Othandizira ayenera kukhala ndi luso loganiza bwino lachipatala kuti apange zisankho zoyenera, zotetezeka zachipatala ndikupewa zolakwika m'machitidwe.Maluso oganiza bwino azachipatala amatha kusokoneza chitetezo cha odwala ndikuchedwetsa chisamaliro kapena chithandizo, makamaka m'madipatimenti osamalira odwala kwambiri komanso m'madipatimenti azadzidzidzi.Maphunziro otengera kayeresedwe amagwiritsa ntchito makambirano ophunzirira mowunikira motsatira kuyerekezera ngati njira yowunikira kuti akweze luso la kulingalira zachipatala ndikusunga chitetezo cha odwala.Komabe, chifukwa cha kuchuluka kwa malingaliro azachipatala, chiwopsezo chomwe chingakhale chochulukirachulukira, komanso kugwiritsa ntchito mosiyanasiyana kwa kusanthula (hypothetico-deductive) ndi njira zosakanika (zachilengedwe) zolingalira zachipatala ndi otenga nawo gawo apamwamba komanso achichepere, ndikofunikira ganizirani zinachitikira, luso, zinthu zokhudzana ndi kuyenda ndi kuchuluka kwa zidziwitso, ndi zovuta kuti mukwaniritse kulingalira kwachipatala pochita zokambirana zamagulu ophunzirira pambuyo poyerekezera ngati njira yofotokozera.Cholinga chathu ndi kufotokoza kakulidwe kachitsanzo cha zokambirana zowonetsera pambuyo-simulation zomwe zimaganizira zinthu zingapo zomwe zimakhudza kupindula kwa kulingalira kwachipatala.
Gulu logwirira ntchito limodzi (N = 18), lopangidwa ndi madokotala, anamwino, ofufuza, aphunzitsi, ndi oyimilira odwala, adagwirizana kudzera m'misonkhano yotsatizana kuti agwirizane kupanga njira yophunzirira yowunikira pambuyo poyeserera kuti afotokoze mongoyerekeza.Gulu logwirira ntchito limodzi linapanga chitsanzocho kupyolera mu ndondomeko yamaganizo ndi malingaliro ndi ndemanga zamagulu ambiri.Kuphatikizika kofananira kwa kafukufuku wowunika wa kuphatikiza/kuchotsera ndi taxonomy ya Bloom kumakhulupirira kuti kumapangitsa kuti otenga nawo gawo azitha kulingalira zachipatala pomwe akutenga nawo gawo pazoyeserera.Content validity index (CVI) ndi content validity ratio (CVR) njira zinagwiritsiridwa ntchito kutsimikizira kutsimikizika kwa nkhope ndi kutsimikizika kwa zinthu zachitsanzocho.
Chitsanzo cha zokambirana zowonetsera pophunzira pambuyo poyerekezera chinapangidwa ndikuyesedwa.Chitsanzocho chimathandizidwa ndi zitsanzo zogwiritsidwa ntchito ndi malangizo a malemba.Mawonekedwe a nkhope ndi zomwe zili zachitsanzozo zinayesedwa ndikutsimikiziridwa.
Chitsanzo chatsopano chogwirizanitsa chinapangidwa poganizira za luso ndi luso la anthu osiyanasiyana owonetserako, kuyenda ndi kuchuluka kwa chidziwitso, ndi zovuta za zochitika zachitsanzo.Zinthu izi zimaganiziridwa kuti zimakulitsa malingaliro azachipatala pochita nawo zochitika zofananiza zamagulu.
Kulingalira kwachipatala kumaonedwa kuti ndi maziko a zochitika zachipatala mu chisamaliro chaumoyo [1, 2] ndi chinthu chofunika kwambiri cha luso lachipatala [1, 3, 4].Ndi njira yowonetsera yomwe akatswiri amagwiritsa ntchito kuti azindikire ndikugwiritsa ntchito njira yoyenera kwambiri pazochitika zilizonse zachipatala zomwe amakumana nazo [5, 6].Lingaliro lachipatala limafotokozedwa ngati njira yovuta yachidziwitso yomwe imagwiritsa ntchito njira zoganiza zokhazikika komanso zosadziwika bwino kuti asonkhanitse ndi kusanthula zambiri za wodwala, kuyesa kufunikira kwa chidziwitsocho, ndikuzindikira kufunika kwa njira zina zochitira [7, 8].Zimatengera kutha kusonkhanitsa zidziwitso, kukonza zambiri, ndikumvetsetsa vuto la wodwalayo kuti achitepo kanthu moyenera kwa wodwalayo panthawi yoyenera komanso pazifukwa zolondola [9, 10].
