|Ph.D Thesis||Department of Education in Science and Technology|
|Supervisors:||Prof. Dori Yehudit|
|Full Thesis text - in Hebrew|
Simulation in medicine and nursing applies a variety of models for training in different technological levels, ranging from low-tech/fidelity simulators, through hybrid models, to high-tech/fidelity and virtual reality simulators. In spite of the growing use of simulation in medical education, only few studies have examined simulations' contribution to meaningful learning and acquisition of clinical skills in nursing. This research assesses the effect of simulation-based training and learning on perceptions of models and on clinical skills among instructors, medical graduates and graduate and novice nursing students. The research was conducted at MSR - the Israeli Center for Medical Simulation located at Sheba Medical Center, Tel Hashomer and at a simulation laboratory in a nursing school at an academic college in Israel. These facilities were built as virtual hospitals and operate various types of simulators for both individual and team training. The research population included approximately 30 instructors, 100 medical students, and 170 nursing students. Research tools included interviews with simulation-lab instructors, and pre-and post-training model perceptions’ and clinical skills’ questionnaires, which were administered to medical and nursing students and their instructors.
Analysis of the medical and nursing students' responses to the model perception questionnaires revealed four types of perceptions: primary, affective-caring, analytic-technological, and integrated perception. Among graduate medical students, simulation-based training led to conceptual change, strengthening integrated perception and reducing undecided perceptions. Among novice nursing students, the most prominent perceptions at the end of the simulation program were integrated and affective-caring perceptions. Perceptions of graduate nursing students were between the novice nursing students' perceptions and the medical graduates’ perceptions.
Since the medical students were at an advanced stage of their studies, they were better prepared to apply complex simulation-based training, and were able to employ a variety of clinical skills and combine hybrid and advanced-hybrid models, as well as multiple model scenarios. Novice nursing students, who were in a primary learning phase, needed separation between artificial and human models and had difficulties studying combinations of models.
As for theoretical aspects, the research contributions are twofold: (a) augmentation of the body of knowledge on simulation-based instruction, learning, and (b) assessment in medicine and nursing, and development of assessment tools for evaluating simulation programs for medical and nursing professions. As for practical aspects, the research contributions include increasing models' incorporation into simulation-based and non-simulation-based environments, improving simulation-based programs, and applying these simulations as tools for assessment and licensing of health science professionals.