Abasebenzi kufuneka babe nezakhono ezisebenzayo zokuqiqa zonyango ukwenza izigqibo ezifanelekileyo, ezikhuselekileyo zonyango kunye nokuphepha iimpazamo zokuziqhelanisa.Izakhono zokuqiqa zeklinikhi ezingaphuhliswanga kakuhle zinokuphazamisa ukhuseleko lwesigulane kunye nokulibazisa ukhathalelo okanye unyango, ngakumbi kunyango olunzulu kunye namasebe angxamisekileyo.Uqeqesho olusekwe kukulinganisa lusebenzisa iincoko zokufunda ezicingayo ezilandela ukulinganisa njengendlela yokuhlaziya ukuphuhlisa izakhono zokuqiqa zonyango ngelixa ugcina ukhuseleko lwesigulane.Nangona kunjalo, ngenxa yobuninzi bendalo yokuqiqa kweklinikhi, umngcipheko onokuthi ubekho wokuxinana kwengqondo, kunye nokusetyenziswa okwahlukileyo kokuhlalutya (i-hypothetico-deductive) kunye ne-non-analytical (intuitive) iinkqubo zokucinga zeklinikhi ngabathathi-nxaxheba abaphambili nabancinci, kubalulekile ukuba qwalasela amava, izakhono, imiba enxulumene nokuhamba kunye nomthamo wolwazi, kunye nemeko entsonkothileyo yokwandisa ukucinga kweklinikhi ngokubandakanyeka kwiingxoxo zokufunda ezibonisa iqela emva kokulinganisa njengendlela yokuxubusha.Injongo yethu kukuchaza ukuphuhliswa komzekelo wengxoxo yokufunda ebonisa emva kokulinganisa eqwalasela izinto ezininzi ezichaphazela ukufezekiswa kokuqiqa kweklinikhi.
Iqela elisebenzayo lokuyila (N = 18), elibandakanya oogqirha, abongikazi, abaphandi, abafundisi, kunye nabameli bezigulane, baye basebenzisana ngeendibano zocweyo ezilandelelanayo ukuze baqulunqe imodeli yencoko yababini ebonisa emva kokulinganisa ukulinganisa ukulinganisa.Iqela elisebenzayo lokuyila ngokubambisana liphuhlise imodeli ngenkqubo yethiyori kunye nengqikelelo kunye nophononongo loontanga lwamanqanaba amaninzi.Ukudityaniswa okunxuseneyo kophando lovavanyo lwe-plus/minus kunye ne-taxonomy ye-Bloom kukholelwa ukuba iyakwandisa ukuqiqa kweklinikhi kwabathathi-nxaxheba abalinganisayo ngelixa bethatha inxaxheba kwimisebenzi yokulinganisa.Isalathisi sokuqinisekiswa komxholo (i-CVI) kunye neendlela zokuqinisekiswa komxholo (i-CVR) zisetyenziselwe ukuseka ukuqinisekiswa kobuso kunye nokuqinisekiswa komxholo wemodeli.
Kwaphuhliswa kwaza kwavavanywa imodeli yengxoxo yasemva kokulinganisa ebonisa ukufunda.Imodeli ixhaswa yimizekelo esebenzayo kunye nesikhokelo sokubhala.Ubuso kunye nomxholo osemthethweni wemodeli wavavanywa kwaye waqinisekiswa.
Imodeli entsha yoyilo oludibeneyo yenziwa kuthathelwa ingqalelo izakhono kunye nobuchule babathathi-nxaxheba abahlukeneyo bomzekelo, ukuhamba kunye nomthamo wolwazi, kunye nobunzima bamatyala omzekelo.Ezi zinto zicingelwa ukuba zandise ukucinga kweklinikhi xa zithatha inxaxheba kwimisebenzi yokulinganisa iqela.
Ukuqiqa ngeklinikhi kuthathwa njengesiseko sokusebenza kwekliniki kukhathalelo lwempilo [1, 2] kunye nento ebalulekileyo yobuchule bekliniki [1, 3, 4].Yinkqubo ebonisa ukuba abasebenzi basebenzise ukuchonga nokuphumeza ukungenelela okufanelekileyo kwimeko nganye yeklinikhi abadibana nayo [5, 6].Ukuqiqa ngeklinikhi kuchazwa njengenkqubo yokuqonda eyinkimbinkimbi esebenzisa izicwangciso zokucinga ezisemthethweni kunye nezingekho sikweni ukuqokelela nokuhlalutya ulwazi malunga nesigulane, ukuvavanya ukubaluleka kwaloo lwazi, kwaye unqume ixabiso lezinye izifundo zesenzo [7, 8].Kuxhomekeke kwikhono lokuqokelela imikhondo, inkqubo yolwazi, nokuqonda ingxaki yesigulane ukuze kuthathelwe amanyathelo afanelekileyo kwisigulane esifanelekileyo ngexesha elifanelekileyo kunye nesizathu esifanelekileyo [9, 10].
