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      Different ways to present clinical cases in a classroom: video projection versus live representation of a simulated clinical scene with actors

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          Abstract

          Background

          Use of the video digital format in the classroom is a common way to present clinical cases to stimulate discussion and increase learning. A simulated live performance with actors, also in the classroom, could be an alternative way to present cases that may be more attractive to arouse students’ interest and attention. The aim of the present study was to compare the learning process between a group of students who saw a clinical case as a simulated live scene in the classroom and others seeing the same clinical case projected by video.

          Method

          One hundred and thirty-one students (69 from physiotherapy and 62 from medicine) attended an interactive seminar on delirium in older people. Each group was subdivided into two groups: one saw the clinical case as a theatrical performance in the classroom (scene group; n = 68), while the other saw the same case projected on video (video group; n = 63). Before and after attending the seminar, students answered a questionnaire [four questions on theoretical knowledge of delirium (score 0–7) and two on subjective learning perception (linear scale: 0–10) (score 0–20)]. At the end, a further question was included on the usefulness of the scene or a video in the learning process (linear scale: 0–10).

          Results

          Students in both groups (live scene and video) significantly improved in all questionnaire scores after the seminar ( p = 0.001) with a large Effect Size (ES > 0.80). Students of the scene group obtained higher scores on theoretical delirium knowledge [6.41 ± 0.73 vs 5.93 ± 1.31 ( p = 0.05)], subjective learning perception questions (what they thought they knew about delirium) (16.28 ± 3.51 versus 15.92 ± 2.47 ( p = 0.072)], and the overall questionnaire (22.45 ± 4.15 versus 21.48 ± 2.94 ( p = 0.027)] than the video group. Students of the scene group opined that live scene was very useful for learning with a mean score of 9.04 ± 1.16 (range 0–10), and opinion in the student’s video group scored 8.21 ± 1.22 ( p = 0.001).

          Conclusions

          All students improved significantly their knowledge but those who saw the theatrical performance obtained slightly better results, which suggest that this form of clinical case presentation in the classroom may be an alternative at least as effective as traditional video projections.

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          Most cited references12

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          Observer roles that optimise learning in healthcare simulation education: a systematic review

          Background Simulation is widely used in health professional education. The convention that learners are actively involved may limit access to this educational method. The aim of this paper is to review the evidence for learning methods that employ directed observation as an alternative to hands-on participation in scenario-based simulation training. We sought studies that included either direct comparison of the learning outcomes of observers with those of active participants or identified factors important for the engagement of observers in simulation. We systematically searched health and education databases and reviewed journals and bibliographies for studies investigating or referring to observer roles in simulation using mannequins, simulated patients or role play simulations. A quality framework was used to rate the studies. Methods We sought studies that included either direct comparison of the learning outcomes of observers with those of active participants or identified factors important for the engagement of observers in simulation. We systematically searched health and education databases and reviewed journals and bibliographies for studies investigating or referring to observer roles in simulation using mannequins, simulated patients or role play simulations. A quality framework was used to rate the studies. Results Nine studies met the inclusion criteria. Five studies suggest learning outcomes in observer roles are as good or better than hands-on roles in simulation. Four studies document learner satisfaction in observer roles. Five studies used a tool to guide observers. Eight studies involved observers in the debrief. Learning and satisfaction in observer roles is closely associated with observer tools, learner engagement, role clarity and contribution to the debrief. Learners that valued observer roles described them as affording an overarching view, examination of details from a distance, and meaningful feedback during the debrief. Learners who did not value observer roles described them as passive, or boring when compared to hands-on engagement in the simulation encounter. Conclusions Learning outcomes and role satisfaction for observers is improved through learner engagement and the use of observer tools. The value that students attach to observer roles appear contingent on role clarity, use of observer tools, and inclusion of observers’ perspectives in the debrief.
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            Vicarious learning: a review of the literature.

            Experiential learning theory stresses the primacy of personal experience and the literature suggests that direct clinical experience is required in order for learning to take place. However, raw or first hand experience may not be the only mechanisms by which students engage in experiential learning. There is a growing body of literature within higher education which suggests that students are able to use another's experience to learn: vicarious learning. This literature review aims to outline vicarious learning within a nursing context. Many of the studies regarding vicarious learning are situated within Higher Education in general, however, within the United States these relate more specifically to nursing students. The literature indicates the increasing global interest in this area. This paper reveals that whilst the literature offers a number of examples illustrating how vicarious learning takes place, opinion on the role of the lecturer is divided and requires further exploration and clarification. The implications for nurse education are discussed.
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              A picture is worth a thousand words: practical use of videotape in teaching.

              Videotapes, through vividly displayed clinical images and teaching interactions, are valuable tools for both learners and teachers. Visual images in combination with verbal instruction have been shown to significantly increase recall and retention. Many clinicians and medical teachers are aware of videotape resources, but have not had a chance to develop their use in medical education. In this paper, we discuss creative applications of videotapes in three major categories: presenting information, triggering discussion, and as a tool for direct self-observation and feedback. Videotapes may be valuable for presenting information in settings of didactic instruction; for triggering discussion during teaching workshops; and for self-observation of patient-doctor interactions and learner-teacher encounters. The article presents learner-centered approaches to review a videotaped clinical encounter in order to enhance value and comfort for the learner and teacher. Sources of tapes include on-site videotaping, published educational tapes and commercial tapes shown in accordance with fair use guidelines, examples of which are referenced. Videotapes add another dimension to traditional sources of physician education.
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                Author and article information

                Contributors
                91737@parcdesalutmar.cat
                Ramon.Miralles@uab.es
                AEsperanza@parcdesalutmar.cat
                18968@parcdesalutmar.cat
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                4 March 2019
                4 March 2019
                2019
                : 19
                : 70
                Affiliations
                [1 ]Geriatric Department Consorcio Parc de Salut Mar de Barcelona, Paseo Marítimo, 25-29, 08003 Barcelona, Spain
                [2 ]GRID grid.7080.f, Faculty of Medicine, , Universidad Autónoma de Barcelona, ; Barcelona, Spain
                [3 ]Department of Nursing, Consorcio Parc de Salut Mar de Barcelona, Barcelona, Spain
                Article
                1494
                10.1186/s12909-019-1494-1
                6399977
                30832709
                adecda85-a103-451c-8df4-b486a1c09d7c
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 December 2018
                : 13 February 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Education
                Education

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