Varapi vanofanira kuva nehunyanzvi hwekufunga nezvekiriniki hunoshanda kuti vaite sarudzo dzakakodzera uye dzakachengeteka dzekiriniki uye vadzivise zvikanganiso zvekudzidzira. Unyanzvi hwekufunga nezvekiriniki husina kukura zvakanaka hunogona kukanganisa kuchengetedzeka kwemurwere uye kunonoka kurapwa kana kurapwa, kunyanya muzvipatara zvakanyanya uye mumadhipatimendi ekukurumidza. Kudzidziswa kwakavakirwa pakuenzanisa kunoshandisa hurukuro dzekudzidza dzinofungisisa mushure mekuenzanisa senzira yekutsanangura kuti vagadzire hunyanzvi hwekufunga nezvekiriniki uku vachichengetedza kuchengetedzeka kwemurwere. Zvisinei, nekuda kwehunhu hwakawanda hwekufunga nezvekiriniki, njodzi inogona kuitika yekuwedzeredza pfungwa, uye kushandiswa kwakasiyana kwemaitiro ekuongorora (hypothetico-deductive) uye asiri ekuongorora (intuitive) ekurapa nevatori vechikamu vepamusoro nevechidiki vekuenzanisa, zvakakosha kufunga nezveruzivo, kugona, zvinhu zvine chekuita nekuyerera uye huwandu hweruzivo, uye kuoma kwenyaya kuti tigadzirise kufunga kwekiriniki nekuita hurukuro dzekudzidza dzeboka mushure mekuenzanisa senzira yekutsanangura. Chinangwa chedu ndechekutsanangura kugadzirwa kwemuenzaniso wehurukuro yekudzidza yekufungisisa mushure mekuenzanisa inofunga zvinhu zvakawanda zvinopesvedzera kubudirira kwekugadzirisa kufunga kwekiriniki.
Boka revashandi vekugadzira pamwe chete (N = 18), rine vanachiremba, vanamukoti, vaongorori, vadzidzisi, nevamiriri vevarwere, vakashanda pamwe chete kuburikidza nemaworkshop akatevedzana kuti vagadzire pamwe chete modhi yekukurukurirana yekudzidza mushure mekufananidzira kuti vatsanangure kutevedzera. Boka revashandi vekugadzira pamwe chete rakagadzira modhi kuburikidza nemaitiro edzidziso uye epfungwa uye ongororo yevana vechikamu vakawanda. Kubatanidzwa kwakafanana kwekutsvaga kwekuongorora kwe plus/minus uye taxonomy yaBloom kunofungidzirwa kuti kunogadzirisa kufunga kwekiriniki kwevatori vechikamu vekuenzanisa uku vachitora chikamu muzviitiko zvekufananidzira. Nzira dzeContent validation index (CVI) uye content validation ratio (CVR) dzakashandiswa kusimbisa kuvimbika kwechiso uye kuvimbika kwezviri mukati memodhi.
Modhi yekukurukurirana yekudzidza mushure mekufananidzira yakagadzirwa uye yakaedzwa. Modhi iyi inotsigirwa nemienzaniso yakashanda uye gwara rekunyora. Kuonekwa uye chokwadi chemodhi iyi zvakaongororwa uye zvakasimbiswa.
Modhi itsva yekugadzira pamwe chete yakagadzirwa tichifunga nezvehunyanzvi nehunyanzvi hwevatori vechikamu vakasiyana-siyana vemuenzaniso, kufambiswa kweruzivo uye huwandu hweruzivo, uye kuoma kwezviitiko zvemuenzaniso. Zvinhu izvi zvinofungidzirwa kuti zvinovandudza kufunga kwekiriniki pakutora chikamu muzviitiko zvekuenzanisa kweboka.
Kufunga kwekiriniki kunoonekwa sehwaro hwekuita kwekiriniki muhutano [1, 2] uye chinhu chakakosha chehunyanzvi hwekiriniki [1, 3, 4]. Inzira yekufungisisa inoshandiswa nevarapi kuona nekushandisa nzira yakakodzera yekurapa yega yega yavanosangana nayo [5, 6]. Kufunga kwekiriniki kunotsanangurwa senzira yakaoma yekufunga inoshandisa nzira dzekufunga dzakarongeka uye dzisina kurongeka kuunganidza nekuongorora ruzivo nezvemurwere, kuongorora kukosha kweruzivo irworwo, uye kuona kukosha kwenzira dzakasiyana dzekuita [7, 8]. Zvinoenderana nekukwanisa kuunganidza zviratidzo, kugadzirisa ruzivo, uye kunzwisisa dambudziko remurwere kuitira kuti atore matanho akakodzera murwere akakodzera panguva yakakodzera uye nechikonzero chakakodzera [9, 10].