Bonke ababoneleli bezempilo bajongene nesidingo sokwenza izigqibo ezinzima kwiimeko zokungaqiniseki okuphezulu [11].Ekunyamekelweni okubalulekileyo kunye nonyango olungxamisekileyo, iimeko zeklinikhi kunye neemeko eziphuthumayo zivela apho ukuphendula ngokukhawuleza kunye nokungenelela kubalulekile ekusindiseni ubomi kunye nokuqinisekisa ukhuseleko lwesigulane [12].Izakhono zeklinikhi zokuqiqa ezingalunganga kunye nobuchule ekusebenzeni kokunyamekela okubalulekileyo zihambelana namazinga aphezulu eempazamo zeklinikhi, ukulibaziseka ekunyamekelweni okanye unyango [13] kunye neengozi kukhuseleko lwesigulane [14,15,16].Ukuze ugweme iimpazamo ezisebenzayo, abaqeqeshi kufuneka babe nobuchule kwaye babe nezakhono zokuqiqa zonyango ezisebenzayo ukwenza izigqibo ezikhuselekileyo nezifanelekileyo [16, 17, 18].Inkqubo yokuqiqa engeyiyo yohlalutyo (enembile) yinkqubo ekhawulezayo ethandwa ngabasebenzi abaziingcali.Ngokwahlukileyo koko, iinkqubo zokuqiqa ezihlalutyayo (i-hypothetico-deductive) ziyacotha ngokwemvelo, zenziwe ngabom, kwaye zihlala zisetyenziswa ngabasebenzi abanamava angaphantsi [2, 19, 20].Ngenxa yobunzima bemeko yekliniki yezempilo kunye nomngcipheko onokuthi ube neempazamo zokwenza [14,15,16], imfundo esekelwe kwi-simulation (SBE) isoloko isetyenziselwa ukubonelela ngabasebenzi ngamathuba okuphuhlisa ubuchule kunye nezakhono zokuqiqa zonyango.indawo ekhuselekileyo kunye nokuvezwa kwiindidi zemingeni enzima ngelixa ugcina ukhuseleko lwesigulane [21, 22, 23, 24].
I-Society for Simulation in Health (SSH) ichaza ukulinganisa njenge "teknoloji eyenza imeko okanye indawo apho abantu bafumana ukubonakaliswa kweziganeko zobomi bokwenyani ngenjongo yokuziqhelanisa, uqeqesho, ukuvavanya, ukuvavanya, okanye ukufumana ukuqonda kweenkqubo zabantu okanye ukuziphatha.”[23] Iiseshoni zokulinganisa ezilungiselelwe kakuhle zinika abathathi-nxaxheba ithuba lokuzicwilisela kwiimeko ezifanisa iimeko zeklinikhi ngelixa zinciphisa imingcipheko yokhuseleko [24,25] kwaye usebenzise ukucinga kwekliniki ngamathuba okufunda okujoliswe kuyo [21,24,26,27,28] I-SBE iphucula amava onyango entsimi, iveza abafundi kumava ezonyango ekusenokwenzeka ukuba abazange babe nawo kwiisetingi zokhathalelo lwezigulane [24, 29].Le yindawo yokufunda engoyikiyo, ayinakubekwa tyala, iliso elibukhali, ekhuselekileyo, enomngcipheko ophantsi.Ikhuthaza ukuphuhliswa kolwazi, izakhono zeklinikhi, izakhono, ukucinga okubalulekileyo kunye nokuqiqa kwekliniki [22,29,30,31] kwaye inokunceda abaqeqeshi bezempilo ukuba banqobe uxinzelelo lweemvakalelo kwimeko, ngaloo ndlela kuphuculwe amandla okufunda [22, 27, 28] ., 30, 32].
Ukuxhasa uphuhliso olusebenzayo lokuqiqa kweklinikhi kunye nezakhono zokwenza izigqibo nge-SBE, ingqalelo kufuneka ihlawulwe kwi-design, itemplate, kunye nesakhiwo senkqubo ye-post-simulation debriefing [24, 33, 34, 35].I-post-simulation reflective learning conversations (RLC) isetyenziswe njengendlela yokuxubusha ukunceda abathathi-nxaxheba babonise, bachaze izenzo, kwaye basebenzise amandla okuxhaswa koontanga kunye neqela lokucinga kumxholo weqela [32, 33, 36].Ukusetyenziswa kweqela le-RLCs inomngcipheko onokuthi ubekho wokuqiqa kweklinikhi engaphuhliswanga, ngokukodwa ngokumalunga nezakhono ezahlukeneyo kunye namanqanaba aphezulu abathathi-nxaxheba.Imodeli yenkqubo emibini ichaza ubume beendlela ezininzi zokuqiqa kweklinikhi kunye nokwahluka kwi-propensity yabasebenzi abaphezulu ukuba basebenzise iinkqubo zokuhlalutya (i-hypothetico-deductive) yokuqiqa kunye nabasebenzi abancinci ukuba basebenzise iinkqubo zokuqiqa ezingahlalutywayo (intuitive) [34, 37].].Ezi nkqubo zimbini zokuqiqa zibandakanya umngeni wokulungelelanisa iinkqubo ezifanelekileyo zokuqiqa kwiimeko ezahlukeneyo, kwaye akucaci kwaye kungqubuzana indlela yokusebenzisa ngokufanelekileyo iindlela zokuhlalutya kunye nezingahlalutyiyo xa kukho abathathi-nxaxheba abaphezulu nabancinci kwiqela elifanayo lomzekelo.Abafundi bezikolo eziphakamileyo kunye nabafundi bezikolo zamabanga aphakamileyo abanobuchule obahlukeneyo kunye namanqanaba amava bathatha inxaxheba kwiimeko zokulinganisa ezinobunzima obahlukeneyo [34, 37].Ubume bobuninzi bokuqiqa kweklinikhi bunxulunyaniswa nomngcipheko onokuthi ubekho wokuqiqa kweklinikhi engaphuhliswanga kunye nokugcwala kwengqondo, ngakumbi xa iingcali zithatha inxaxheba kwiqela le-SBE ezinobunzima obuhlukeneyo kunye namanqanaba aphezulu [38].Kubalulekile ukuba uqaphele ukuba nangona kukho inani leemodeli zokuxubusha usebenzisa i-RLC, akukho nanye kwezi modeli eziye zayilwa ngokugxila ngokukodwa kuphuhliso lwezakhono zokuqiqa zonyango, kuthathelwa ingqalelo amava, ubuchule, ukuhamba kunye nomthamo wolwazi, kwaye ukulinganisa izinto ezintsonkothileyo [38].]., 39].Konke oku kufuna ukuphuhliswa kwemodeli ecwangcisiweyo eqwalasela iminikelo eyahlukeneyo kunye neempembelelo ezichaphazelayo zokuphucula ukucinga kweklinikhi, ngelixa kubandakanywa i-post-simulation RLC njengendlela yokunika ingxelo.Sichaza inkqubo eqhutywa ngokwethiyori kunye nengqikelelo yoyilo lwentsebenziswano kunye nophuhliso lwe-RLC yasemva kokulinganisa.Imodeli yaphuhliswa ukuze kuphuculwe izakhono zeklinikhi zokuqiqa ngexesha lokuthatha inxaxheba kwi-SBE, kuqwalaselwa uluhlu olubanzi lwezinto eziququzelelayo kunye neempembelelo zokufezekisa uphuhliso lweklinikhi yokuqiqa.