Othandizira onse azaumoyo akukumana ndi kufunikira kopanga zisankho zovuta m'malo osatsimikizika kwambiri [11].Pachisamaliro chovuta komanso chithandizo chadzidzidzi, zochitika zachipatala ndi zochitika zadzidzidzi zimayamba pamene kuyankha mwamsanga ndi kuchitapo kanthu ndizofunikira kuti apulumutse miyoyo ndi kuonetsetsa chitetezo cha odwala [12].Maluso oganiza bwino azachipatala komanso luso lazochita zolimbitsa thupi zimagwirizanitsidwa ndi kuchuluka kwa zolakwika zachipatala, kuchedwa kwa chisamaliro kapena chithandizo [13] komanso kuopsa kwa chitetezo cha odwala [14,15,16].Kuti mupewe zolakwika zenizeni, akatswiri ayenera kukhala odziwa bwino komanso kukhala ndi luso loganiza bwino lachipatala kuti apange zisankho zotetezeka komanso zoyenera [16, 17, 18].Kulingalira kopanda kusanthula (mwachidziwitso) ndi njira yofulumira yomwe akatswiri amawakonda.Mosiyana ndi izi, kulingalira (hypothetico-deductive) njira zolingalira zimakhala zocheperapo, zadala, ndipo zimagwiritsidwa ntchito ndi asing'anga osadziwa zambiri [2, 19, 20].Chifukwa cha zovuta za chikhalidwe chachipatala chachipatala komanso kuopsa kwa zolakwika zomwe zingatheke [14,15,16], maphunziro otsanzira (SBE) amagwiritsidwa ntchito nthawi zambiri kuti apereke mwayi kwa akatswiri kuti akulitse luso komanso luso la kulingalira.malo otetezeka komanso kukumana ndi zovuta zosiyanasiyana ndikusunga chitetezo cha odwala [21, 22, 23, 24].
Society for Simulation in Health (SSH) imatanthauzira kuyerekezera kukhala “ukadaulo womwe umapanga malo kapena malo omwe anthu amawonera zochitika zenizeni pamoyo ndi cholinga chochita, kuphunzitsa, kuyesa, kuyesa, kapena kumvetsetsa machitidwe a anthu kapena khalidwe.”[23] Magawo oyerekeza opangidwa bwino amapatsa ophunzira mwayi woti adzilowetse muzochitika zomwe zimatsanzira zochitika zachipatala ndikuchepetsa kuopsa kwa chitetezo [24,25] ndikuyesa kulingalira zachipatala pogwiritsa ntchito mwayi wophunzira [21,24,26,27,28] SBE imakulitsa zochitika zachipatala, kuwonetsa ophunzira ku zochitika zachipatala zomwe mwina sanakumanepo nazo m'malo osamalira odwala [24, 29].Awa ndi malo osawopseza, opanda cholakwa, oyang'aniridwa, otetezeka, malo ophunzirira omwe ali pachiwopsezo chochepa.Zimalimbikitsa chitukuko cha chidziwitso, luso lachipatala, luso, kulingalira mozama ndi kulingalira kwachipatala [22,29,30,31] ndipo zingathandize akatswiri a zaumoyo kuthana ndi kupsinjika maganizo kwazochitika, potero kupititsa patsogolo luso la kuphunzira [22, 27, 28] ., 30, 32].
Pofuna kuthandizira kupititsa patsogolo luso la kulingalira kwachipatala ndi luso lopanga zisankho kudzera mu SBE, chidwi chiyenera kuperekedwa ku mapangidwe, template, ndi ndondomeko ya ndondomeko yowonongeka pambuyo poyerekezera [24, 33, 34, 35].Zokambirana za post-simulation reflective learning (RLC) zinagwiritsidwa ntchito ngati njira yowunikira kuti athandize ophunzira kuwonetsera, kufotokoza zochita, ndi kugwiritsa ntchito mphamvu zothandizira anzawo komanso kuganiza mozama pamagulu amagulu [32, 33, 36].Kugwiritsiridwa ntchito kwa gulu la RLCs kumakhala ndi chiopsezo cha kulingalira kosakhazikika kwachipatala, makamaka zokhudzana ndi luso losiyanasiyana ndi msinkhu wa otenga nawo mbali.Njira yapawiriyi imafotokoza zamitundu yambiri yamalingaliro azachipatala komanso kusiyana kwa chizolowezi cha akatswiri akuluakulu kugwiritsa ntchito njira zowunikira (hypothetico-deductive) ndi akatswiri achichepere kuti agwiritse ntchito malingaliro osasanthula (mwanzeru) [34, 37].].Njira zoganizira zapawirizi zimaphatikizapo zovuta zosinthira malingaliro abwino pamikhalidwe yosiyanasiyana, ndipo sizidziwika bwino komanso zotsutsana momwe angagwiritsire ntchito bwino njira zowunikira komanso zosasanthula ngati pali otenga nawo mbali akulu ndi ang'onoang'ono m'gulu lomwelo lachitsanzo.Ophunzira akusukulu yasekondale ndi ocheperako omwe ali ndi kuthekera kosiyanasiyana komanso zochitika zosiyanasiyana amatenga nawo gawo pazoyeserera mosiyanasiyana [34, 37].Mkhalidwe wosiyanasiyana wamalingaliro azachipatala umalumikizidwa ndi chiwopsezo chokhala ndi malingaliro osakhazikika azachipatala komanso kuchulukitsitsa kwachidziwitso, makamaka akatswiri akamatenga nawo gawo m'magulu a SBE okhala ndi zovuta zosiyanasiyana komanso milingo yauchikulire [38].Ndikofunika kuzindikira kuti ngakhale pali zitsanzo zambiri zogwiritsira ntchito RLC, palibe imodzi mwa zitsanzozi zomwe zapangidwa ndi cholinga chenicheni cha chitukuko cha luso la kulingalira kwachipatala, poganizira zochitika, luso, kutuluka ndi kuchuluka kwa chidziwitso, ndi zitsanzo zovuta zovuta [38].]., 39].Zonsezi zimafuna kuti pakhale chitsanzo chokhazikika chomwe chimaganizira zopereka zosiyanasiyana ndi zisonkhezero zokhutiritsa zolingalira zachipatala, ndikuphatikizanso pambuyo poyerekezera RLC monga njira yofotokozera.Timalongosola ndondomeko yoyendetsedwa mwamalingaliro komanso mwamalingaliro pakupanga kogwirizana ndi kakulidwe ka RLC yapambuyo poyerekezera.Chitsanzo chinapangidwa kuti chiwongolere luso la kulingalira pazachipatala panthawi yomwe mukuchita nawo SBE, poganizira zinthu zambiri zomwe zimathandizira komanso zokhudzidwa kuti mukwaniritse bwino kulingalira kwachipatala.