Vese vanopa hutano vanotarisana nekudiwa kwekuita sarudzo dzakaoma mumamiriro ezvinhu asina chokwadi [11]. Mukurapa kwakakosha uye kurapwa kwekukurumidzira, mamiriro ezvinhu ekiriniki uye emergency anoitika apo mhinduro nekupindira nekukurumidza zvakakosha mukuponesa hupenyu uye kuve nechokwadi chekuchengetedzwa kwemurwere [12]. Unyanzvi husina kunaka hwekufunga nezvekiriniki uye kugona mukurapa kwakakosha zvine chekuita nehuwandu hwakakwira hwekukanganisa kwekiriniki, kunonoka mukutarisira kana kurapwa [13] uye njodzi kukuchengetedzwa kwemurwere [14,15,16]. Kuti vadzivise zvikanganiso zvinoshanda, vanachiremba vanofanirwa kuve nehunyanzvi uye vane hunyanzvi hwekufunga hwekiriniki hunoshanda kuti vaite sarudzo dzakachengeteka uye dzakakodzera [16, 17, 18]. Maitiro ekufunga asingaongorore (asinganzwisisike) ndiwo maitiro anokurumidza kufarirwa nevashandi vane hunyanzvi. Kusiyana neizvi, maitiro ekufunga ekuongorora (hypothetico-deductive) anononoka, ane hungwaru, uye anowanzo shandiswa nevashandi vasina ruzivo rwakawanda [2, 19, 20]. Tichifunga nezvekuoma kwenzvimbo yekiriniki yehutano uye njodzi inogona kuitika yekukanganisa kwekuita [14,15,16], dzidzo yakavakirwa pakufananidzira (SBE) inowanzo shandiswa kupa vanachiremba mikana yekuvandudza hunyanzvi uye hunyanzvi hwekufunga nezvekiriniki. nzvimbo yakachengeteka uye kusangana nematambudziko akasiyana-siyana ukuwo murwere achichengetedza kuchengetedzeka kwake [21, 22, 23, 24].
Sangano reSociety for Simulation in Health (SSH) rinotsanangura simulation se "tekinoroji inogadzira mamiriro ezvinhu kana nzvimbo umo vanhu vanowana kuratidzwa kwezviitiko zvehupenyu chaihwo nechinangwa chekudzidzira, kudzidziswa, kuongororwa, kuyedzwa, kana kuwana kunzwisisa masisitimu evanhu kana maitiro." [23] Zvidzidzo zve simulation zvakarongeka zvinopa vatori vechikamu mukana wekunyura mumamiriro ezvinhu anotevedzera mamiriro ekiriniki uku vachideredza njodzi dzekuchengetedza [24,25] uye kuita kufunga kwekiriniki kuburikidza nemikana yekudzidza yakanangwa [21,24,26,27,28] SBE inowedzera ruzivo rwekiriniki mumunda, ichiisa vadzidzi kune ruzivo rwekiriniki rwavangave vasina kusangana narwo munzvimbo chaiyo yekutarisira varwere [24, 29]. Iyi inzvimbo yekudzidza isingatyisidzi, isina mhosva, inotarisirwa, yakachengeteka, isina njodzi shoma. Inokurudzira kukura kweruzivo, hunyanzvi hwekiriniki, hunyanzvi, kufunga kwakakosha uye kufunga kwekiriniki [22,29,30,31] uye inogona kubatsira nyanzvi dzehutano kukunda kushushikana kwepfungwa kwemamiriro ezvinhu, nokudaro ichivandudza kugona kwekudzidza [22, 27, 28]. , 30, 32].
Kuti titsigire kuvandudzwa kunobudirira kwekufunga kwekiriniki uye hunyanzvi hwekuita sarudzo kuburikidza neSBE, kunofanira kutariswa dhizaini, template, uye chimiro chemaitiro ekudzokorora mushure mekufananidzira [24, 33, 34, 35]. Hurukuro dzekudzidza dzinoratidza kufungisisa mushure mekufananidzira (RLC) dzakashandiswa senzira yekudzokorora kubatsira vatori vechikamu kufungisisa, kutsanangura zviito, uye kushandisa simba rerutsigiro rwevezera uye kufunga kweboka mukushanda pamwe chete [32, 33, 36]. Kushandiswa kweRLC dzeboka kune njodzi inogona kuitika yekufunga kwekiriniki kusina kusimba, kunyanya maererano nehunyanzvi hwakasiyana uye mazinga evakuru vevatori vechikamu. Muenzaniso wemaitiro maviri unotsanangura hunhu hwakawanda hwekufunga kwekiriniki uye musiyano mukuda kwevashandi vakuru kushandisa maitiro ekufunga ekuongorora (hypothetico-deductive) uye vashandi vechidiki kushandisa maitiro ekufunga asiri ekuongorora (intuitive) [34, 37].]