Imodeli yokulinganisa emva kwe-RLC yaphuhliswa ngokubambisana ngokusekelwe kwiimodeli ezikhoyo kunye neengcamango zeklinikhi yokuqiqa, ukufunda okubonakalayo, imfundo kunye nokulinganisa.Ukuphuhlisa ngokudibeneyo imodeli, iqela elisebenzayo elisebenzisanayo (N = 18) lasekwa, elibandakanya abongikazi abali-10 abanokhathalelo olunzulu, omnye u-intensivist, kunye nabameli abathathu bezigulana ebezikade zibhedlele zamanqanaba ahlukeneyo, amava kunye nesini.Iyunithi enye yokhathalelo olumandla, abancedisi bophando aba-2 kunye nabafundisi-ntsapho aba-2 abakwizinga eliphezulu.Olu lutsha luyilwe ngokubambisana luyilwe kwaye luphuhliswe ngokusebenzisana koontanga phakathi kwabachaphazelekayo abanamava okwenene kukhathalelo lwempilo, nokuba ngabaqeqeshi bezempilo ababandakanyekayo ekuphuhliseni imodeli ecetywayo okanye abanye abachaphazelekayo njengezigulane [40,41,42].Ukubandakanya abameli besigulane kwinkqubo yokudibanisa i-co-design inokongeza ixabiso kwinkqubo, njengoko injongo yokugqibela yenkqubo kukuphucula ukunakekelwa kwesigulane kunye nokhuseleko [43].
Iqela elisebenzayo liqhube iiworkshops ezintandathu zeeyure ze-2-4 ukuphuhlisa isakhiwo, iinkqubo kunye nomxholo wemodeli.Iworkshop ibandakanya ingxoxo, ukuziqhelanisa nokulinganisa.Iimpawu zemodeli zisekelwe kuluhlu lwezixhobo ezisekelwe kubungqina, iimodeli, iithiyori kunye nesikhokelo.Ezi ziquka: i-constructivist learning theory [44], i-dual loop concept [37], i-clinical reasoning loop [10], i-appreciative inquiry (AI) indlela [45], kunye ne-reporting plus/delta method [46].Imodeli yaphuhliswa ngokubambisana ngokusekelwe kwimigangatho yenkqubo yokuxubusha i-INACSL ye-International Nurses Association yemfundo yeklinikhi kunye nokulinganisa [36] kwaye idibaniswe nemizekelo esebenzayo ukwenza imodeli yokuzichaza.Lo mzekelo uphuhliswe ngokwezigaba ezine: ukulungiselela incoko yababini ebonisa uluvo emva kokulinganisa, ukuqaliswa kwengxoxo yokufunda ecamngcayo, ukuhlalutya/ukucingisisa kunye nokucacisa (Umfanekiso 1).Iinkcukacha zenqanaba ngalinye zixoxwa ngezantsi.
Isigaba sokulungiselela imodeli yenzelwe ukulungiselela abathathi-nxaxheba ngokwengqondo kwinqanaba elilandelayo kunye nokwandisa inxaxheba yabo esebenzayo kunye notyalo-mali ngelixa beqinisekisa ukhuseleko lwengqondo [36, 47].Eli nqanaba libandakanya intshayelelo yenjongo kunye neenjongo;ixesha elilindelekileyo le-RLC;izinto ezilindelekileyo zomququzeleli kunye nabathathi-nxaxheba ngexesha le-RLC;ukuqhelaniswa nesiza kunye nokuseta ukulinganisa;ukuqinisekisa ubumfihlo kwindawo yokufunda, kunye nokwandisa nokwandisa ukhuseleko ngokwasengqondweni.Ezi mpendulo zilandelayo zabameli ezivela kwiqela elisebenzayo lokuyila ngokubambisana zicatshangelwe ngexesha lesigaba sangaphambili sophuhliso lwemodeli ye-RLC.Umthathi-nxaxheba wesi-7: "Njengomongikazi oyintloko, ukuba ndithatha inxaxheba ekufaniseni ngaphandle komxholo wemeko kunye nabantu abadala abadala babekhona, ndingakuphepha ukuthatha inxaxheba kwincoko yasemva kokulinganisa ngaphandle kokuba ndivakalelwa kukuba ukhuseleko lwam ngokwasengqondweni lwalukho. ihlonitshwa.nokuba ndingakuphepha ukuthatha inxaxheba kwiincoko emva kokulinganisa."Khuselwa kwaye akusayi kubakho ziphumo."Umthathi-nxaxheba 4: “Ndikholelwa ekubeni ukugxila nokuseka imigaqo esisiseko kwangethuba kuya kunceda abafundi emva kokulinganisa.Ukuthatha inxaxheba ngokubonakalayo kwiincoko zokufunda ezicingisisiweyo.”
