Abasebenzi kumele babe namakhono okucabanga asebenzayo ukuze benze izinqumo ezifanele, eziphephile zomtholampilo futhi bagweme amaphutha okwenza.Amakhono okucabanga athuthukiswe kabi angabeka engozini ukuphepha kwesiguli futhi abambezele ukunakekelwa noma ukwelashwa, ikakhulukazi eminyangweni yokunakekelwa okuphuthumayo kanye nezimo eziphuthumayo.Ukuqeqeshwa okusekelwe ekulingiseni kusebenzisa izingxoxo zokufunda ezicabangelayo ezilandela ukulingisa njengendlela yokuxoxisana ukuze kuthuthukiswe amakhono okucabanga emtholampilo kuyilapho kugcinwa ukuphepha kwesiguli.Kodwa-ke, ngenxa yemvelo ehlukahlukene yokucabanga komtholampilo, ubungozi obungaba khona bokugcwala kwengqondo, kanye nokusetshenziswa okuhlukile kokuhlaziya (i-hypothetico-deductive) kanye nezinqubo zokucabanga zomtholampilo ezingahlaziyli (ezinembile) ngabahlanganyeli bokulingisa abathuthukile nabancane, kubalulekile ukuthi cabangela isipiliyoni, amakhono, izici ezihlobene nokugeleza kanye nevolumu yolwazi, kanye necala eliyinkimbinkimbi ukuze uthuthukise ukucabanga komtholampilo ngokuhlanganyela ezingxoxweni zokufunda ezicabangelayo zeqembu ngemva kokulingisa njengendlela yokuxoxisana.Umgomo wethu uwukuchaza ukuthuthukiswa kwemodeli yengxoxo yokufunda okubonisayo ngemva kokulingisa ecabangela izici eziningi ezithonya impumelelo yokuthuthukiswa kokucabanga komtholampilo.
Iqembu elisebenzayo lokuklama ngokubambisana (N = 18), elihlanganisa odokotela, abahlengikazi, abacwaningi, othisha, nabamele isiguli, lihlanganyele ngokusebenzisa ama-workshops alandelanayo ukuze lihlanganise ndawonye imodeli yengxoxo yokufunda ekhanyayo yangemuva kokulingisa ukuze kuxoxwe ngokulingisa.Iqembu elisebenza ngokubambisana lithuthukise imodeli ngokusebenzisa inqubo yethiyori neyomqondo kanye nokubuyekezwa kontanga kwezigaba eziningi.Ukuhlanganiswa okuhambisanayo kocwaningo lokuhlola lokuhlanganisa/lokususa kanye ne-taxonomy ye-Bloom kukholakala ukuthi kuthuthukisa ukucabanga komtholampilo kwabahlanganyeli bokulingiswa kuyilapho bebambe iqhaza emisebenzini yokulingisa.Inkomba yokuqinisekiswa kokuqukethwe (i-CVI) nezindlela zokuqinisekisa isilinganiso sokuqukethwe (CVR) zisetshenziswe ukuze kutholwe ukufaneleka kobuso nokufaneleka kokuqukethwe kwemodeli.
Imodeli yenkhulumomphendvulwano yokufunda yangemuva kokulingisa yasungulwa futhi yavivinywa.Imodeli isekelwa izibonelo esetshenziwe kanye nesiqondiso sombhalo.Ubuso nokuqukethwe kokufaneleka kwemodeli kwahlolwa futhi kwaqinisekiswa.
Imodeli entsha yokuklama ngokubambisana yakhiwe kucatshangelwa amakhono kanye namandla abahlanganyeli abahlukahlukene bokumodela, ukuhamba nomthamo wolwazi, kanye nobunkimbinkimbi bamacala okumodela.Lezi zici kucatshangwa ukuthi zithuthukisa ukucabanga komtholampilo lapho ubamba iqhaza emisebenzini yokulingisa yeqembu.
Ukucabanga komtholampilo kubhekwa njengesisekelo sokusebenza komtholampilo ekunakekelweni kwezempilo [1, 2] kanye nesici esibalulekile sokufaneleka komtholampilo [1, 3, 4].Kuyinqubo ekhombisayo ukuthi odokotela basebenzisa ukukhomba nokusebenzisa ukungenelela okufanele kakhulu esimweni ngasinye somtholampilo abahlangabezana nakho [5, 6].Ukucabanga komtholampilo kuchazwa njengenqubo eyinkimbinkimbi yokucabanga esebenzisa amasu okucabanga ahlelekile futhi angakahleleki ukuze aqoqe futhi ahlaziye ulwazi mayelana nesiguli, ahlole ukubaluleka kwalolo lwazi, futhi anqume ukubaluleka kwezinye izifundo zesenzo [7, 8].Kuncike ekhonweni lokuqoqa izinkomba, ukucubungula ulwazi, nokuqonda inkinga yesiguli ukuze kuthathwe isinyathelo esifanele sesiguli esifanele ngesikhathi esifanele nangesizathu esifanele [9, 10].
