Knowing How and Knowing Why: testing the effect of instruction designed for cognitive integration on procedural skills transfer

被引:39
作者
Cheung, Jeffrey J. H. [1 ,2 ]
Kulasegaram, Kulamakan M. [1 ,3 ]
Woods, Nicole N. [1 ,3 ]
Moulton, Carol-anne [1 ,4 ]
Ringsted, Charlotte V. [5 ]
Brydges, Ryan [1 ,6 ,7 ]
机构
[1] Univ Toronto, Univ Hlth Network, Wilson Ctr, Toronto, ON, Canada
[2] Hosp Sick Children, SickKids Learning Inst, Toronto, ON, Canada
[3] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada
[4] Univ Toronto, Dept Surg, Toronto, ON, Canada
[5] Aarhus Univ, Fac Hlth, Ctr Hlth Sci Educ, Aarhus, Denmark
[6] Univ Toronto, Dept Med, Toronto, ON, Canada
[7] St Michaels Hosp, Allan Waters Family Simulat Ctr, Toronto, ON, Canada
基金
加拿大自然科学与工程研究理事会;
关键词
Basic science; Cognition; Instructional design; Integration; Transfer; Procedural skills; Simulation; Path analysis; TECHNOLOGY-ENHANCED SIMULATION; MEDICAL-EDUCATION RESEARCH; BIOMEDICAL KNOWLEDGE; BASIC SCIENCE; MOTOR; STUDENTS; FLEXIBILITY; ACQUISITION; PERFORMANCE; COMPETENCE;
D O I
10.1007/s10459-017-9774-1
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
Transfer is a desired outcome of simulation-based training, yet evidence for how instructional design features promote transfer is lacking. In clinical reasoning, transfer is improved when trainees experience instruction integrating basic science explanations with clinical signs and symptoms. To test whether integrated instruction has similar effects in procedural skills (i.e., psychomotor skills) training, we studied the impact of instruction that integrates conceptual (why) and procedural (how) knowledge on the retention and transfer of simulation-based lumbar puncture (LP) skill. Medical students (N = 30) were randomized into two groups that accessed different instructional videos during a 60-min self-regulated training session. An unintegrated video provided procedural How instruction via step-by-step demonstrations of LP, and an integrated video provided the same How instruction with integrated conceptual Why explanations (e.g., anatomy) for key steps. Two blinded raters scored post-test, retention, and transfer performances using a global rating scale. Participants also completed written procedural and conceptual knowledge tests. We used simple mediation regression analyses to assess the total and indirect effects (mediated by conceptual knowledge) of integrated instruction on retention and transfer. Integrated instruction was associated with improved conceptual (p < .001) but not procedural knowledge test scores (p = .11). We found no total effect of group (p > .05). We did find a positive indirect group effect on skill retention (B (ab) = .93, p < .05) and transfer (B (ab) = .59, p < .05), mediated through participants improved conceptual knowledge. Integrated instruction may improve trainees' skill retention and transfer through gains in conceptual knowledge. Such integrated instruction may be an instructional design feature for simulation-based training aimed at improving transfer outcomes.
引用
收藏
页码:61 / 74
页数:14
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