Izigaba zokuqala zemodeli ye-RLC ziquka ukuhlola iimvakalelo zomthathi-nxaxheba, ukuchaza iinkqubo ezisisiseko kunye nokuxilonga imeko, kunye nokudwelisa amava abathathi-nxaxheba abalungileyo kunye namabi, kodwa kungekhona uhlalutyo.Imodeli kweli nqanaba yenziwe ukwenzela ukukhuthaza abaviwa ukuba bazenzele ngokwabo kunye nomsebenzi, kunye nokulungiselela ngokwengqondo uhlalutyo olunzulu kunye nokucamngca olunzulu [24, 36].Injongo kukunciphisa umngcipheko onokubakho wokugqithiswa kwengqondo [48], ngakumbi abo batsha kwisihloko somzekelo kwaye abanamava ekliniki angaphambili kunye nobuchule / isihloko [49].Ukucela abathathi-nxaxheba ukuba bachaze ngokufutshane imeko efanisiweyo kwaye benze iingcebiso zokuxilonga kuya kunceda umququzeleli ukuba aqinisekise ukuba abafundi kwiqela banokuqonda okusisiseko kunye nokuqonda ngokubanzi kwimeko ngaphambi kokuba baqhubele phambili kuhlalutyo olwandisiweyo / isigaba sokucinga.Ukongeza, ukumema abathathi-nxaxheba kweli nqanaba ukuba babelane ngeemvakalelo zabo kwiimeko ezilinganisiweyo kuya kubanceda boyise uxinzelelo lweemvakalelo kwimeko, ngaloo ndlela bephucula ukufunda [24, 36].Ukujongana nemiba yeemvakalelo kuya kunceda umququzeleli we-RLC ukuba aqonde ukuba iimvakalelo zabathathi-nxaxheba zichaphazela njani ukusebenza komntu ngamnye kunye neqela, kwaye oku kunokuxoxwa ngokunzulu ngexesha lesigaba sokucinga / sokuhlalutya.Indlela ye-Plus/Delta yakhiwe kwesi sigaba somzekelo njengenyathelo lokulungiselela kunye nesigqibo sesigaba sokubonisa / sokuhlalutya [46].Ukusebenzisa indlela ye-Plus / Delta, bobabini abathathi-nxaxheba kunye nabafundi banokuqhuba / badwelise imigqaliselo yabo, iimvakalelo kunye namava okulinganisa, okunokuthi kuxoxwe ngenqaku ngenqaku ngexesha lokucinga / lokuhlalutya kwemodeli [46].Oku kuya kunceda abathathi-nxaxheba ukuba bafezekise imeko ye-metacognitive ngokusebenzisa amathuba okufunda okujoliswe kuyo kunye nokubaluleka kokubaluleka kokuphucula ukucinga kweklinikhi [24, 48, 49].Ezi mpendulo zilandelayo zabameli ezivela kwiqela elisebenzayo lokuyila ngokubambisana zicatshangelwe ngexesha lophuhliso lokuqala lwemodeli ye-RLC.Umthathi-nxaxheba wesi-2: “Ndicinga ukuba njengesigulana ebesakhe samkelwa kwi-ICU, kufuneka sithathele ingqalelo iimvakalelo kunye neemvakalelo zabafundi abalingiswayo.Ndiwuphakamisa lo mbandela kuba ngexesha lam lokwamkelwa ndibone amanqanaba aphezulu oxinzelelo kunye noxinzelelo, ngakumbi phakathi kwabasebenzi abakhathalela kakhulu.kunye neemeko zonxunguphalo.Le modeli kufuneka ithathele ingqalelo uxinzelelo kunye neemvakalelo ezinxulumene nokulinganisa amava. "Umthathi-nxaxheba 16: “Kum njengomfundisi-ntsapho, ndikufumanisa kubaluleke kakhulu ukusebenzisa indlela ye-Plus/Delta ukuze abafundi bakhuthazwe ukuba bathathe inxaxheba ngokubonakalayo ngokukhankanya izinto ezintle kunye neemfuno abahlangabezane nazo ngexesha lokulinganisa.Iindawo ezifuna ukuphuculwa.”
Nangona izigaba zangaphambili zemodeli zibaluleke kakhulu, ukuhlalutya / ukubonakaliswa kwesigaba sibaluleke kakhulu ekufezekiseni ukulungelelaniswa kwengcinga yeklinikhi.Yenzelwe ukubonelela ngohlalutyo oluphambili / lwe-synthesis kunye nohlalutyo olunzulu olusekelwe kumava eklinikhi, ubuchule, kunye nefuthe lezihloko ezilinganisiweyo;Inkqubo kunye nesakhiwo se-RLC;isixa solwazi olunikezelweyo ukunqanda ukuxinana kwengqondo;ukusetyenziswa ngempumelelo kwemibuzo yokucamngca.iindlela zokuphumelela ukufunda okugxile kumfundi kunye nokuthatha inxaxheba.Ngeli nqanaba, amava eklinikhi kunye nokuqhelana nezihloko zokulinganisa zahlulwe zaba ngamacandelo amathathu ukulungiselela amanqanaba ahlukeneyo amava kunye nobuchule: okokuqala: akukho namava obugcisa beklinikhi yangaphambili / akukho kuvezwa kwangaphambili kwizihloko zokulinganisa, okwesibini: amava ochwepheshe bezonyango, ulwazi kunye nezakhono / akukho nanye.ukuvezwa kwangaphambili kwizihloko zemodeli.Okwesithathu: Amava ezonyango, ulwazi kunye nezakhono.Ukuboniswa kobuchwephesha/kwangaphambili kwizihloko zemodeli.Ulwahlulo lwenziwa ukulungiselela iimfuno zabantu abanamava ahlukeneyo kunye namanqanaba okukwazi kwiqela elinye, ngaloo ndlela kulungelelaniswa utyekelo lwabasebenzi abanamava angaphantsi ekusebenziseni ukuqiqa ngohlalutyo kunye notyekelo lwabasebenzi abanamava ngakumbi ekusebenziseni izakhono zokuqiqa ezingahlalutyi [19, 20, 34]., 37].Inkqubo ye-RLC yacwangciswa malunga nomjikelo wokuqiqa weklinikhi [10], isakhelo sokubonisa imodeli [47], kunye nethiyori yokufunda ngamava [50].Oku kuphunyezwa ngeenkqubo ezininzi: ukutolika, ukwahlula, unxibelelwano, ukuthelekelela kunye nokudibanisa.