Bonke abahlinzeki bezempilo babhekene nesidingo sokwenza izinqumo eziyinkimbinkimbi ezimweni zokungaqiniseki okuphezulu [11].Ekunakekelweni okubucayi kanye nokusebenza kokunakekelwa okuphuthumayo, izimo zomtholampilo kanye nezimo eziphuthumayo zivela lapho impendulo esheshayo nokungenelela kubalulekile ekusindiseni izimpilo nokuqinisekisa ukuphepha kwesiguli [12].Amakhono angalungile okucabanga emtholampilo kanye nekhono ekusebenzeni kokunakekelwa okubucayi kuhlotshaniswa namazinga aphezulu amaphutha emitholampilo, ukubambezeleka ekunakekelweni noma ukwelashwa [13] kanye nezingozi zokuphepha kwesiguli [14,15,16].Ukuze ugweme amaphutha angokoqobo, odokotela kumele babe nekhono futhi babe namakhono asebenzayo okucabanga emtholampilo ukuze benze izinqumo eziphephile nezifanelekile [16, 17, 18].Inqubo yokucabanga engahlaziyli (enembile) iyinqubo esheshayo ethandwa ochwepheshe.Ngokuphambene, izinqubo zokucabanga zokuhlaziya (i-hypothetico-deductive) zihamba kancane ngokwemvelo, zenziwe ngamabomu kakhulu, futhi zivame ukusetshenziswa odokotela abanolwazi oluncane [2, 19, 20].Uma kubhekwa inkimbinkimbi yendawo yomtholampilo wokunakekelwa kwezempilo kanye nengozi engaba khona yamaphutha omkhuba [14,15,16], imfundo esekelwe ekulingiseni (SBE) ivame ukusetshenziselwa ukunikeza odokotela amathuba okuthuthukisa amakhono kanye namakhono okucabanga emtholampilo.indawo ephephile kanye nokuchayeka ezimweni ezihlukahlukene eziyinselele ngenkathi kugcinwa ukuphepha kwesiguli [21, 22, 23, 24].
I-Society for Simulation in Health (SSH) ichaza ukulingisa njengokuthi “ubuchwepheshe obudala isimo noma indawo lapho abantu bezwa ukumelwa kwezehlakalo zangempela zempilo ngenjongo yokuzijwayeza, ukuqeqesha, ukuhlola, ukuhlola, noma ukuqonda amasistimu abantu noma ukuziphatha.”[23] Izikhathi zokulingisa ezihlelwe kahle zinikeza ababambiqhaza ithuba lokucwiliswa ezimweni ezilingisa izimo zomtholampilo ngenkathi kunciphisa izingozi zokuphepha [24,25] futhi usebenzise ukucabanga komtholampilo ngokusebenzisa amathuba okufunda ahlosiwe [21,24,26,27,28] I-SBE ithuthukisa okuhlangenwe nakho komtholampilo wasensimini, iveze abafundi kokuhlangenwe nakho komtholampilo okungenzeka abakaze bakuthole kuzilungiselelo zangempela zokunakekelwa kwesiguli [24, 29].Lena indawo yokufunda engasongelayo, engasoleki, egadiwe, ephephile, engenabungozi obuncane.Ikhuthaza ukuthuthukiswa kolwazi, amakhono emitholampilo, amakhono, ukucabanga okujulile nokucabanga komtholampilo [22,29,30,31] futhi ingasiza ochwepheshe bezokunakekelwa kwempilo banqobe ukucindezeleka ngokomzwelo kwesimo, ngaleyo ndlela kuthuthukise ikhono lokufunda [22, 27, 28] ., 30, 32].
Ukuze kusekelwe ukuthuthukiswa okuphumelelayo kwamakhono okucabanga emitholampilo kanye nokwenza izinqumo nge-SBE, kufanele kuqashelwe ukuklama, isifanekiso, kanye nesakhiwo senqubo ye-post-simulation debriefing [24, 33, 34, 35].Izingxoxo zokufunda ezibukwayo ngemuva kokulingisa (i-RLC) zisetshenziswe njengendlela yokuxoxisana ukusiza ababambiqhaza babonise, bachaze izenzo, futhi basebenzise amandla okusekelwa kontanga kanye nokucabanga kweqembu kumongo wokusebenzisana [32, 33, 36].Ukusetshenziswa kwama-RLC eqembu kuthwala ingcuphe engaba khona yokucabanga komtholampilo okungathuthukisiwe, ikakhulukazi ngokuphathelene namakhono ahlukahlukene kanye namazinga aphezulu wabahlanganyeli.Imodeli yezinqubo ezimbili ichaza imvelo eminingi yokucabanga komtholampilo kanye nomehluko ekuthambekeni kwabasebenzi abaphezulu ukusebenzisa izinqubo zokucabanga zokuhlaziya (i-hypothetico-deductive) kanye nodokotela abancane ukuze basebenzise izinqubo zokucabanga ezingahlaziyli (esinembile) [34, 37].].Lezi zinqubo zokucabanga ezimbaxambili zibandakanya inselele yokulungisa izinqubo zokucabanga ezifanele ezimweni ezihlukahlukene, futhi akucacile futhi kuyimpikiswano ukuthi ungasebenzisa kanjani ngempumelelo izindlela zokuhlaziya nezingezona zokuhlaziya lapho kukhona ababambiqhaza abadala nabancane eqenjini elifanayo lokumodela.Abafundi besikole samabanga aphakeme nabancane besikole samabanga aphakeme abanamakhono ahlukahlukene kanye namazinga esipiliyoni babamba iqhaza ezimeni zokulingisa eziyinkimbinkimbi ehlukahlukene [34, 37].Imvelo ye-multidimensional yokucabanga komtholampilo ihlotshaniswa nengozi engaba khona yokucabanga komtholampilo okungathuthukisiwe kanye nokugcwala kwengqondo, ikakhulukazi lapho odokotela bebamba iqhaza kuma-SBE eqembu anezimo eziyinkimbinkimbi namazinga aphezulu [38].Kubalulekile ukuqaphela ukuthi nakuba kunamamodeli amaningi okuxoxisana asebenzisa i-RLC, awekho kulawa mamodeli aklanywe ngokugxila okukhethekile ekuthuthukisweni kwamakhono okucabanga emtholampilo, kucatshangelwa isipiliyoni, ikhono, ukugeleza kanye nevolumu yolwazi, futhi ukumodela izinto eziyinkimbinkimbi [38].]., 39].Konke lokhu kudinga ukuthuthukiswa kwemodeli ehlelekile ecabangela iminikelo ehlukahlukene kanye nezici ezithonya ukuze kuthuthukiswe ukucabanga komtholampilo, kuyilapho ihlanganisa i-RLC yangemuva kokulingisa njengendlela yokubika.Sichaza inqubo eqhutshwa ithiyori nengokomqondo yokuklama ngokubambisana nokuthuthukiswa kwe-RLC yangemuva kokulingisa.Imodeli yasungulwa ukuze kuthuthukiswe amakhono okucabanga emtholampilo ngesikhathi sokubamba iqhaza ku-SBE, kucatshangelwa izinhlobonhlobo zezinto ezisizayo nezinomthelela ukuze kuzuzwe ukuthuthukiswa kokucabanga komtholampilo okuthuthukisiwe.