RLC post-simulation model inapangidwa mogwirizana kutengera zitsanzo zomwe zilipo kale ndi malingaliro a kaganizidwe kachipatala, kuphunzira kowunikira, maphunziro, ndi kuyerekezera.Kuti tichite limodzi chitsanzochi, gulu logwira ntchito limodzi (N = 18) linapangidwa, lokhala ndi anamwino 10 osamalira odwala kwambiri, wolimbikira m'modzi, ndi nthumwi zitatu za odwala omwe adagonekedwa m'chipatala amisinkhu yosiyana, zokumana nazo, komanso jenda.Chipinda chimodzi chosamalira odwala kwambiri, 2 othandizira kafukufuku ndi 2 aphunzitsi akuluakulu anamwino.Kukonzekera kophatikizana kumeneku kumapangidwa ndikupangidwa kudzera mu mgwirizano wa anzawo pakati pa ogwira nawo ntchito omwe ali ndi zochitika zenizeni padziko lapansi pazachipatala, kaya akatswiri azachipatala omwe akukhudzidwa ndi chitukuko cha chitsanzocho kapena ena okhudzidwa monga odwala [40,41,42].Kuphatikizirapo oimira odwala mu ndondomeko yopangira mgwirizano akhoza kuwonjezera phindu pa ndondomekoyi, monga cholinga chachikulu cha pulogalamuyi ndikupititsa patsogolo chisamaliro cha odwala ndi chitetezo [43].
Gulu logwira ntchito lidachita zokambirana zisanu ndi chimodzi za maola 2-4 kuti apange mapangidwe, njira ndi zomwe zili mu chitsanzocho.Msonkhanowu umaphatikizapo kukambirana, kuchita komanso kuyerekezera.Zinthu zachitsanzo zimachokera kuzinthu zambiri zozikidwa pa umboni, zitsanzo, malingaliro ndi ndondomeko.Izi zikuphatikizapo: chiphunzitso cha constructivist learning theory [44], mfundo yapawiri ya loop [37], njira yachipatala yolingalira [10], njira yoyamikira (AI) [45], ndi njira yofotokozera / yowonjezera / delta [46].Chitsanzocho chinapangidwa mogwirizana kutengera ndondomeko ya International Nurses Association's INACSL debriefing process of clinic and simulation education [36] ndipo inaphatikizidwa ndi zitsanzo zogwiritsidwa ntchito kuti apange chitsanzo chofotokozera.Chitsanzocho chinapangidwa m'magawo anayi: kukonzekera zokambirana zophunzirira zowunikira pambuyo poyerekezera, kuyambitsa zokambirana zowunikira, kusanthula / kulingalira ndi kukambirana (Chithunzi 1).Tsatanetsatane wa gawo lirilonse likukambidwa pansipa.
Gawo lokonzekera lachitsanzoli lidapangidwa kuti likonzekeretse otenga nawo mbali pagawo lotsatira ndikuwonjezera kutenga nawo gawo mwachangu komanso kusungitsa ndalama kwinaku akuwonetsetsa chitetezo chamalingaliro [36, 47].Gawoli likuphatikizapo kulongosola zolinga ndi zolinga;kuyembekezera nthawi ya RLC;ziyembekezo za otsogolera ndi otenga nawo mbali pa RLC;kalozera wa malo ndi kakhazikitsidwe kayeseleledwe;kuonetsetsa chinsinsi m'malo ophunzirira, ndikuwonjezera ndi kupititsa patsogolo chitetezo chamalingaliro.Mayankho oyimira otsatirawa kuchokera ku gulu logwirizanitsa ntchito adaganiziridwa panthawi yachitukuko cha RLC chitsanzo.Wophunzira 7: "Monga namwino wamkulu wa namwino, ndikanakhala ndikuchita nawo masewero popanda zochitika ndipo akuluakulu achikulire analipo, ndikanapewa kutenga nawo mbali pazokambirana pambuyo pake pokhapokha nditamva kuti chitetezo changa cha m'maganizo chikukhala. kulemekezedwa.ndi kuti ndingapewe kutenga nawo mbali pazokambirana pambuyo poyerekezera."Kutetezedwa ndipo sipadzakhala zotsatira."Wophunzira 4: "Ndikukhulupirira kuti kukhazikika ndikukhazikitsa malamulo oyambira kungathandize ophunzira pambuyo poyerekezera.Kutenga nawo mbali mwachangu pazokambirana zowunikira."