Ukuthintela ukuxinana kwengqondo, ukukhuthaza inkqubo yokuthetha egxile kumfundi kunye neyokucamngca ngexesha elaneleyo kunye namathuba okuba abathathi-nxaxheba babonakalise, bahlalutye, kwaye badibanise ukuzuza ukuzithemba.Iinkqubo zengqondo ngexesha le-RLC ziqwalaselwa ngokudibanisa, ukuqinisekiswa, ukubunjwa, kunye neenkqubo zokudibanisa ngokusekelwe kwisakhelo se-double-loop [37] kunye nethiyori yomthwalo wokuqonda [48].Ukuba nenkqubo yeengxoxo ezicwangcisiweyo kunye nokuvumela ixesha elaneleyo lokucamngca, kuthathelwa ingqalelo abathathi-nxaxheba abanamava nabangenamava, kuya kunciphisa umngcipheko onokubakho womthwalo wokuqonda, ngokukodwa kwimifuziselo enzima kunye namava ahlukeneyo angaphambili, ukuvezwa kunye namanqanaba okukwazi kwabathathi-nxaxheba.Emva kwesiganeko.Indlela yokubuza imodeli isekelwe kwimodeli ye-taxonomic ye-Bloom [51] kunye neendlela zokubuza ngokuxabisa (AI) [45], apho umququzeleli oyimodeli eqhuba isifundo ngesinyathelo-by-step, i-Socrates, kunye nendlela yokubonakalisa.Buza imibuzo, uqale ngemibuzo esekelwe kulwazi.kunye nokujongana nezakhono kunye nemiba enxulumene nokuqiqa.Ubuchwephesha bokubuza buza kuphucula ukwenziwa kokuqiqa kwezonyango ngokukhuthaza intatho-nxaxheba esebenzayo kunye nokucinga okuqhubelekayo kunye nomngcipheko omncinci wokuxinana kwengqondo.Ezi mpendulo zilandelayo zabameli ezivela kwiqela elisebenzayo lokuyila ngokubambisana zicatshangelwe ngexesha lokuhlalutya / ukubonakaliswa kwesigaba sophuhliso lwemodeli ye-RLC.Umthathi-nxaxheba 13: "Ukunqanda ukugqithiswa kwengqondo, kufuneka sithathele ingqalelo isixa kunye nokuhamba kolwazi xa sisenza iingxoxo zokufunda emva kokulinganisa, kwaye ukwenza oku, ndicinga ukuba kubalulekile ukunika abafundi ixesha elaneleyo lokucamngca kwaye baqale ngezinto ezisisiseko. .Ulwazi.iqala iincoko kunye nezakhono, emva koko inyukele kumanqanaba aphezulu olwazi kunye nezakhono zokufikelela kwi-metacognition. "Umthathi-nxaxheba wesi-9: "Ndikholelwa ngamandla ukuba iindlela zokubuza imibuzo zisebenzisa ubuchule be-Appreciative Inquiry (AI) kunye nemibuzo ecingisisiweyo kusetyenziswa imodeli yeTaxonomy yeBloom iya kukhuthaza ukufunda okusebenzayo kunye nokugxila komfundi ngelixa kuncitshiswa ukubakho komngcipheko wokuxinana kwengqondo."Isigaba sokubonisana salo mzekelo sijolise ekushwankatheleni iingongoma zokufunda eziphakanyiswe ngexesha le-RLC nokuqinisekisa ukuba iinjongo zokufunda ziyafezekiswa.Umthathi-nxaxheba 8: “Kubaluleke kakhulu ukuba bobabini umfundi kunye nombhexeshi bavumelane ngezona ngcinga zibalulekileyo zibalulekileyo kunye nemiba ephambili ekufuneka iqwalaselwe xa usiya kuziqhelanisa.”
Imvume yokuziphatha ifunyenwe phantsi kweenombolo zeprotocol (MRC-01-22-117) kunye (HSK/PGR/UH/04728).Le modeli yavavanywa kwiikhosi ezintathu zokulinganisa ukhathalelo olunzulu lokuvavanya ukusebenziseka kunye nokusebenza komzekelo.Ukunyaniseka kobuso bomzekelo kwavavanywa liqela elisebenzayo lokuyila ngokubambisana (N = 18) kunye neengcali zemfundo ezisebenza njengabalawuli bezemfundo (N = 6) ukulungisa imiba enxulumene nokubonakala, igrama kunye nenkqubo.Emva kokuqinisekiswa kobuso, ukuqinisekiswa komxholo kunqunywe ngabahlohli abaphezulu (N = 6) abaye baqinisekiswa yi-American Nurses Credentialing Centre (ANCC) kwaye bakhonza njengabacwangcisi bezemfundo, kunye (N = 6) ababeneminyaka engaphezu kwe-10 yemfundo kunye amava okufundisa.Amava oMsebenzi Uvavanyo lwenziwe ngabalawuli bezemfundo (N = 6).Amava omzekelo.Ukunyaniseka komxholo kuye kwamiselwa kusetyenziswa iContent Validity Ratio (CVR) kunye neContent Validity Index (CVI).Indlela ye-Lawshe [52] yasetyenziswa ukuqikelela i-CVI, kwaye indlela ka-Waltz ne-Bausell [53] yasetyenziswa ukuqikelela i-CVR.Iiprojekthi ze-CVR ziyimfuneko, ziluncedo, kodwa azifuneki okanye azikhethi.I-CVI ifunyenwe kwinqanaba leengongoma ezine ezisekelwe kukubaluleka, ukulula, kunye nokucaca, kunye ne-1 = ayifanelekanga, i-2 = ifanelekileyo, 3 = efanelekileyo, kunye ne-4 = efanelekileyo kakhulu.Emva kokuqinisekisa ukuchaneka kobuso nokuchaneka kwekhontenti, ukongeza koomasifundisane bepraktikhali, iiseshoni zokuqhelaniswa nezifundo zenziwa kootitshala abaza kusebenzisa imodeli.