Imodeli yangemuva kokulingisa ye-RLC yathuthukiswa ngokubambisana ngokusekelwe kumamodeli akhona kanye nethiyori yokucabanga komtholampilo, ukufunda okucabangelayo, imfundo, kanye nokulingisa.Ukuze kuthuthukiswe ngokuhlanganyela imodeli, kwasungulwa iqembu elisebenzayo elisebenzisanayo (N = 18), elihlanganisa abahlengikazi abayi-10 abanakekela abagula kakhulu, oyedwa we-intensivist, kanye nabameleli abathathu beziguli ezazilaliswe esibhedlela ngaphambilini zamazinga ahlukene, isipiliyoni, nobulili.Igumbi labagula kakhulu, abasizi bocwaningo abangu-2 kanye nabafundisi abahlengikazi ababili.Lokhu kuqamba kabusha kwe-co-design yakhelwe futhi yathuthukiswa ngokusebenzisana kontanga phakathi kwababambe iqhaza abanolwazi lwezwe langempela ekunakekelweni kwezempilo, kungaba ochwepheshe bezempilo abahilelekile ekuthuthukisweni kwemodeli ehlongozwayo noma abanye ababambiqhaza njengeziguli [40,41,42].Kubandakanya abamele isiguli enqubweni yokuklama ngokubambisana kungaqhubeka nokwengeza inani kule nqubo, njengoba umgomo omkhulu wohlelo ukuthuthukisa ukunakekelwa kwesiguli nokuphepha [43].
Iqembu elisebenzayo lenze ama-workshops ayisithupha amahora angu-2-4 ukuthuthukisa isakhiwo, izinqubo kanye nokuqukethwe kwemodeli.I-workshop ihlanganisa ingxoxo, ukuzijwayeza kanye nokulingisa.Izici zemodeli zisekelwe ezinhlobonhlobo zezinsiza ezisekelwe ebufakazini, amamodeli, amathiyori kanye nezinhlaka.Lokhu kufaka phakathi: ithiyori yokufunda ye-constructivist [44], i-dual loop concept [37], i-clinical reasoning loop [10], indlela yokubuza ngokwazisa (AI) [45], kanye nendlela yokubika yokuhlanganisa/ye-delta [46].Imodeli yathuthukiswa ngokubambisana ngokusekelwe kumazinga enqubo yokuxoxisana yeNhlangano Yamazwe Ngamazwe ye-INACSL yemfundo yomtholampilo neyokulingisa [36] futhi yahlanganiswa nezibonelo ezisetshenzisiwe ukuze kwakhiwe imodeli ezichazayo.Imodeli yathuthukiswa ngezigaba ezine: ukulungiselela inkhulumomphendvulwano yokufunda ecabangelayo ngemva kokulingisa, ukuqaliswa kwengxoxo yokufunda ecabangelayo, ukuhlaziya/ukucabangisisa kanye nokudingida (Umdwebo 1).Imininingwane yesigaba ngasinye kuxoxwa ngayo ngezansi.
Isigaba sokulungiselela semodeli senzelwe ukulungiselela abahlanganyeli ngokwengqondo esigabeni esilandelayo futhi kwandiswe ukubamba iqhaza kwabo okusebenzayo kanye nokutshalwa kwezimali ngenkathi kuqinisekiswa ukuphepha kwengqondo [36, 47].Lesi sigaba sihlanganisa isingeniso senhloso nezinjongo;ubude besikhathi obulindelwe be-RLC;okulindelwe umsizi kanye nabahlanganyeli ngesikhathi se-RLC;ukuma kwesayithi nokusethwa kokulingisa;ukuqinisekisa ukugcinwa kuyimfihlo endaweni yokufunda, nokwandisa nokuthuthukisa ukuphepha kwengqondo.Izimpendulo ezimele ezilandelayo ezivela eqenjini elisebenzayo lokuklama zicatshangelwe phakathi nesigaba sangaphambi kokuthuthukiswa kwemodeli ye-RLC.Umbambiqhaza wesi-7: “Njengomsebenzi wokunakekela oyinhloko, ukube bengibamba iqhaza ekulingiseni ngaphandle komongo wesimo futhi abantu abadala asebekhulile babekhona, cishe bengingagwema ukuhlanganyela engxoxweni yangemva kokulingisa ngaphandle uma ngizwa sengathi ukuphepha kwami ngokwengqondo bekukhona. ehlonishwayo.nokuthi ngizogwema ukuhlanganyela ezingxoxweni ngemva kokulingisa."Vikelwa futhi ngeke kube nemiphumela."Umhlanganyeli 4: “Ngikholwa ukuthi ukugxila kanye nokubeka imithetho eyisisekelo kusenesikhathi kuzosiza abafundi ngemuva kokulingisa.Ukuhlanganyela ngentshiseko ezingxoxweni zokufunda ezibonisayo.”
