Building Competency with Blended Learning
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This document discusses best practices for integrating simulation into education for adult learners. It defines competency assessment versus education and how that affects simulation design. It reviews key characteristics of adult learners, including that they are self-directed, draw from experience, and want immediately applicable learning. Different learning styles are identified, like visual, auditory, reading/writing, and kinesthetic, and how simulations can address each. Best practices discussed include experiential learning, contextual learning, situated learning, deliberate practice, feedback, and mastery learning. The document emphasizes applying learning theories to the design of simulations and debriefings to effectively educate adult learners.
Building Competency with Blended Learning
- 1. Building Competency with Blended Learning: Integrating Simulation into Education Charles M. Ware, D.H.Ed., CHES
- 2. What we are covering? • Define Continuing Education • Motivations for Learning • Competency Assessment vs. Education • Learning Styles (VARK) Questionnaire • Adult Learner Characteristics (Knowles) • Best Practices in Simulation Education
- 3. Objectives At the end of this session learners will be able to: • Differentiate between competency assessment and education and how that affects simulation design • Review key elements of adult learners • Identify different learning styles and how different forms of simulation can address each • Initiate simulation design based on some best practices in Simulation Education
- 5. Motivations for Learning 1. Social Relationships 2. External Expectations 3. Social Welfare 4. Professional Advancement 5. Escape/Stimulation 6. Cognitive Interest Morstain and Smart (1974), noted in Learning in adulthood.
- 6. Competency Assessment vs. Education • Sometimes what we call “education” is really assessment, and what we call assessment is not that, either. • What happens when we assess the quality of someone’s work, and they don’t pass?????
- 7. Competency Assessment vs. Education • “Fail” • What do you do when you find a knowledge deficit? A skills deficit? • How do you remediate? • Reteach • Reassess • Performance Plan • What do you do with them in the meantime?
- 8. Competency Assessment vs. Education • eLearning • Pre Assessment (study/practice) • New to simulation • Nervous performers • Post Assessment (remediation) • Specific goals based on performance • Score-based • Knowledge deficit • Decision-making deficit • Unlimited time access
- 9. Competency Assessment vs. Education • Skills deficit • Partial Task Trainers (hands on training tools) • I.O. Leg • IV arm • Central Line Trainer • Intubation head • Virtual Reality
- 10. Adult Learners: • Are more independent and self-directed • Want to feel accepted, respected and supported when learning • Want to feel a partnership with their instructor • Have a wealth of experience they draw from when learning • Want to feel they can immediately use what they are learning (problem-centered) • Have many different motivations for learning Malcolm Knowles, Andragogy, 1968, 1980.
- 11. Simulation & the Adult Learner • Work independently or with a group; use debrief to direct learning • Create a environment of respect, support, and safety during simulations • Dialogue between trainer and learner • Build on previous experience and create new experiences • Scenarios that are directly applicable to job • Goal oriented learning
- 12. Learning Styles • How a person approaches learning tasks • “Manner in which…learners most efficiently and effectively perceive, process, store and recall what they are attempting to learn” (James and Blank, 1993, pp. 47-48). • Helps you identify your strengths and weaknesses as learners
- 13. Learning Styles-How do you learn best? • VARK- Link to VARK Questionnaire • Multiple Intelligences-Link to Multiple Intelligences Questionnaire • Learning Styles Inventory-Link to Learning Styles Inventory Questionnaire
- 14. Learning Styles How do you learn best? • Visual • Aural • Read/write • Kinesthetic
- 16. Learning Styles How do you learn best? • Visual • Charts • graphs • flow charts (arrows, circles, hierarchies) • algorithms
- 17. Learning Styles How do you learn best? • Aural • Lectures • Tutorials • Tapes • Group discussion • Email • Speaking • Webchat • “Talking Things Through”
- 18. Learning Styles How do you learn best? • Read/write • Text-based input and output • List-makers
- 19. Learning Styles How do you learn best? • Kinesthetic • Practice • Hands-on • Examples • Simulations
- 20. Learning Styles • V- • schematics, algorithms in debriefs • A- • Debrief discussions • Interactive online (with feedback) • May be better at telling you the answers than doing them • R- • handout and ppt debriefings • Readings on evidence-based new info. • K- • Simulation, hands-on debriefing • Can include eSimulation as well
- 21. Best Practices in Simulation Education • Experiential Learning (Kolb) • Contextual Learning (Kneebone) • Situated Learning/Peripheral Participation (Lave & Wenger) • Self-Efficacy and Competency (Maibach et al, Miller) • Deliberate Practice (Ericcson) • Feedback (Van de Ridder) • Mastery Learning (Bloom) Hunt et al, 2008