Iqela lomsebenzi liye lakwazi ukuphuhlisa nokuvavanya imodeli ye-RLC ye-post-simulation ukuze kuphuculwe izakhono zokucinga zeklinikhi ngexesha lokuthatha inxaxheba kwi-SBE kwiiyunithi zokunyamekela kakhulu (Amanani 1, 2, kunye ne-3).CVR = 1.00, CVI = 1.00, ebonisa ubuso obufanelekileyo kunye nokuqinisekiswa komxholo [52, 53].
Imodeli yenzelwe iqela le-SBE, apho iimeko ezinomdla kunye nomngeni zisetyenziselwa abathathi-nxaxheba abanamanqanaba afanayo okanye ahlukeneyo amava, ulwazi kunye nobukhulu.Imodeli yengqiqo ye-RLC yaphuhliswa ngokwemigangatho ye-INACSL yokulinganisa ukulinganisa i-flight [36] kwaye igxile kumfundi kwaye iyazichaza, kubandakanywa nemizekelo esebenzayo (Amanani 1, 2 kunye ne-3).Imodeli yaphuhliswa ngenjongo yaza yahlulahlulwe yangamanqanaba amane okuhlangabezana nemigangatho yokumisela: ukuqala ngoshwankathelo, kulandelwa lucazululo olubonakalisayo/ukuhlanganiswa, nokuphela ngolwazi nesishwankathelo.Ukuze ugweme umngcipheko onokubakho wokugqithiswa kwengqondo, isigaba ngasinye somzekelo senziwe ngenjongo njengento efunekayo kwisigaba esilandelayo [34].
Impembelelo yobukhulu kunye nezinto zokuhambelana kweqela ekuthatheni inxaxheba kwi-RLC ayizange ifundwe ngaphambili [38].Ukuthathela ingqalelo iikhonsepthi eziphathekayo ze-double loop kunye ne-cognitive overload theory kwi-simulation practice [34, 37], kubalulekile ukuqwalasela ukuba ukuthatha inxaxheba kwiqela le-SBE elinamava ahlukeneyo kunye namanqanaba okukwazi abathathi-nxaxheba kwiqela elifanayo lokulinganisa ngumngeni.Ukungahoywa komthamo wolwazi, ukuhamba kunye nesakhiwo sokufunda, kunye nokusetyenziswa kwangaxeshanye kweenkqubo zengqondo ezikhawulezayo nezicothayo ngabafundi bezikolo eziphakamileyo kunye nabafundi bezikolo eziphakamileyo eziphakamileyo zibeka umngcipheko onokubakho wokuxinana kwengqondo [18, 38, 46].Ezi zinto zithathelwa ingqalelo xa kuphuhliswa imodeli ye-RLC ukuphepha ukungaphuhlisi kunye / okanye ukuqiqa okuncinci kweklinikhi [18, 38].Kubalulekile ukuba kuthathelwe ingqalelo ukuba ukuqhuba i-RLC enamanqanaba ahlukeneyo aphezulu kunye nobuchule kubangela impembelelo yokulawula phakathi kwabathathi-nxaxheba abakhulu.Oku kwenzeka ngenxa yokuba abathathi-nxaxheba abaphambili bavame ukuphepha ukufunda iikhonsepthi ezisisiseko, ezibaluleke kakhulu kubathathi-nxaxheba abancinci ukuphumeza i-metacognition kwaye bangene kwinqanaba eliphezulu lokucinga kunye neenkqubo zokuqiqa [38, 47].Imodeli ye-RLC yenzelwe ukubandakanya abongikazi abaphezulu nabancinci ngokubuza ngokuxabisa kunye nendlela ye-delta [45, 46, 51].Ukusebenzisa ezi ndlela, iimbono zabathathi-nxaxheba abaphezulu kunye nabancinci abanezakhono ezahlukeneyo kunye namanqanaba amava aya kuboniswa into kunye nento kwaye ixoxwe ngokucingisisayo ngumodareyitha kunye neemodareyitha ezidibeneyo [45, 51].Ukongeza kwigalelo labathathi-nxaxheba bokulinganisa, umququzeleli we-debriefing wongeza igalelo labo ukuze aqinisekise ukuba zonke iimvavanyo ezihlangeneyo zigubungela ngokugqibeleleyo umzuzu ngamnye wokufunda, ngaloo ndlela kuphuculwe ukuqonda kwe-metacognition ukwandisa ukucinga kweklinikhi [10].