Magawo oyambilira a mtundu wa RLC akuphatikizapo kuwunika momwe otenga nawo mbali akumvera, kufotokoza zomwe zikuchitika ndikuzindikira zochitikazo, ndikulemba zomwe adakumana nazo zabwino ndi zoyipa, koma osati kusanthula.Chitsanzo pa nthawiyi chimapangidwa kuti chilimbikitse ofuna kukhala odzikonda komanso okonda ntchito, komanso kukonzekera m'maganizo kuti afufuze mozama ndi kusinkhasinkha mozama [24, 36].Cholinga ndi kuchepetsa chiopsezo cha kuchulukitsitsa kwachidziwitso [48], makamaka kwa iwo omwe ali atsopano pamutu wa chitsanzo ndipo alibe chidziwitso chachipatala cham'mbuyo ndi luso / mutu [49].Kufunsa ophunzira kuti afotokoze mwachidule nkhani yofanana ndi kupanga malingaliro okhudzana ndi matenda kudzathandiza wotsogolera kuti awonetsetse kuti ophunzira mu gulu ali ndi chidziwitso choyambirira komanso chodziwika bwino cha nkhaniyi asanapitirire ku gawo lowunikira / kulingalira.Kuphatikiza apo, kuitana ophunzira pa nthawi ino kuti afotokoze zakukhosi kwawo muzochitika zofananira kudzawathandiza kuthana ndi kupsinjika komwe kulipo, potero kukulitsa kuphunzira [24, 36].Kuthana ndi zovuta zamalingaliro kungathandizenso wotsogolera wa RLC kumvetsetsa momwe malingaliro a ophunzira amakhudzira kachitidwe kawo ndi gulu, ndipo izi zitha kukambidwa mozama panthawi yowunikira.Njira ya Plus/Delta imamangidwa mu gawo ili lachitsanzo ngati gawo lokonzekera komanso lotsimikizika la gawo lowunikira / kusanthula [46].Pogwiritsa ntchito njira ya Plus/Delta, onse otenga nawo mbali ndi ophunzira amatha kukonza/kulemba zomwe akuwona, momwe amamvera komanso zomwe akumana nazo pakufanizira, zomwe zitha kukambidwa mfundo ndi mfundo panthawi yowunikira / kusanthula kwachitsanzo [46].Izi zithandiza otenga nawo mbali kuti akwaniritse chidziwitso chodziwika bwino kudzera m'mipata yophunzirira yomwe akutsata komanso yofunika kwambiri kuti akwaniritse malingaliro azachipatala [24, 48, 49].Mayankho otsatirawa oyimira kuchokera ku gulu logwirizanitsa ntchito adaganiziridwa panthawi yachitukuko choyambirira cha chitsanzo cha RLC.Wophunzira 2: "Ndikuganiza kuti monga wodwala yemwe adaloledwa kale ku ICU, tiyenera kuganizira momwe akumvera komanso momwe akumvera ophunzira omwe amafanana nawo.Ndimadzutsa nkhaniyi chifukwa pakuvomerezedwa ndidawona kupsinjika kwakukulu komanso nkhawa, makamaka pakati pa osamalira odwala.ndi zochitika zadzidzidzi.Chitsanzochi chiyenera kuganizira za kupsinjika maganizo ndi malingaliro okhudzana ndi kuyerekezera zochitikazo. "Wophunzira 16: "Kwa ine monga mphunzitsi, ndimaona kuti ndizofunikira kwambiri kugwiritsa ntchito njira ya Plus / Delta kuti ophunzira alimbikitsidwe kutenga nawo mbali potchula zinthu zabwino ndi zosowa zomwe adakumana nazo panthawi yoyerekeza.Malo oyenera kukonza. "
Ngakhale magawo am'mbuyomu achitsanzowo ndi ovuta, gawo lowunikira / kuwunikira ndilofunika kwambiri pakukwaniritsa kukhathamiritsa kwamalingaliro azachipatala.Lapangidwa kuti lipereke kusanthula kwapamwamba / kaphatikizidwe ndi kusanthula mozama motengera zomwe zachitika pachipatala, luso, ndi zotsatira za mitu yotsatiridwa;RLC ndondomeko ndi kapangidwe;kuchuluka kwa chidziwitso choperekedwa kuti mupewe kuchuluka kwa chidziwitso;kugwiritsa ntchito bwino mafunso owunikira.njira zopezera maphunziro okhazikika komanso achangu.Panthawiyi, zochitika zachipatala komanso kuzolowerana ndi mitu yofananira zimagawidwa m'magawo atatu kuti zigwirizane ndi zochitika zosiyanasiyana ndi luso: choyamba: palibe chidziwitso chachipatala cham'mbuyomu / palibe chidziwitso cham'mbuyo pamitu yofananitsa, chachiwiri: zochitika zachipatala, chidziwitso ndi luso / palibe.kuwonekera m'mbuyomu mitu yachitsanzo.Chachitatu: Zochitika zachipatala, chidziwitso ndi luso.Kuwonetsedwa kwaukadaulo/m'mbuyomu kumitu yamachitsanzo.Gululi limapangidwa kuti likwaniritse zosowa za anthu omwe ali ndi zokumana nazo zosiyanasiyana komanso kuthekera kosiyanasiyana mkati mwa gulu lomwelo, potero kulinganiza chizolowezi cha akatswiri osadziwa zambiri kugwiritsa ntchito malingaliro owunikira ndi chizolowezi cha akatswiri odziwa zambiri kugwiritsa ntchito luso loganiza mopanda kusanthula [19, [Chithunzi patsamba 20, 34]., 37].Njira ya RLC idapangidwa mozungulira malingaliro azachipatala [10], mawonekedwe owonetsera [47], ndi chiphunzitso chophunzirira [50].Izi zimatheka kudzera m'njira zingapo: kutanthauzira, kusiyanitsa, kulankhulana, kulingalira ndi kaphatikizidwe.
