Pedagogy before Technology: A Design-Based Research Approach to Enhancing Skills Development in Paramedic Science Using Mixed Reality

Abstract

Abstract:In health sciences education, there is growing evidence that simulation improves learners' safety, competence, and skills, especially when compared to traditional didactic methods or no simulation training. However, this approach to simulation becomes difficult when students are studying at a distance, leading to the need to develop simulations that suit this pedagogical problem and the logistics of this intervention method. This paper describes the use of a design-based research (DBR) methodology, combined with a new model for putting 'pedagogy before technology' when approaching these types of education problems, to develop a mixed reality education solution. This combined model is used to analyse a classroom learning problem in paramedic health sciences with respect to student evidence, assisting the educational designer to identify a solution, and subsequently develop a technology-based mixed reality simulation via a mobile phone application and three-dimensional (3D) printed tools to provide an analogue approximation for an on-campus simulation experience. The developed intervention was tested with students and refined through a repeat of the process, showing that a DBR process, supported by a model that puts 'pedagogy before technology', can produce over several iterations a much-improved simulation that results in a simulation that satisfies student pedagogical needs.

Exploring mobile mixed reality in healthcare higher education: A systematic review

“…A variety of study designs were employed in the included studies -qualitative studies (n = 1); randomised controlled trials (RCTs) (n = 5); non-RCTs (n = 1); quantitative descriptive studies (n = 3); mixed methods (n = 7); and design-based research (DBR) (n = 1). All studies that included qualitative design performed well on the MMAT; however, those that included RCT in their mixed methods were more variable, with only three meeting all criteria in the MMAT (Aebersold et al 2018;Cowling and Birt 2018;De Oliveira et al 2013). The purpose of the four descriptive studies was to establish validity of the TouchSurgery® modules (Khelemsky, Hill, and Buchbinder 2017;Kowalewski et al 2017;Morone et al 2017;Sugand, Mawkin, and Gupte 2015), therefore they included survey and cross-sectional analytic study in their design.…”

“…Not all studies identified the participant age and/or gender. Two studies included undergraduate nursing students (Aebersold et al 2018;Garrett, Jackson, and Wilson 2015); 12 included medical students (Albrecht et al 2013;Amer et al 2017;Bartlett et al 2017;De Oliveira et al 2013;John et al 2015;Kowalewski et al 2017;Küçük, Kapakin, and Göktaş 2016;Moro et al 2017;Morone et al 2017;Noll et al 2014Noll et al , 2017Sugand, Mawkin, and Gupte 2015); 3 included paramedicine students (Birt et al 2017a(Birt et al , 2017bCowling and Birt 2018) and 1 included dentistry students (Khelemsky, Hill, and Buchbinder 2017).…”

“…Common skills included mMR was utilised for procedural clinical skills, assessment skills and anatomy knowledge. Twelve studies focused on clinical skills, with the majority focused on catheter or scope insertion (Aebersold et al2018;Bartlett et al 2017;Birt et al 2017aBirt et al , 2017bCowling and Birt 2018;De Oliveira et al 2013); surgical procedures (Amer et al 2017;John et al 2015;Khelemsky, Hill, and Buchbinder 2017;Kowalewski et al 2017;Morone et al 2017); familiarisation with general clinical skills and equipment (Garrett, Jackson, and Wilson 2015); wound and dermatology management (Albrecht et al 2013;Noll et al 2014Noll et al , 2017; and aiding clinical anatomy knowledge (Küçük, Kapakin, and Göktaş 2016;Moro et al 2017). One study used mMR for augmenting a respiratory failure case scenario (Garrett, Jackson, and Wilson 2015).…”

“…Some mobile devices required Internet connectivity to download the mMR application while others were preinstalled prior to the study commencing. The majority of studies included iPhone and/or Android mobile phones (Albrecht et al 2013;Amer et al 2017;Bartlett et al 2017;Birt et al 2017aBirt et al , 2017bCowling and Birt 2018;De Oliveira et al 2013;Garrett, Jackson, and Wilson 2015;John et al 2015;Khelemsky, Hill, and Buchbinder 2017;Küçük, Kapakin, and Göktaş 2016;Morone et al 2017;Noll et al 2014Noll et al , 2017, with some also including tablets alongside the phones or as the sole means of mMR. The iPad was mentioned in the majority of tablet-led studies (Aebersold et al 2018;De Oliveira et al 2013;Garrett, Jackson, and Wilson 2015;John et al 2015;Khelemsky, Hill, and Buchbinder 2017;Kowalewski et al 2017;Küçük, Kapakin, and Göktaş 2016;Noll et al 2014Noll et al , 2017, while others used the iPad alongside other tablets or did not specify the brand or type (Garrett, Jackson, and Wilson 2015;Khelemsky, Hill, and Buchbinder 2017;Küçük, Kapakin, and Göktaş 2016;Moro et al 2017).…”

“…The iPad was mentioned in the majority of tablet-led studies (Aebersold et al 2018;De Oliveira et al 2013;Garrett, Jackson, and Wilson 2015;John et al 2015;Khelemsky, Hill, and Buchbinder 2017;Kowalewski et al 2017;Küçük, Kapakin, and Göktaş 2016;Noll et al 2014Noll et al , 2017, while others used the iPad alongside other tablets or did not specify the brand or type (Garrett, Jackson, and Wilson 2015;Khelemsky, Hill, and Buchbinder 2017;Küçük, Kapakin, and Göktaş 2016;Moro et al 2017). Google Cardboard or ColorCross were also used with mobile phones in three studies (Birt et al 2017a(Birt et al , 2017bCowling and Birt 2018).…”