Research Opportunities in Simulation‐based Medical Education Using Deliberate Practice

Abstract

There are many opportunities for the academic emergency medicine (EM) community to engage in simulation-based educational research using deliberate practice (DP). This article begins by defining and giving examples of two key concepts: deliberate practice and mastery learning. The article proceeds to report six lessons learned from a research legacy in simulation-based medical education (SBME). It concludes by listing and amplifying 10 DP research opportunities in academic EM. A coda states that the research agenda is rich and ambitious and should focus on the goal of educating superb, expert clinicians. Keywords: research agenda, simulation, deliberate practice, emergency medicine T his article amplifies an earlier report in Academic Emergency Medicine that sets forth an ambitious simulation research agenda in the specialty.1 The earlier report addressed the simulation research agenda as five broad categories: 1) simulation for education and training in emergency medicine (EM)-clinical experience and reflection, behavioral and team training, procedural simulation, computer screen-based simulation, and immersive environments; 2) simulation for evaluation and testing in EM; 3) special topics in EM-care process and organizational design, studying and improving performance, disaster management, and undergraduate medical education; 4) challenges in simulation-based research; and 5) future directions. The research opportunities identified in this article have a much narrower focus, i.e., the use of deliberate practice (DP) as an independent variable in the context of simulation-based education in EM.This article reviews the following: DP, a mastery learning model, six lessons learned, and 10 DP research opportunities. It does not, however, address other important topics in simulation-based EM education, including high-stakes personnel evaluation, systemsbased practice, and patient safety, which are covered in the companion articles in this thematic issue of Academic Emergency Medicine. DPDeliberate practice is an educational variable first described and evaluated by learning psychologist K. Anders Ericsson.2-5 DP endorses the idea that educational interventions must be strong, consistent, and sustained to promote lasting skill and knowledge attainment.6 Learners work hard when engaged in DP; it is not child's play. DP is an evidence-based variable that works and is grounded in information processing and behavioral theories of skill acquisition and maintenance.2-5 It involves at least nine features that can contribute to simulation-based education in EM:1. Highly motivated learners with good concentration (e.g., EM residents); 2. Engagement with a well-defined learning objective or task; at an 3. Appropriate level of difficulty; with 4. Focused, repetitive practice; that leads to 5. Rigorous, precise educational measurements; that yield 6. Informative feedback from educational sources (e.g., simulators, teachers); and where 7. Trainees also monitor their learning experiences and correct strategies, errors, and...

Internal Medicine Postgraduate Training and Assessment of Patient Handoff Skills

“…In mastery learning, training time varies, whereas education outcomes are uniform. 32 Mastery learning programs feature deliberate practice, 33 predetermined minimum passing standards, and periodic objective assessment. This format allows residency programs to accurately document skill achievement and retention.…”

Translational Educational Research

“…Research opportunities focused on SBME include studies on the duration and intensity of deliberate practice, mea surement development and refi nement, skill maintenance, faculty development, and many others. 62 Health-care improvement needs to be addressed by translational research programs with or without a foundation in simulation. Key areas needing improvement include interprofessional education and its clinical impact; clinical team training and measurement of its downstream impact on patient care, safety, and outcomes; and enhanced patient safety and quality in a variety of inpatient and outpatient settings.…”

L’expérience pionnière Virtual Vet entreprise en 2012 à Oniris pour compléter la formation clinique grâce à des apprentissages par simulation

“…Cette formation clinique peut aussi maintenant bénéficier de créativité ou d'innovations. En 2012, le directeur de l'École Nationale Vétérinaire, Agroalimentaire et de l'Alimentation Nantes-Atlantique (Oniris) a ainsi pris la décision de complé-ter à Oniris la formation clinique classique par une modalité pédagogique complémentaire basée sur l'utilisation de situations virtuelles (Devitt et al 2001;Rosen, 2008;McGaghie, 2008;McGaghie et al 2010;Abraham et al 2011 ;Cook et al 2011). Selon la définition donnée par la Société pour la simulation en santé, « le terme simulation en santé correspond à l'utilisation d'un matériel, de la réalité virtuelle ou d'un patient standardisé pour reproduire des situations ou des environnements de soin.…”