Pofuna kupewa kuchulukitsitsa kwachidziwitso, kulimbikitsa njira yolankhulirana molunjika komanso molingalira bwino ndi nthawi yokwanira ndi mwayi woti ophunzira aganizire, kusanthula, ndi kuphatikiza kuti akwaniritse kudzidalira adaganiziridwa.Njira zachidziwitso pa RLC zimayankhidwa kudzera pakuphatikiza, kutsimikizira, kuumbika, ndi kuphatikizira njira zozikidwa pawiri-loop chimango [37] ndi chidziwitso cholemetsa [48].Kukhala ndi ndondomeko yokonzekera zokambirana ndi kulola nthawi yokwanira yosinkhasinkha, poganizira onse omwe ali ndi chidziwitso komanso osadziwa zambiri, zidzachepetsa chiopsezo cha chidziwitso cha chidziwitso, makamaka muzofananitsa zovuta ndi zochitika zosiyanasiyana zam'mbuyo, kuwonetseratu ndi luso la otenga nawo mbali.Pambuyo powonekera.Njira yofunsa mafunso yachitsanzoyi idatengera mtundu wa Bloom wa taxonomic [51] ndi njira zoyamikirira zofunsa (AI) [45], momwe wotsogolera wachitsanzo amafikira phunzirolo pang'onopang'ono, Socrates, komanso mowunikira.Funsani mafunso, kuyambira ndi mafunso ozikidwa pa chidziwitso.ndi kuthana ndi luso ndi nkhani zokhudzana ndi kulingalira.Njira yofunsayi ithandizira kukhathamiritsa kwa malingaliro azachipatala polimbikitsa kutenga nawo gawo mwachangu komanso kuganiza mopitilira muyeso popanda chiopsezo chochepa chakuchulukirachulukira kwa chidziwitso.Mayankho oyimira otsatirawa kuchokera ku gulu logwirizanitsa ntchito adaganiziridwa panthawi yowunikira / kuwonetseratu kwachitsanzo cha RLC.Wophunzira 13: "Kuti tipewe kuchulukitsitsa kwachidziwitso, tiyenera kuganizira kuchuluka kwa chidziwitso ndi kutuluka kwa chidziwitso tikamakambirana zophunzirira pambuyo pake, ndipo kuti tichite izi, ndikuganiza kuti ndikofunikira kupatsa ophunzira nthawi yokwanira yolingalira ndikuyamba ndi zoyambira. .Chidziwitso.imayambitsa zokambirana ndi luso, kenako imapita kumagulu apamwamba a chidziwitso ndi luso kuti akwaniritse metacognition. "Wophunzira 9: "Ndikukhulupirira mwamphamvu kuti njira zofunsa mafunso pogwiritsa ntchito njira za Appreciative Inquiry (AI) ndi mafunso owunikira pogwiritsa ntchito chitsanzo cha Bloom's Taxonomy zidzalimbikitsa kuphunzira mwakhama komanso kukhazikika kwa ophunzira pamene zimachepetsa kuthekera kwa chiwopsezo cha chidziwitso."Gawo lofotokozera lachitsanzo likufuna kufotokoza mwachidule mfundo zophunzirira zomwe zatulutsidwa pa RLC ndikuwonetsetsa kuti zolinga zophunzirira zikukwaniritsidwa.Wophunzira 8: "Ndikofunikira kwambiri kuti wophunzira ndi wotsogolera agwirizane pa mfundo zofunika kwambiri ndi mfundo zazikuluzikulu zomwe ziyenera kuganiziridwa poyambira kuchita."