Izigaba zokuqala zemodeli ye-RLC zifaka phakathi ukuhlola imizwa yombambi qhaza, ukuchaza izinqubo eziwumsuka kanye nokuxilonga isimo, kanye nokufakwa kuhlu okuhlangenwe nakho okuhle nokubi komhlanganyeli, kodwa hhayi ukuhlaziya.Imodeli kulesi sigaba idalwe ukuze kugqugquzelwe abazongenela ukhetho ukuthi bazijwayeze futhi bagxile emsebenzini, futhi balungiselele ngokwengqondo ukuhlaziya okujulile nokuzindla ngokujulile [24, 36].Umgomo uwukunciphisa ubungozi obungaba khona bokugcwala kwengqondo [48], ikakhulukazi kulabo abasanda kufunda esihlokweni sokumodela futhi abangenaso isipiliyoni somtholampilo sangaphambilini ngekhono/isihloko [49].Ukucela abahlanganyeli ukuthi bachaze kafushane icala elilingiswayo futhi benze izincomo zokuxilonga kuzosiza umsizi wokufundisa aqinisekise ukuthi abafundi eqenjini banokuqonda okuyisisekelo nokujwayelekile kwecala ngaphambi kokudlulela esigabeni sokuhlaziya/sokuzindla okwandisiwe.Ukwengeza, ukumema ababambiqhaza kulesi sigaba ukuthi babelane ngemizwa yabo ezimeni ezilingiswayo kuzobasiza banqobe ukucindezeleka ngokomzwelo kwalesi simo, ngaleyo ndlela kuthuthukise ukufunda [24, 36].Ukubhekana nezindaba ezithinta imizwa kuzosiza futhi umsizi we-RLC ukuthi aqonde ukuthi imizwa yabahlanganyeli ithinta kanjani ukusebenza komuntu ngamunye neqembu, futhi lokhu kungaxoxwa ngakho ngokujulile phakathi nesigaba sokuzindla/sokuhlaziya.Indlela ye-Plus/Delta yakhelwe kulesi sigaba semodeli njengesinyathelo sokulungiselela nesiwujuqu sesigaba sokuzindla/sokuhlaziya [46].Ngokusebenzisa indlela ye-Plus/Delta, bobabili ababambiqhaza nabafundi bangacubungula/babhale ohlwini abakubonile, imizwa kanye nokuhlangenwe nakho kwabo kokulingisa, okungabe sekuxoxwa ngakho iphuzu nephuzu phakathi nesigaba sokuzindla/sokuhlaziya semodeli [46].Lokhu kuzosiza ababambiqhaza ukuthi bafinyelele isimo se-metacognitive ngokusebenzisa amathuba okufunda ahlosiwe futhi abekwe kuqala ukuze kuthuthukiswe ukucabanga komtholampilo [24, 48, 49].Izimpendulo ezimele ezilandelayo ezivela eqenjini elisebenzayo lokuklama zicatshangelwe ngesikhathi sokuthuthukiswa kokuqala kwemodeli ye-RLC.Umhlanganyeli 2: “Ngicabanga ukuthi njengesiguli esake sangeniswa e-ICU, sidinga ukucabangela imizwa nemizwelo yabafundi abalingiswa.Ngiphakamisa lolu daba ngoba ngesikhathi sokungeniswa kwami ngibone amazinga aphezulu okucindezeleka nokukhathazeka, ikakhulukazi phakathi kwabasebenzi bokunakekelwa okubucayi.kanye nezimo eziphuthumayo.Le modeli kufanele icabangele ingcindezi nemizwelo ehambisana nokulingisa isipiliyoni.”Umhlanganyeli 16: “Kimina njengothisha, ngikuthola kubaluleke kakhulu ukusebenzisa indlela ye-Plus/Delta ukuze abafundi bakhuthazwe ukuthi babambe iqhaza ngokukhuthele ngokubalula izinto ezinhle nezidingo abahlangabezane nazo ngesikhathi sokulingisa.Izindawo okumele zithuthukiswe.”
Nakuba izigaba zangaphambilini zemodeli zibucayi, isigaba sokuhlaziya / sokubonisa sibaluleke kakhulu ekufezeni ukuthuthukiswa kokucabanga komtholampilo.Iklanyelwe ukuhlinzeka ngokuhlaziywa okuthuthukile/ukuhlanganiswa kanye nokuhlaziya okujulile okusekelwe kokuhlangenwe nakho komtholampilo, amakhono, nomthelela wezihloko ezimodeliwe;Inqubo nesakhiwo se-RLC;inani lolwazi olunikeziwe ukugwema ukugcwala kwengqondo;ukusetshenziswa ngempumelelo kwemibuzo yokuzindla.izindlela zokuzuza ukufunda okugxile kumfundi kanye nokufunda ngenkuthalo.Kuleli qophelo, ulwazi lomtholampilo kanye nokujwayelana nezihloko zokulingisa kuhlukaniswe izingxenye ezintathu ukuze kuhlangatshezwane namazinga ahlukene esipiliyoni nekhono: okokuqala: akukho okuhlangenwe nakho kochwepheshe bezokwelapha kwangaphambilini/akukho ukuchayeka kwangaphambilini ezihlokweni zokulingisa, okwesibili: ulwazi lwezokwelapha, ulwazi kanye namakhono/ akukho.ukuchayeka kwangaphambilini ezihlokweni zokumodela.Okwesithathu: Isipiliyoni somtholampilo, ulwazi namakhono.Ukuchayeka kochwepheshe/kwangaphambilini ezihlokweni zokumodela.Ukuhlukaniswa kwenziwa ukuze kuhlangatshezwane nezidingo zabantu abanolwazi oluhlukene kanye namazinga ekhono ngaphakathi kweqembu elifanayo, ngaleyo ndlela kulinganisa ukuthambekela kodokotela abanolwazi oluncane lokusebenzisa ukucabanga kokuhlaziya nokuthambekela kodokotela abanolwazi oluthe xaxa ekusebenziseni amakhono okucabanga angahlaziyli [19, 20, 34]., 37].Inqubo ye-RLC yahlelwa ngokuzungeza umjikelezo wokucabanga womtholampilo [10], uhlaka lokubonisa imodeli [47], kanye nethiyori yokufunda okuhlangenwe nakho [50].Lokhu kufezwa ngezinqubo eziningi: ukuhumusha, ukuhlukanisa, ukuxhumana, ukucabangela kanye nokuhlanganisa.
