Browsing by Author "Palkkimäki, Susanna"
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Palkkimäki, Susanna (2015)This thesis analyzed interaction and learning in simulation debriefing. Simulation usage has increased in the social and health care during the last years, and the new technology has given more opportunities to use high-fidelity simulations more widely. Simulations enable a new way for students to learn different kinds of patient situations in the real life and in work-based environments that are still completely safe. The investments are expensive and create discussion in universities whether these simulations can create the learning they are supposed to create. The research focused on simulation debriefing is an essential phase in simulation learning. The research approach drew on adults learning theories as well as on simulation and debriefing research. The approach is based on socio-constructivist understanding on learning and on studentcentered teaching (Engeström 1982; Miettinen 1993), which represents criticism towards traditional classroom teaching and introduces the concept of learning activity. From these theoretical starting points emerged three key learning concepts, interaction, feedback and reflection. The research questions were: 1. How is the interaction of the debriefing constructed? 2. What kind of feedback by peer students and by the instructors and 3. what kind of reflection takes place during the debriefing? The data was collected from one simulation center's simulation day in the Southern Finland University of Applied Sciences. The data includes one simulation group's (9 students and 2 instructors) all five videotaped debriefing situations. The analysis was both data and learning theory driven, and both qualitative and quantitative research methods were applied. The results indicate that debriefings interaction was led by the instructors, and was based on a question–answer dynamics. The analysis found three different kinds of peer feedback types, four instructors' feedback types and five self-reflection types. Both the peer and instructor feedback were mostly positive encouragement. Students' self-reflection was mostly reflecting on the confusion caused by the simulation. . Clinical skills were emphasized in both feedback and self-reflection. It can be concluded that debriefing's script and the way it is used leads and restricts the interaction. The script should be developed to be more dialogical. Especially the form and meaning of peer feedback should be critically considered. The peer feedback remained quite superficial, whereas instructors' feedback has a clear impact on students' constructive self-reflection. The instructors' cultivation of constructive criticism would best enhance the students' learning.
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