Chivomerezo cha chikhalidwe chinapezedwa pansi pa manambala a protocol (MRC-01-22-117) ndi (HSK/PGR/UH/04728).Chitsanzocho chinayesedwa m'maphunziro atatu owonetsera chisamaliro chapadera kuti awone momwe angagwiritsire ntchito ndi momwe chitsanzocho chikuyendera.Kuwoneka kwa nkhope kwa chitsanzocho kunayesedwa ndi gulu logwirizanitsa ntchito (N = 18) ndi akatswiri a maphunziro omwe amagwira ntchito monga otsogolera maphunziro (N = 6) kuti akonze zinthu zokhudzana ndi maonekedwe, galamala, ndi ndondomeko.Pambuyo pa kutsimikizika kwa nkhope, kutsimikizika kwazinthu kudatsimikiziridwa ndi aphunzitsi akuluakulu anamwino (N = 6) omwe adatsimikiziridwa ndi American Nurses Credentialing Center (ANCC) ndipo adakhala ngati okonzekera maphunziro, ndi (N = 6) omwe anali ndi zaka zopitilira 10 zamaphunziro ndi luso la kuphunzitsa.Zochitika Pantchito Kuunikaku kunachitika ndi oyang'anira maphunziro (N = 6).Kutengera zochitika.Kutsimikizika kwazinthu kudatsimikiziridwa pogwiritsa ntchito Content Validity Ratio (CVR) ndi Content Validity Index (CVI).Njira ya Lawshe [52] idagwiritsidwa ntchito kuyerekezera CVI, ndipo njira ya Waltz ndi Bausell [53] idagwiritsidwa ntchito kuyerekeza CVR.Mapulojekiti a CVR ndi ofunikira, othandiza, koma osafunikira kapena osankha.CVI imaperekedwa pamlingo wa mfundo zinayi kutengera kufunika kwake, kuphweka, ndi kumveka bwino, ndi 1 = si yoyenera, 2 = yofunikira, 3 = yofunikira, ndi 4 = yofunikira kwambiri.Pambuyo potsimikizira nkhope ndi zokhutira, kuwonjezera pa zokambirana zothandiza, maphunziro otsogolera ndi otsogolera adachitidwa kwa aphunzitsi omwe adzagwiritse ntchito chitsanzocho.
Gulu la ntchito linatha kupanga ndi kuyesa chitsanzo cha post-simulation RLC kuti apititse patsogolo luso la kulingalira kwachipatala panthawi ya SBE m'magulu osamalira odwala kwambiri (Zithunzi 1, 2, ndi 3).CVR = 1.00, CVI = 1.00, kusonyeza nkhope yoyenera ndi zokhutira zokhutira [52, 53].
Chitsanzocho chinapangidwira gulu la SBE, kumene zochitika zosangalatsa ndi zovuta zimagwiritsidwa ntchito kwa omwe ali ndi zochitika zofanana kapena zosiyana, chidziwitso ndi akuluakulu.Mtundu wamalingaliro a RLC unapangidwa molingana ndi INACSL kusanthula kayeseleledwe ka ndege [36] ndipo imakhala yokhazikika pakuphunzira komanso yodzifotokozera, kuphatikiza zitsanzo zogwiritsidwa ntchito (Zithunzi 1, 2 ndi 3).Chitsanzocho chinapangidwa mwadala ndipo chinagawidwa m'magawo anayi kuti akwaniritse zofunikira zachitsanzo: kuyambira ndi chidule, kutsatiridwa ndi kuwunikira / kaphatikizidwe, ndikutha ndi chidziwitso ndi chidule.Kuti mupewe chiopsezo chochulukirachulukira, gawo lililonse lachitsanzo limapangidwa mwadala ngati chofunikira pagawo lotsatira [34].
Chikoka cha ukalamba ndi mgwirizano wamagulu pakuchita nawo RLC sichinaphunzirepo kale [38].Poganizira mfundo zothandiza za kubwerezabwereza komanso chidziwitso cholemetsa muzochita zoyerekeza [34, 37], ndikofunikira kulingalira kuti kutenga nawo gawo mu gulu la SBE ndi zokumana nazo zosiyanasiyana komanso kuthekera kwa omwe akuchita nawo gulu limodzi loyerekeza ndizovuta.Kunyalanyaza kuchuluka kwa chidziwitso, kuyenda ndi kapangidwe ka maphunziro, komanso kugwiritsa ntchito nthawi imodzi yachangu komanso pang'onopang'ono njira zachidziwitso za ana asukulu zasekondale ndi asukulu za sekondale zimakhala pachiwopsezo chakuchulukirachulukira kwachidziwitso [18, 38, 46].Zinthu izi zidaganiziridwa popanga mtundu wa RLC kuti mupewe kusakhazikika komanso / kapena kulingalira kwachipatala kocheperako [18, 38].Ndikofunika kuganizira kuti kuchita RLC ndi magulu osiyanasiyana a ukalamba ndi luso kumayambitsa kulamulira pakati pa akuluakulu.Izi zimachitika chifukwa omwe apita patsogolo amakonda kupeŵa kuphunzira mfundo zofunika kwambiri, zomwe ndizofunikira kuti achinyamata azitha kuzindikira komanso kulowa m'malingaliro apamwamba kwambiri [38, 47].Mtundu wa RLC wapangidwa kuti ugwirizane ndi anamwino akuluakulu ndi aang'ono kupyolera mwa kufunsa koyamikira ndi njira ya delta [45, 46, 51].Pogwiritsa ntchito njirazi, malingaliro a otsogolera akuluakulu ndi aang'ono omwe ali ndi luso losiyanasiyana ndi zochitika zosiyanasiyana adzawonetsedwa chinthu ndi chinthu ndikukambidwa mozama ndi woyang'anira ndi oyang'anira nawo [45, 51].Kuphatikiza pa zomwe otenga nawo gawo oyeserera, wotsogolera amawonjezera zomwe akuganiza kuti awonetsetse kuti zowonera zonse zimakwaniritsa mphindi iliyonse yophunzirira, potero kumathandizira kuzindikira kuti kuwongolera malingaliro azachipatala [10].