Ukuze kugwenywe ukuchichima kwengqondo, ukukhuthaza inqubo yokukhuluma egxile kumfundi kanye nesikhathi esanele kanye namathuba okuba ababambiqhaza bazindle, bahlaziye, bahlanganise ukuze bathole ukuzethemba.Izinqubo zokuqonda ngesikhathi se-RLC zisingathwa ngokuhlanganisa, ukuqinisekiswa, ukubumba, kanye nezinqubo zokuhlanganisa ngokusekelwe kuhlaka lwe-double-loop [37] kanye nethiyori yomthwalo wokuqonda [48].Ukuba nenqubo yenkhulumomphendvulwano ehlelekile nokuvumela isikhathi esanele sokuzindla, kucatshangelwa abahlanganyeli abanolwazi nabangenalwazi, kuzonciphisa ingcuphe engase ibe khona yomthwalo wokuqonda, ikakhulukazi ekufanisweni okuyinkimbinkimbi okunokuhlangenwe nakho okuhlukahlukene kwangaphambilini, ukuchayeka kanye namazinga wamandla ababambiqhaza.Ngemva kwesigameko.Indlela yemodeli yokubuza imibuzo isekelwe kumodeli ye-taxonomic ka-Bloom [51] nezindlela zokubuza ngokwazisa (AI) [45], lapho umsizi oyimodeli esondela esihlokweni ngendlela yesinyathelo nesinyathelo, ye-Socrates, ne-reflection.Buza imibuzo, uqale ngemibuzo esekelwe olwazini.kanye nokubhekana namakhono nezindaba ezihlobene nokucabanga.Le nqubo yokubuza izothuthukisa ukuthuthukiswa kokucabanga komtholampilo ngokukhuthaza ukuhlanganyela okukhuthele kanye nokucabanga okuthuthukayo okunengozi encane yokugcwala kwengqondo.Izimpendulo ezimele ezilandelayo ezivela eqenjini elisebenzayo le-co-design zicatshangelwe ngesikhathi sokuhlaziya/isigaba sokubonisa sokuthuthukiswa kwemodeli ye-RLC.Umhlanganyeli 13: “Ukuze sigweme ukuchichima kwengqondo, sidinga ukucabangela inani nokugeleza kolwazi lapho sihlanganyela ezingxoxweni zokufunda ngemva kokulingisa, futhi ukwenza lokhu, ngicabanga ukuthi kubalulekile ukunikeza abafundi isikhathi esanele sokuzindla futhi siqale ngezinto eziyisisekelo. .Ulwazi.iqala izingxoxo namakhono, bese idlulela emazingeni aphezulu olwazi namakhono ukuze kuzuzwe ukuqondana. "Umbambiqhaza wesi-9: “Ngikholelwa ngokuqinile ukuthi izindlela zokubuza kusetshenziswa amasu e-Appreciative Inquiry (AI) kanye nemibuzo ecabangisisayo kusetshenziswa imodeli ye-Bloom's Taxonomy kuzothuthukisa ukufunda okusebenzayo kanye nokugxila komfundi kuyilapho kunciphisa amathuba okuba nengcuphe yokugcwala kwengqondo.”Isigaba sokudingida semodeli sihlose ukufingqa amaphuzu okufunda aphakanyiswe ngesikhathi se-RLC nokuqinisekisa ukuthi izinjongo zokufunda ziyafezeka.Umhlanganyeli 8: “Kubaluleke kakhulu ukuthi bobabili umfundi nomsizi bavumelane ngemibono esemqoka ebaluleke kakhulu kanye nezici ezibalulekile okufanele zicatshangelwe lapho kwenziwa ukwenza.”