Ukuhamba kolwazi kunye nesakhiwo sokufunda kusetyenziswa imodeli ye-RLC kujongwana nayo ngenkqubo ecwangcisiweyo kunye namanyathelo amaninzi.Oku kwenzelwa ukunceda ababhexeshi bengxoxo nokuqinisekisa ukuba umthathi-nxaxheba ngamnye uthetha ngokucacileyo nangokuzithemba kwinqanaba ngalinye phambi kokudlulela kwinqanaba elilandelayo.Imodareyitha iya kukwazi ukuqalisa iingxoxo ezibonisayo apho bonke abathathi-nxaxheba bathatha inxaxheba, kwaye bafikelele kwinqanaba apho abathathi-nxaxheba bamanqanaba ahlukeneyo aphezulu kunye nobuchule bavumelana ngezona ndlela zibalaseleyo zengxoxo nganye ngaphambi kokudlulela kwelinye [38].Ukusebenzisa le ndlela kuya kunceda abathathi-nxaxheba abanamava kunye nabanobuchule babelane ngeminikelo yabo / imigqaliselo, ngelixa iminikelo / ukuqwalaselwa kwabathathi-nxaxheba abanamava kunye nabanobuchule kuya kuvavanywa kwaye kuxoxwe [38].Nangona kunjalo, ukufezekisa le njongo, abaququzeleli kuya kufuneka bajongane nomngeni wokulinganisa iingxoxo kunye nokubonelela ngamathuba alinganayo kubathathi-nxaxheba abakhulu nabancinci.Ukuza kuthi ga ngoku, indlela yokuhlola imodeli yaphuhliswa ngenjongo kusetyenziswa imodeli ye-taxonomic ye-Bloom, edibanisa uphando lokuvavanya kunye nendlela yokudibanisa / ye-delta [45, 46, 51].Ukusebenzisa obu buchule kunye nokuqala ngolwazi kunye nokuqonda imibuzo egxininisekileyo / iingxoxo zokucamngca kuya kukhuthaza abathathi-nxaxheba abanamava ukuba bathathe inxaxheba kwaye bathathe inxaxheba ngokukhutheleyo kwingxoxo, emva koko umbhexeshi uya kuhamba ngokuthe ngcembe ukuya kwinqanaba eliphezulu lovavanyo kunye nokuhlanganiswa kwemibuzo / iingxoxo. apho omabini amaqela kufuneka anike abantu abadala kunye nabathathi-nxaxheba abancinci banethuba elilinganayo lokuthatha inxaxheba ngokusekelwe kumava abo angaphambili kunye namava ngezakhono zonyango okanye iimeko ezifanisiweyo.Le ndlela iya kunceda abathathi-nxaxheba abangenamava aphantsi bathathe inxaxheba kwaye bazuze kumava ekwabelwana ngawo ngabathathi-nxaxheba abanamava kunye negalelo lombhexeshi wengxoxo.Ngakolunye uhlangothi, imodeli ayilungiselelwe kuphela ii-SBE ezinezakhono ezahlukeneyo zokuthatha inxaxheba kunye namanqanaba amava, kodwa kunye nabathathi-nxaxheba beqela le-SBE abanamava afanayo kunye namanqanaba okukwazi.Imodeli yenzelwe ukuququzelela intshukumo egudileyo necwangcisiweyo yeqela ukusuka ekugxininiseni kulwazi nokuqonda ukuya kugxininiso ekuhlanganiseni nasekuvavanyeni ukufezekisa iinjongo zokufunda.Ubume bemodeli kunye neenkqubo ziyilelwe ukuba zihambelane namaqela abonisa izakhono ezahlukeneyo kunye namanqanaba alinganayo kunye namava.
Ukongeza, nangona i-SBE kukhathalelo lwempilo ngokudibanisa ne-RLC isetyenziselwa ukuphuhlisa ukucinga kweklinikhi kunye nobuchule kubasebenzi [22,30,38], nangona kunjalo, izinto ezifanelekileyo kufuneka zithathelwe ingqalelo ezinxulumene nobunzima bemeko kunye neengozi ezinokuthi zibekho zokuxinana kwengqondo, ngakumbi. xa Abathathi-nxaxheba babandakanyeka kwiimeko ze-SBE zifaniswe kakhulu, izigulane ezigula kakhulu ezifuna ukungenelela ngokukhawuleza kunye nokwenziwa kwezigqibo ezibalulekileyo [2,18,37,38,47,48].Ukuza kuthi ga ngoku, kubalulekile ukuba kuthathelwe ingqalelo ukuthambekela kwabathathi-nxaxheba abanamava nabangenamava ukuba ngaxeshanye batshintshe phakathi kweenkqubo zokuqiqa ezihlalutyayo nezingahlalutyiyo xa bethatha inxaxheba kwi-SBE, kunye nokuseka indlela esekelwe kubungqina evumela ukuba abadala nabancinci. abafundi ukuba bathathe inxaxheba ngokukhutheleyo kwinkqubo yokufunda.Ke ngoko, imodeli yayiyilwe ngendlela yokuba, kungakhathaliseki ubunzima betyala elifanisiweyo elinikiweyo, umququzeleli kufuneka aqinisekise ukuba imiba yolwazi kunye nemvelaphi yokuqonda kwabo bobabini abathathi-nxaxheba abaphezulu nabancinci iqala igutyungelwe kwaye emva koko ngokuthe ngcembe kwaye ukuququzelela uhlalutyo.ukudibanisa kunye nokuqonda.inkalo yovavanyo.Oku kuya kunceda abafundi abancinci ukuba bakhe kwaye badibanise oko bakufundileyo, kwaye kuncede abafundi abadala badibanise kwaye baphuhlise ulwazi olutsha.Oku kuya kuhlangabezana neemfuno zenkqubo yokuqiqa, kuthathelwa ingqalelo amava angaphambili kunye nobuchule bomthathi-nxaxheba ngamnye, kwaye ibe nefomathi eqhelekileyo ejongana notyekelo lwabafundi bezikolo eziphakamileyo nabafunda kwisikolo samabanga aphakamileyo abahamba ngaxeshanye phakathi kweenkqubo zokuqiqa zocazululo nezingeyonyani, ngokwenjenjalo. ukuqinisekisa ukufaneleka kokuqiqa kweklinikhi.