Mayendedwe a chidziwitso ndi kapangidwe ka kuphunzira pogwiritsa ntchito mtundu wa RLC amayankhidwa kudzera munjira yokhazikika komanso yamasitepe ambiri.Izi ndi kuthandiza otsogolera zokambirana ndikuwonetsetsa kuti wophunzira aliyense alankhula momveka bwino komanso molimba mtima pagawo lililonse asanalowe gawo lina.Woyang'anira azitha kuyambitsa zokambirana zowunikira momwe onse amatenga nawo mbali, ndikufika poti anthu omwe ali ndi ukalamba ndi kuthekera kosiyanasiyana amavomerezana za njira zabwino zokambitsirana pamfundo iliyonse asanapite ku ina [38].Kugwiritsa ntchito njirayi kudzathandiza omwe akudziwa bwino komanso odziwa bwino ntchito yawo kugawana zomwe apereka / zomwe akuwona, pomwe zopereka / zowonera za omwe atenga nawo mbali osadziwa komanso odziwa zambiri zidzawunikidwa ndikukambidwa [38].Komabe, kuti akwaniritse cholingachi, otsogolera akuyenera kukumana ndi zovuta zogwirizanitsa zokambirana ndikupereka mwayi wofanana kwa akuluakulu ndi aang'ono.Kuti izi zitheke, njira yofufuzira yachitsanzo idapangidwa mwadala pogwiritsa ntchito mtundu wa Bloom's taxonomic, womwe umaphatikiza kafukufuku wowunika ndi njira yowonjezera / delta [45, 46, 51].Kugwiritsa ntchito njirazi ndikuyamba ndi chidziwitso ndi kumvetsetsa kwa mafunso ofunika kwambiri/kukambilana kozama kudzalimbikitsa ophunzira omwe alibe chidziwitso chochepa kutenga nawo mbali ndi kutenga nawo mbali pazokambirana, pambuyo pake wotsogolera adzapita patsogolo pang'onopang'ono ndikuwunika ndikuphatikiza mafunso/zokambiranazo. momwe mbali zonse ziwiri ziyenera kupatsa Akuluakulu ndi Achinyamata omwe ali ndi mwayi wofanana kutenga nawo mbali potengera zomwe adakumana nazo m'mbuyomu komanso zomwe adakumana nazo kale ndi luso lachipatala kapena zochitika zofananira.Njirayi ithandiza anthu omwe sakudziwa zambiri kutenga nawo mbali ndikupindula ndi zomwe aphunzira komanso zomwe wotsogolera zokambirana akambirana.Kumbali inayi, chitsanzocho sichinapangidwe kokha kwa ma SBE omwe ali ndi luso losiyana la otenga nawo mbali komanso milingo yokumana nawo, komanso kwa omwe atenga nawo gawo pagulu la SBE omwe ali ndi chidziwitso chofananira ndi milingo yaluso.Chitsanzocho chinapangidwa kuti chiwongolere kayendetsedwe kabwino ka gululo kuchoka pa chidziwitso ndi kumvetsetsa ndikuyang'ana pa kaphatikizidwe ndi kuwunika kuti akwaniritse zolinga za maphunziro.Mapangidwe achitsanzo ndi njira zake zimapangidwira kuti zigwirizane ndi magulu amitundu yosiyanasiyana komanso ofanana ndi zochitika.
Kuonjezera apo, ngakhale SBE mu chisamaliro chaumoyo pamodzi ndi RLC imagwiritsidwa ntchito popanga malingaliro achipatala ndi luso la akatswiri [22,30,38], komabe, zinthu zoyenera ziyenera kuganiziridwa zokhudzana ndi zovuta komanso zoopsa zomwe zingakhalepo chifukwa cha kuchulukitsitsa kwachidziwitso, makamaka. pamene Ophunzirawo adakhudzidwa ndi zochitika za SBE zomwe zimatengera odwala ovuta kwambiri, odwala kwambiri omwe amafunikira kuti achitepo kanthu mwamsanga ndi kupanga zisankho zovuta [2,18,37,38,47,48].Kuti izi zitheke, ndikofunikira kulingalira za chizolowezi cha onse odziwa zambiri komanso osadziwa zambiri kusintha nthawi imodzi pakati pa njira zowunikira komanso zosasanthula pochita nawo SBE, ndikukhazikitsa njira yozikidwa pa umboni yomwe imalola achikulire ndi achichepere. ophunzira kutenga nawo mbali pakuphunzira.Choncho, chitsanzocho chinapangidwa m'njira yoti, mosasamala kanthu za zovuta za nkhani yofananira yomwe yaperekedwa, wotsogolera ayenera kuonetsetsa kuti mbali za chidziwitso ndi kumvetsetsa kwapakati pa onse akuluakulu ndi aang'ono omwe atenga nawo mbali akuyamba kufotokozedwa ndiyeno pang'onopang'ono komanso momveka bwino. kuthandizira kusanthula.kaphatikizidwe ndi kumvetsetsa.kuwunika mbali.Izi zithandiza ophunzira achichepere kupanga ndi kuphatikiza zomwe aphunzira, komanso kuthandiza ophunzira achikulire kuphatikizira ndikukulitsa chidziwitso chatsopano.Izi zikwaniritsa zofunikira pakukambitsirana, poganizira zomwe adakumana nazo m'mbuyomu komanso luso la wophunzira aliyense, ndikukhala ndi mawonekedwe omwe amawongolera chizolowezi cha ophunzira akusukulu yasekondale ndi asukulu za sekondale nthawi imodzi kusuntha pakati pa njira zowunikira ndi zosawerengeka, potero. kuonetsetsa kukhathamiritsa kwa kulingalira kwachipatala.
