine%22">Decision making in clinical medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Task+performance%22">Task performance</searchLink><br /><searchLink fieldCode="DE" term="%22Education+theory%22">Education theory</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink>
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  Data: Objective The aim of this study was to assess the feasibility of incorporating the Delphi process within the simplifying conditions method ( SCM) described in elaboration theory ( ET) to identify conditions impacting the complexity of procedural skills for novice learners. Methods We generated an initial list of conditions impacting the complexity of lumbar puncture ( LP) from key informant interviews ( n = 5) and a literature review. Eighteen clinician-educators from six different medical specialties were subsequently recruited as expert panellists. Over three Delphi rounds, these panellists rated: (i) their agreement with the inclusion of the simple version of the conditions in a representative ('epitome') training scenario, and (ii) how much the inverse (complex) version increases LP complexity for a novice. Cronbach's α-values were used to assess inter-rater agreement. Results All panellists completed Rounds 1 and 2 of the survey and 17 completed Round 3. In Round 1, Cronbach's α-values were 0.89 and 0.94 for conditions that simplify and increase LP complexity, respectively; both values increased to 0.98 in Rounds 2 and 3. With the exception of 'high CSF (cerebral spinal fluid) pressure', panellists agreed with the inclusion of all conditions in the simplest (epitome) training scenario. Panellists rated patient movement, spinal anatomy, patient cooperativeness, body habitus, and the presence or absence of an experienced assistant as having the greatest impact on the complexity of LP. Conclusions This study demonstrated the feasibility of using expert consensus to establish conditions impacting the complexity of procedural skills, and the benefits of incorporating the Delphi method into the SCM. These data can be used to develop and sequence simulation scenarios in a progressively challenging manner. If the theorised learning gains associated with ET are realised, the methods described in this study may be applied to the design of simulation training for other procedural and non-procedural skills, thereby advancing the agenda of theoretically based instruction design in health care simulation. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/medu.12726
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      – Code: eng
        Text: English
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        PageCount: 13
        StartPage: 576
    Subjects:
      – SubjectFull: Delphi method
        Type: general
      – SubjectFull: Lumbar puncture
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      – SubjectFull: Medical teaching personnel
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      – SubjectFull: Medical simulation
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      – SubjectFull: Medical students
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      – SubjectFull: Research funding
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      – SubjectFull: School environment
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      – SubjectFull: Decision making in clinical medicine
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      – SubjectFull: Education theory
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      – SubjectFull: Data analysis software
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      – SubjectFull: Descriptive statistics
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      – TitleFull: Operationalising elaboration theory for simulation instruction design: a Delphi study.
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              Text: Jun2015
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