Ukugunyazwa kwezimiso zokuziphatha kutholwe ngaphansi kwezinombolo zephrothokholi (MRC-01-22-117) kanye (HSK/PGR/UH/04728).Imodeli ihlolwe ezifundweni ezintathu zokulingisa ukunakekelwa okujulile kochwepheshe ukuze kuhlolwe ukusebenziseka nokusebenza kwemodeli.Ukufaneleka kobuso bemodeli kuye kwahlolwa iqembu elisebenzayo le-co-design (N = 18) kanye nochwepheshe bezemfundo abasebenza njengabaqondisi bezemfundo (N = 6) ukuze balungise izinkinga ezihlobene nokubukeka, uhlelo lolimi, nenqubo.Ngemuva kokuqinisekiswa kobuso, ukufaneleka kokuqukethwe kwanqunywa othisha abahlengikazi abakhulu (N = 6) abagunyazwe yi-American Nurses Credentialing Center (ANCC) futhi basebenza njengabahleli bezemfundo, kanye (N = 6) ababeneminyaka engaphezu kwe-10 yemfundo futhi isipiliyoni sokufundisa.Isipiliyoni Somsebenzi Ukuhlola kwenziwe ngabaqondisi bezemfundo (N = 6).Isipiliyoni sokumodela.Ukufaneleka kokuqukethwe kunqunywe kusetshenziswa i-Content Validity Ratio (CVR) kanye ne-Content Validity Index (CVI).Indlela ye-Lawshe [52] yasetshenziswa ukulinganisa i-CVI, futhi indlela ka-Waltz no-Bausell [53] yasetshenziswa ukuze kulinganiswe i-CVR.Amaphrojekthi e-CVR ayadingeka, awusizo, kodwa awadingeki noma uyazikhethela.I-CVI ithola amaphuzu esikalini samaphuzu amane ngokusekelwe ekuhlobaneni, ebulula, nasekucaceni, ngo-1 = akubalulekile, 2 = kufanelekile, 3 = kufanelekile, futhi 4 = kufanelekile kakhulu.Ngemva kokuqinisekisa ukuthi ubuso nokuqukethwe kuyiqiniso yini, ngaphezu kwemihlangano yokucobelelana ngolwazi eyenziwayo, amaseshini okujwayela nokuqondisisa aqhutshelwa othisha abazosebenzisa imodeli.
Iqembu lomsebenzi lakwazi ukuthuthukisa nokuhlola imodeli ye-RLC ye-post-simulation ukuze kuthuthukiswe amakhono okucabanga emtholampilo ngesikhathi sokuhlanganyela ku-SBE ezinyunithi zokunakekelwa okujulile (Izibalo 1, 2, kanye ne-3).CVR = 1.00, CVI = 1.00, ebonisa ubuso obufanele nokufaneleka kokuqukethwe [52, 53].
Imodeli yenzelwe iqembu le-SBE, lapho kusetshenziswa izimo ezithokozisayo neziyinselele kubahlanganyeli abanamazinga afanayo noma ahlukene okuhlangenwe nakho, ulwazi kanye nobukhulu.Imodeli yomqondo ye-RLC yathuthukiswa ngokuvumelana nezindinganiso zokuhlaziya ukulingisa indiza ye-INACSL [36] futhi igxile kumfundi futhi izichaza ngokwayo, okuhlanganisa izibonelo ezisetshenziwe (Izibalo 1, 2 kanye no-3).Imodeli yathuthukiswa ngenhloso futhi yahlukaniswa yaba izigaba ezine ukuze ihlangabezane nezindinganiso zokumodela: iqala ngokwazisa, ilandelwe ukuhlaziya okucabangelayo/ukuhlanganiswa, futhi igcine ngolwazi nesifinyezo.Ukuze ugweme ingozi engaba khona yokugcwala kwengqondo, isigaba ngasinye semodeli siklanywe ngamabomu njengemfuneko yesigaba esilandelayo [34].
Umthelela wezikhundla eziphezulu kanye nezici zokuvumelana kweqembu ekubambeni iqhaza ku-RLC akuzange kufundwe ngaphambili [38].Kucatshangelwa imiqondo engokoqobo ye-double loop kanye nethiyori yokulayisha ngokweqile kwengqondo ekusetshenzisweni kokulingisa [34, 37], kubalulekile ukucabangela ukuthi ukubamba iqhaza eqenjini le-SBE elinolwazi oluhlukene kanye namazinga ekhono abahlanganyeli eqenjini elifanayo lokulingisa kuyinselele.Ukunganakwa kwevolumu yolwazi, ukugeleza kanye nesakhiwo sokufunda, kanye nokusetshenziswa ngesikhathi esisodwa kwezinqubo zokuqonda ezisheshayo nezinensayo yibo bobabili abafundi basesikoleni esiphakeme kanye nabafundi besikole samabanga aphakeme abancane kubeka engcupheni engaba khona yokugcwala kwengqondo [18, 38, 46].Lezi zici zacatshangelwa lapho kuthuthukiswa imodeli ye-RLC ukuze kugwenywe ukucabanga okungathuthukisiwe kanye/noma okungafaneleki komtholampilo [18, 38].Kubalulekile ukucabangela ukuthi ukwenza i-RLC enamazinga ahlukene aphezulu kanye nekhono kubangela umphumela wokubusa phakathi kwabahlanganyeli abadala.Lokhu kwenzeka ngoba ababambiqhaza abathuthukile bavame ukugwema ukufunda imiqondo eyisisekelo, okubalulekile kubahlanganyeli abasebasha ukuze bathole ukuqonda nokungena ezinqubweni zokucabanga nezinga eliphezulu [38, 47].Imodeli ye-RLC yakhelwe ukubandakanya abahlengikazi abadala nabancane ngokubuza ngokwazisa nangendlela ye-delta [45, 46, 51].Kusetshenziswa lezi zindlela, imibono yabahlanganyeli abaphezulu nabancane abanamakhono ahlukahlukene kanye namazinga okuhlangenwe nakho izokwethulwa into ngayinye futhi kuxoxwe ngokucabangisisa ngayo umongameli wengxoxo kanye nabalingani bomengameli [45, 51].Ngokungeziwe embonweni wabahlanganyeli bokulingisa, umsizi wengxoxo wengeza okokufaka kwakhe ukuze aqinisekise ukuthi konke okubukiwe okuqoqiwe kuhlanganisa ngokugcwele umzuzu ngamunye wokufunda, ngaleyo ndlela kuthuthukiswe ukuqonda ukuze kuthuthukiswe ukucabanga komtholampilo [10].