Ukongeza, abaququzeleli bokulinganisa/abachazi banokuba nobunzima ekulawuleni izakhono zokulinganisa.Ukusetyenziswa kwezikripthi ze-cognitive debriefing scripts kukholelwa ukuba kusebenza kakuhle ekuphuculeni ukufumana ulwazi kunye nezakhono zokuziphatha zabaququzeleli xa kuthelekiswa nabo bangasebenzisi izikripthi [54].Iimeko sisixhobo sokuqonda esinokuthi siququzelele umsebenzi katitshala wokumisela nokuphucula izakhono zokunika ingxelo, ngakumbi kootitshala abasahlanganisa amava abo okufunda [55].ukufikelela kusetyenziso olukhulu kwaye uphuhlise iimodeli ezisebenziseka lula.(Umfanekiso 2 kunye nomfanekiso 3).
Udibaniso olunxuseneyo lwe-plus/delta, uphando oluxabisayo, kunye neendlela zovavanyo lwe-Bloom's Taxonomy azikasonjululwa kuhlalutyo lokulinganisa olukhoyo ngoku kunye neemodeli ezikhokelwayo zokubonisa.Ukudityaniswa kwezi ndlela kugxininisa ukutsha kwemodeli ye-RLC, apho ezi ndlela zidityaniswe kwifomathi enye ukuphumeza ukulungelelaniswa kwengcinga yeklinikhi kunye nokugxila komfundi.Abafundisi bezoNyango banokuzuza kwimodeli yeqela le-SBE besebenzisa imodeli ye-RLC ukuphucula nokwandisa amandla okuqiqa eklinikhi abathathi-nxaxheba.Iimeko zale modeli zinganceda ootitshala ukuba babe nobuchule kwinkqubo yokubonisa ingcaciso kwaye bomeleze izakhono zabo ukuze babe ngababhexeshi abanobuchule bokwenza ingcaciso.
I-SBE inokubandakanya iindlela ezininzi ezahlukeneyo kunye nobuchule, kubandakanywa kodwa kungaphelelanga kwi-SBE esekelwe kwi-mannequin, i-simulators yomsebenzi, i-simulators yesigulane, izigulane ezisemgangathweni, i-virtual and augmented reality.Ukuqwalasela ukuba ukunika ingxelo yenye yeendlela ezibalulekileyo zokulinganisa, imodeli ye-RLC efanisiweyo ingasetyenziswa njengomzekelo wokunika ingxelo xa usebenzisa ezi ndlela.Ngaphezu koko, nangona imodeli yaphuhliswa kuqeqesho lokonga, inamandla okusetyenziswa kwi-SBE yokhathalelo lwempilo phakathi kweengcali, igxininisa imfuneko yamanyathelo ophando lwexesha elizayo ukuvavanya imodeli ye-RLC kwimfundo yabasebenzi.
Uphuhliso kunye novavanyo lwemodeli ye-RLC ye-post-simulation yokunakekelwa koongikazi kwiiyunithi zokunakekelwa kwe-SBE.Uvavanyo lwexesha elizayo / ukuqinisekiswa komzekelo kucetyiswa ukuba kwandiswe ngokubanzi imodeli yokusetyenziswa kwezinye iinkalo zempilo kunye ne-SBE ye-interprofessional.
Imodeli yaphuhliswa liqela elidibeneyo elisebenzayo elisekelwe kwithiyori kunye nengqiqo.Ukuphucula ukunyaniseka kunye nokufezekiswa ngokubanzi kwemodeli, ukusetyenziswa kwamanyathelo okuthembeka okuphuculweyo kwizifundo ezithelekisayo kunokuqwalaselwa kwixesha elizayo.
Ukunciphisa iimpazamo zokuziqhelanisa, iingcali kufuneka zibe nezakhono ezisebenzayo zokuqiqa zonyango ukuqinisekisa ukhuseleko kunye nokwenza izigqibo ezifanelekileyo zeklinikhi.Ukusebenzisa i-SBE RLC njengobuchule bokuxoxa kukhuthaza uphuhliso lolwazi kunye nezakhono ezisebenzayo eziyimfuneko ukuphuhlisa ukucinga ngonyango.Nangona kunjalo, ubume bezinto ezininzi zokuqiqa kweklinikhi, ezinxulumene namava angaphambili kunye nokuvezwa, utshintsho kwikhono, umthamo kunye nokuhamba kolwazi, kunye nobunzima beemeko zokulinganisa, kubonisa ukubaluleka kokuphuhlisa imizekelo ye-RLC emva kokulinganisa apho ukucinga kweklinikhi kunokusebenza ngokusebenzayo. kwaye iphunyezwe ngempumelelo.izakhono.Ukungahoyi ezi zinto kunokukhokelela ekuphuhliseni kunye nokuqiqa okuncinci kweklinikhi.Imodeli ye-RLC yaphuhliswa ukujongana nale miba ukuze kuphuculwe ukucinga kweklinikhi xa kuthatyathwa inxaxheba kwimisebenzi yokulinganisa iqela.Ukufezekisa le njongo, imodeli ngaxeshanye idibanisa i-plus/minus yohlolo yovavanyo kunye nokusetyenziswa kwe-taxonomy kaBloom.
Iisethi zedatha ezisetyenzisiweyo kunye / okanye zihlalutywe ngexesha lokufunda ngoku ziyafumaneka kumbhali ohambelanayo ngesicelo esifanelekileyo.
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Ixesha lokuposa: Jan-08-2024