- 22. Best Practices in Simulation Education Experiential Learning (Kolb) 1. Direct encounter with the phenomenon being studied rather than merely thinking about the encounter, or only considering the possibility of doing something about it 2. Education that occurs as a direct participation in the events of life
- 23. Best Practices in Simulation Education Contextual Learning (Kneebone) • For learning to be most effective, it must occur within a context parallel to how individuals will apply the knowledge in their own professional practice
- 24. Best Practices in Simulation Education • Same equipment as in unit • Groups bring specific equipment • Basic Life Support (BLS) training for med students includes how to function with new BLS skills in hospital setting
- 25. Best Practices in Simulation Education Situated Learning/Peripheral Participation (Lave & Wenger) • Learning through real-life participation • Learners observe actions while working side-by- side with a skilled person (content expert) • Begin participating in observed tasks, bringing them from periphery to participation
- 26. Best Practices in Simulation Education Self-Efficacy and Competency (Maibach et al) • A person’s belief in their capability to organize and execute a course of action to produce given attainments • 4 levels of Competence: 1.Unconsciously incompetent 2.Consciously incompetent 3.Consciously competent 4.Unconsciously competent
- 27. Best Practices in Simulation Education Self-Efficacy and Competency (Maibach et al) • Framework for assessing clinical competency (Miller) 1.Knowledge (knows) 2.Competence (knows how) 3.Performance (shows how) 4.Action (does)
- 28. Best Practices in Simulation Education • Hybrid simulations to practice very specific skills • Tension Pneumothorax • Patient death • Intubation • Aspiration
- 29. Best Practices in Simulation Education Deliberate Practice (Ericcson) • Training activities that promote consistent improvements in expert performance domains • Repetitive performance in a focused domain • Rigorous skills assessment (specific formative feedback) • Progressively improved performance in a controlled setting
- 30. Best Practices in Simulation Education Feedback • “Specific information about the comparison between a trainee’s observed performance and a standard, given with an intent to improve the trainee’s performance” (Van de Ridder)
- 31. Best Practices in Simulation Education • Build debrief tools based on agreed upon standards • Debrief should be based on simulation objectives
- 32. Best Practices in Simulation Education Mastery Learning (Bloom) • Aptitude is the length of time it takes a person to learn not how "bright" a person is, i.e., everyone can learn given the right circumstances • Goal: all learners to achieve the target outcome with little/no variability; amount of time to achieve will vary based on the learners
- 33. Best Practices in Simulation Education • eLearning • Practice makes Perfect PERMANENT • Automotive Service Excellent (ACE) • National Automotive Technicians Education Foundation (NATEF) practical simulation course • Journeyman Electrician License
- 34. Putting it all Together • Continuing education in healthcare should include: • Opportunities to reflect on learning • Opportunities to apply learning to practice • Interpersonal interaction
- 35. Putting it all Together • Competency assessment looks for level of knowledge/skills and identifies deficits. Focus is not on new learning. • Should include avenues for remediation and opportunities for student study/practice prior
- 36. Putting it all Together • Adult learners: • Are problem-centered • Have a wealth of experience to draw from • Have many different motivations for learning
- 37. Putting it all Together • Different learning styles mean people are most comfortable in a particular way. • Build simulations and debriefings to meet these styles
- 38. Putting it all Together • Key learning theories to consider when building a simulation are: • Experiential Learning • Contextual Learning • Situated Learning/ Peripheral Participation • Deliberate Practice • Feedback • Mastery Learning
- 39. Resources Allen, M., Curran, V. Ferrier, D. Ho, K., Kirby, F., Allen, J. et al (2004). Interactive on-line continuing medical education: Physician’s perceptions and experiences. The Journal of Continuing Education in the Health Professions 24 (4): 227-236. Hunt, E.A., Fiedor-Hamilton, M., Eppich, W. (2008). Resuscitation education: Narrowing the gap between evidence-based resuscitation guidelines and performance using best educational practices. Pediatric Clinics of North America. 55: 1035-1050. Institute of Medicine. 2003. Health professions education: A bridge to quality. Washington, DC: The National Academy Press. Merriam, S.B., Caffarella, R.S. (1999). Learning in Adulthood. San Fransisco: Jossey Bass. Notes from a Benjamin Bloom Lecture. (1987, April). Retrieved May 15, 2009, from http://www.humboldt.edu/~tha1/mastery.html Smith, M.K. David A. Kolb on experiential learning. Retrieved May 1, 2009 from http://www.infed.org/biblio/b-explrn.htm VARK Categories. (2001-2009). Retrieved August 10, 2007, from VARK-A Guide to Learning Styles: http://www.vark- learn.com/english/page.asp?p=categories
- 40. Questions?