Ukugeleza kolwazi nesakhiwo sokufunda kusetshenziswa imodeli ye-RLC kubhekwana nayo ngenqubo ehlelekile nenezinyathelo eziningi.Lokhu kwenzelwa ukusiza abagqugquzeli abadingida izindaba nokuqinisekisa ukuthi umhlanganyeli ngamunye ukhuluma ngokucacile nangokuzethemba esigabeni ngasinye ngaphambi kokudlulela esigabeni esilandelayo.Umongameli uzokwazi ukuqalisa izingxoxo zokubonisa lapho bonke abahlanganyeli behlanganyela khona, futhi afinyelele eqophelweni lapho ababambiqhaza bamazinga ahlukahlukene aphezulu nekhono bevumelana ngezinqubo ezingcono kakhulu zephuzu ngalinye lengxoxo ngaphambi kokudlulela kwelilandelayo [38].Ukusebenzisa le ndlela kuzosiza ababambiqhaza abanolwazi nabanekhono babelane ngeminikelo yabo/abakubhekile, kuyilapho iminikelo/okuphawulwe abahlanganyeli abanolwazi oluncane nabanekhono kuzohlolwa futhi kuxoxwe ngakho [38].Nokho, ukufeza lo mgomo, abagqugquzeli kuzodingeka babhekane nenselele yokulinganisa izingxoxo kanye nokuhlinzeka ngamathuba alinganayo kubahlanganyeli abadala nabancane.Kuze kube manje, indlela yenhlolovo eyimodeli yenziwa ngamabomu kusetshenziswa imodeli ye-taxonomic ye-Bloom, ehlanganisa inhlolovo yokuhlola kanye nendlela yokwengeza/ye-delta [45, 46, 51].Ukusebenzisa lezi zindlela zokufundisa nokuqala ngolwazi nokuqonda imibuzo egxilile/izingxoxo zokuzindla kuzokhuthaza ababambiqhaza abanolwazi oluncane ukuba babambe iqhaza futhi babambe iqhaza ngenkuthalo engxoxweni, emva kwalokho umsizi kancane kancane ayodlulela ezingeni eliphezulu lokuhlola kanye nokuhlanganisa imibuzo/izingxoxo. lapho womabili amaqembu kufanele anikeze abadala nabancane ababambiqhaza ithuba elilinganayo lokubamba iqhaza ngokusekelwe kokuhlangenwe nakho kwabo kwangaphambilini nolwazi ngamakhono omtholampilo noma izimo ezilingiswayo.Le ndlela izosiza abahlanganyeli abanolwazi oluncane ukuba babambe iqhaza futhi bazuze ekuhlangenwe nakho okwabiwe abahlanganyeli abanolwazi oluthe xaxa kanye nemibono yomgqugquzeli wezingxoxo.Ngakolunye uhlangothi, imodeli yakhelwe hhayi kuphela ama-SBE anamakhono ahlukene ababambiqhaza namazinga esipiliyoni, kodwa futhi nabahlanganyeli beqembu le-SBE abanolwazi olufanayo namazinga ekhono.Imodeli yayiklanyelwe ukusiza ukunyakaza okushelelayo nokuhlelekile kweqembu kusukela ekugxileni olwazini nasekuqondeni kuya ekugxileni ekuhlanganiseni nasekuhloleni ukuze kuzuzwe imigomo yokufunda.Isakhiwo nezinqubo zemodeli yakhelwe ukufanela amaqembu wokumodela amakhono ahlukene nalinganayo namazinga esipiliyoni.
Ukwengeza, nakuba i-SBE ekunakekelweni kwezempilo ngokuhlanganiswa ne-RLC isetshenziselwa ukuthuthukisa ukucabanga komtholampilo kanye nekhono kubasebenzi [22,30,38], nokho, izici ezifanele kufanele zicatshangelwe ezihlobene nobunzima becala kanye nezingozi ezingase zibe khona zokugcwala kwengqondo, ikakhulukazi. lapho Ababambiqhaza behileleka izimo ze-SBE ezilingisa iziguli eziyinkimbinkimbi kakhulu, ezigula kakhulu ezidinga ukungenelela ngokushesha kanye nokuthatha izinqumo ezibucayi [2,18,37,38,47,48].Kulokhu, kubalulekile ukucabangela ukuthambekela kwabo bobabili ababambiqhaza abanolwazi nabancane ekushintsheni ngesikhathi esisodwa phakathi kwezinhlelo zokucabanga ezihlaziywayo nezingezona ukuhlaziya lapho bebambe iqhaza ku-SBE, kanye nokusungula indlela esekelwe ebufakazini evumela kokubili abadala nabancane. abafundi ukuthi babambe iqhaza ngenkuthalo ohlelweni lokufunda.Ngakho, imodeli yaklanywa ngendlela yokuthi, kungakhathaliseki inkimbinkimbi yecala elifanisiwe elethulwa, umgqugquzeli kufanele aqinisekise ukuthi izici zolwazi nokuqonda kwasemuva kwabo bobabili ababambiqhaza abaphezulu nabancane ziyahlanganiswa kuqala bese kancane kancane zithuthukiswa lula ukuhlaziya.synthesis nokuqonda.isici sokuhlola.Lokhu kuzosiza abafundi abancane bakhe futhi bahlanganise abakufundile, futhi kusize abafundi abadala ukuthi bahlanganise futhi bathuthukise ulwazi olusha.Lokhu kuzohlangabezana nezidingo zenqubo yokucabanga, kucatshangelwa ulwazi lwangaphambili kanye namakhono ombambiqhaza ngamunye, futhi kube nefomethi evamile ebhekana nokuthambekela kwabafundi besikole samabanga aphezulu nabancane ukuhamba ngesikhathi esisodwa phakathi kwezinhlelo zokucabanga ezihlaziywayo nezingacabangi, ngaleyo ndlela. ukuqinisekisa ukwenziwa kahle kokucabanga komtholampilo.