Kuonjezera apo, otsogolera / ofotokozera akhoza kukhala ndi vuto lodziwa luso lofotokozera.Kugwiritsiridwa ntchito kwa malemba ofotokozera mwachidziwitso kumakhulupirira kuti kumakhala kothandiza kupititsa patsogolo chidziwitso ndi luso la otsogolera poyerekeza ndi omwe sagwiritsa ntchito malemba [54].Zochitika ndi chida chanzeru chomwe chingathandize aphunzitsi ntchito yowonetsera ndikuwongolera luso lofotokozera, makamaka kwa aphunzitsi omwe akuphatikizabe zomwe amaphunzira [55].kukwanitsa kugwiritsa ntchito kwambiri ndikupanga zitsanzo zosavuta kugwiritsa ntchito.(Chithunzi 2 ndi Chithunzi 3).
Kuphatikizika kofananira kwa kuphatikiza / delta, kafukufuku woyamikira, ndi njira zofufuzira za Bloom's Taxonomy sizinayankhidwebe pakuwunika koyerekeza komwe kulipo komanso zitsanzo zowunikira motsogozedwa.Kuphatikizika kwa njirazi kumawunikira luso lachitsanzo la RLC, momwe njirazi zimaphatikizidwira mumtundu umodzi kuti zikwaniritse kukhathamiritsa kwa malingaliro azachipatala komanso kukhazikika kwa ophunzira.Ophunzitsa zachipatala atha kupindula ndi gulu lachitsanzo la SBE pogwiritsa ntchito chitsanzo cha RLC kuti apititse patsogolo luso la kulingalira kwa otenga nawo mbali.Zochitika zachitsanzozi zitha kuthandiza ophunzitsa kuti azitha kuwongolera bwino ndikulimbitsa luso lawo kuti akhale otsogolera odzidalira komanso aluso.
SBE ingaphatikizepo njira ndi njira zambiri zosiyanasiyana, kuphatikiza koma osangokhala ndi SBE yochokera ku mannequin, oyeserera ntchito, oyeserera odwala, odwala okhazikika, zenizeni zenizeni komanso zowonjezereka.Poganizira kuti kupereka lipoti ndi imodzi mwazofunikira zotsatsira, mtundu wofananira wa RLC ukhoza kugwiritsidwa ntchito ngati fanizo pogwiritsira ntchito mitundu iyi.Komanso, ngakhale kuti chitsanzocho chinapangidwira mwambo wa unamwino, chikhoza kugwiritsidwa ntchito mu interprofessional healthcare SBE, kuwonetsa kufunikira kwa kafukufuku wamtsogolo kuti ayese chitsanzo cha RLC cha maphunziro a interprofessional.
Kupititsa patsogolo ndi kuwunika kwa chitsanzo cha post-simulation RLC cha chisamaliro cha unamwino m'magulu osamalira odwala kwambiri a SBE.Kuwunika kwamtsogolo / kutsimikizika kwachitsanzo kumalimbikitsidwa kuti awonjezere kufalikira kwachitsanzo kuti chigwiritsidwe ntchito m'magulu ena azaumoyo ndi interprofessional SBE.
Chitsanzocho chinapangidwa ndi gulu logwira ntchito limodzi logwirizana ndi chiphunzitso ndi lingaliro.Kupititsa patsogolo kutsimikizika ndi kukhazikika kwachitsanzocho, kugwiritsa ntchito njira zodalirika zolimbikitsira maphunziro ofananitsa zitha kuganiziridwa mtsogolo.
Kuti achepetse zolakwika zomwe zimachitika m'machitidwe, madokotala ayenera kukhala ndi luso loganiza bwino lachipatala kuti athe kupanga zisankho zoyenera komanso zotetezeka.Kugwiritsa ntchito SBE RLC monga njira yofotokozera kumalimbikitsa chitukuko cha chidziwitso ndi luso lothandizira lofunikira kuti mukhale ndi malingaliro achipatala.Komabe, chikhalidwe chamitundumitundu chamalingaliro azachipatala, chokhudzana ndi zomwe zidachitika kale komanso kuwonekera, kusintha kwa kuthekera, kuchuluka kwa chidziwitso ndi kutulutsa kwa chidziwitso, komanso zovuta za zochitika zofananira, zikuwonetsa kufunikira kopanga zitsanzo za RLC pambuyo pake zomwe malingaliro azachipatala amatha kukhala achangu. ndi kukhazikitsidwa bwino.luso.Kunyalanyaza zinthu izi kungayambitse malingaliro osatukuka komanso osakwanira bwino azachipatala.Mtundu wa RLC udapangidwa kuti ugwirizane ndi izi kuti athe kuwongolera malingaliro azachipatala pochita nawo zochitika zofananiza zamagulu.Kuti akwaniritse cholingachi, chitsanzochi chimaphatikizanso kufufuza kowonjezera/kuchotsa ndi kugwiritsa ntchito taxonomy ya Bloom.
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Nthawi yotumiza: Jan-08-2024