Ukwengeza, abagqugquzeli bokulingisa/abadingida bangase babe nobunzima bokufunda amakhono okulingisa okulingisa.Ukusetshenziswa kwemibhalo ye-cognitive debriefing kukholakala ukuthi kuphumelela ekuthuthukiseni ukutholwa kolwazi namakhono okuziphatha abagqugquzeli uma kuqhathaniswa nalabo abangasebenzisi imibhalo [54].Izimo ziyithuluzi lokuqonda elingakwazi ukusiza umsebenzi wokumodela wothisha futhi lithuthukise amakhono okuxoxa, ikakhulukazi kothisha abasahlanganisa ulwazi lwabo lokuxoxa [55].finyelela ukusebenziseka okukhulu futhi uthuthukise amamodeli asebenziseka kalula.(Umfanekiso 2 kanye nomfanekiso 3).
Ukuhlanganiswa okuhambisanayo kwe-plus/delta, inhlolovo yokwazisa, kanye nezindlela zenhlolovo ye-Bloom's Taxonomy akukabhekwana nayo ekuhlaziyeni okutholakalayo kwamanje kokulingisa namamodeli aqondisiwe aqondisiwe.Ukuhlanganiswa kwalezi zindlela kugqamisa ukusungulwa kwemodeli ye-RLC, lapho lezi zindlela zihlanganiswa ngefomethi eyodwa ukuze kuzuzwe ukuthuthukiswa kokucabanga komtholampilo kanye nokugxila komfundi.Othisha bezokwelapha bangase bazuze eqenjini lokumodela le-SBE lisebenzisa imodeli ye-RLC ukuze bathuthukise futhi bathuthukise amakhono ababambiqhaza okucabanga ngomtholampilo.Izimo zale modeli zingasiza othisha babe yingcweti enqubweni yokubonisana futhi baqinise amakhono abo ukuze babe abagqugquzeli bezingxoxo abazethembayo nabanekhono.
I-SBE ingafaka izindlela nezindlela eziningi ezihlukene, okuhlanganisa kodwa kungagcini nje nge-SBE esekelwe ku-mannequin, izilingisi zemisebenzi, izilingisi zesiguli, iziguli ezijwayelekile, okungokoqobo okubonakalayo kanye ne-augmented.Uma kucatshangelwa ukuthi ukubika kungenye yezindlela zokumodela ezibalulekile, imodeli elingisiwe ye-RLC ingasetshenziswa njengemodeli yokubika lapho kusetshenziswa lezi zindlela.Ngaphezu kwalokho, nakuba imodeli yenzelwe isiyalo sabahlengikazi, inamandla okusetshenziswa ku-SBE yokunakekelwa kwezempilo kwe-interprofessional, igqamisa isidingo sezinhlelo zocwaningo zesikhathi esizayo zokuhlola imodeli ye-RLC yemfundo yochwepheshe.
Ukuthuthukiswa nokuhlolwa kwemodeli ye-RLC ye-post-simulation yokunakekelwa kwabahlengikazi kumayunithi okunakekela kakhulu e-SBE.Ukuhlola/ukuqinisekiswa kwesikhathi esizayo kwemodeli kunconywa ukwandisa ukugcwaliseka kwemodeli ukuze kusetshenziswe kwezinye iziyalo zokunakekelwa kwezempilo kanye ne-interprofessional SBE.
Imodeli yasungulwa yiqembu elisebenzayo elihlangene elisekelwe kumbono kanye nomqondo.Ukuze kuthuthukiswe ukufaneleka nokugcwaliseka kwemodeli, ukusetshenziswa kwezinyathelo zokwethembeka ezithuthukisiwe zezifundo zokuqhathanisa kungase kucatshangelwe esikhathini esizayo.
Ukuze kuncishiswe amaphutha okuzijwayeza, odokotela kumele babe namakhono asebenzayo okucabanga emtholampilo ukuze kuqinisekiswe ukuthathwa kwezinqumo zomtholampilo eziphephile nezifanele.Ukusebenzisa i-SBE RLC njengendlela yokuxoxisana kukhuthaza ukuthuthukiswa kolwazi namakhono asebenzayo adingekayo ukuthuthukisa ukucabanga komtholampilo.Kodwa-ke, imvelo ye-multidimensional yokucabanga komtholampilo, ehlobene nolwazi lwangaphambili kanye nokuchayeka, izinguquko emandleni, umthamo kanye nokugeleza kolwazi, kanye nezimo eziyinkimbinkimbi zokulingisa, zigqamisa ukubaluleka kokuthuthukisa amamodeli e-RLC angemuva kokulingisa lapho ukucabanga komtholampilo kungaba khona ngenkuthalo. futhi isetshenziswe ngempumelelo.amakhono.Ukungazinaki lezi zici kungase kuphumele ekucabangeni komtholampilo okungathuthukisiwe futhi okungafaneleki.Imodeli ye-RLC yenzelwe ukubhekana nalezi zici ukuze kuthuthukiswe ukucabanga komtholampilo lapho ubamba iqhaza emisebenzini yokulingisa iqembu.Ukuze kuzuzwe lo mgomo, imodeli kanyekanye ihlanganisa imibuzo yokuhlola yokuhlanganisa/nokususa kanye nokusetshenziswa kwe-taxonomy ye-Bloom.
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Isikhathi sokuthumela: Jan-08-2024