. Maitiro aya ekufunga maviri anosanganisira dambudziko rekugadzirisa maitiro ekufunga akakodzera mumamiriro akasiyana, uye hazvina kujeka uye zvinokakavadzana kuti ungashandisa sei nzira dzekuongorora nedzisiri dzekuongorora zvinobudirira kana paine vatori vechikamu vepamusoro nevechidiki muboka rimwe chete remuenzaniso. Vadzidzi vechikoro chesekondari nevechidiki vane hunyanzvi hwakasiyana uye ruzivo rwakasiyana vanotora chikamu muzviitiko zvekufananidzira zvekuoma kwakasiyana [34, 37]. Hunhu hwakawanda hwekufunga kwekiriniki hunobatanidzwa nenjodzi inogona kuitika yekufunga kwekiriniki kusina kusimba uye kuwanda kwepfungwa, kunyanya kana varapi vachitora chikamu mumapoka eSBE ane kuoma kwakasiyana kwenyaya uye mazinga ehukuru [38]. Zvakakosha kucherechedza kuti kunyangwe paine akawanda mamodheru ekukurukura achishandisa RLC, hapana imwe yemamodheru aya yakagadzirwa yakatarisana nekuvandudzwa kwehunyanzvi hwekufunga kwekiriniki, tichifunga nezveruzivo, kugona, kufamba uye huwandu hweruzivo, uye zvinhu zvekuoma kwemuenzaniso [38]. , 39]. Zvese izvi zvinoda kugadzirwa kwemodheru yakarongeka inofunga nezvemipiro yakasiyana-siyana uye zvinhu zvinopesvedzera kugadzirisa kufunga kwekiriniki, uku ichibatanidza post-simulation RLC senzira yekubika. Tinotsanangura maitiro anotungamirirwa nedzidziso uye nepfungwa ekugadzira pamwe chete uye kugadzira RLC mushure mekufananidzira. Muenzaniso wakagadzirwa kuti uvandudze hunyanzvi hwekufunga kwekiriniki panguva yekutora chikamu muSBE, tichifunga nezvezvinhu zvakasiyana-siyana zvinorerutsa uye zvinopesvedzera kuti pave nekuvandudzwa kwekufunga kwekiriniki kwakagadziriswa.
Muenzaniso weRLC mushure mekutevedzera wakagadzirwa pamwe chete zvichibva pamamodeli aripo uye dzidziso dzekufunga kwekiriniki, kudzidza kwekufungisisa, dzidzo, uye kutevedzera. Kuti vagadzire muenzaniso uyu pamwe chete, boka rekushanda pamwe chete (N = 18) rakaumbwa, rine vanamukoti gumi vanochengeta varwere zvakanyanya, mumwe anonyanya kusimbisa, uye vamiriri vatatu vevarwere vakamborapwa muchipatara vane mazinga akasiyana, ruzivo, uye varume nevakadzi. Chikamu chimwe chekuchengetedza varwere zvakanyanya, vabatsiri vaviri vekutsvagisa uye vadzidzisi vaviri vakuru vevanamukoti. Iyi hunyanzvi hwekugadzira pamwe chete hwakagadzirwa uye hwakagadzirwa kuburikidza nekushandira pamwe pakati pevanobatanidzwa vane ruzivo rwechokwadi muhutano, vangave nyanzvi dzehutano dzinobatanidzwa mukugadzirwa kwemuenzaniso wakarongwa kana vamwe vane chekuita navo vakaita sevarwere [40,41,42]. Kusanganisira vamiririri vevarwere mukuita pamwe chete kunogona kuwedzera kukosha kune maitiro aya, sezvo chinangwa chikuru chechirongwa ichi chiri chekuvandudza kutarisirwa kwevarwere nekuchengetedzeka [43].
Boka rekushanda rakaita maworkshop matanhatu emaawa maviri kusvika mana kuti vagadzire chimiro, maitiro uye zviri mukati memuenzaniso. Musangano uyu unosanganisira hurukuro, maitiro uye kutevedzera. Zvinhu zvemuenzaniso uyu zvakavakirwa pamhando dzakasiyana dzezviwanikwa, mamodheru, dzidziso uye maframework akavakirwa pauchapupu. Izvi zvinosanganisira: dzidziso yekudzidza yekuvaka [44], pfungwa ye dual loop [37], nzira yekufunga yekiriniki [10], nzira yekugamuchira inonzwisisika (AI) [45], uye nzira yekubika pamwe chete/delta [46]. Muenzaniso uyu wakagadzirwa pamwe chete zvichibva pamitemo yeInternational Nurses Association's INACSL yekuongorora maitiro ekurapa nekudzidzisa kutevedzera [36] uye wakabatanidzwa nemienzaniso yakashanda kugadzira muenzaniso unozvitsanangura. Muenzaniso uyu wakagadzirwa muzvikamu zvina: kugadzirira hurukuro yekudzidza mushure mekuenzanisa, kutanga hurukuro yekudzidza, kuongorora/kufungisisa uye kudzokorora (Mufananidzo 1). Ruzivo rwechikamu chimwe nechimwe rwunokurukurwa pazasi.
Danho rekugadzirira modhi rakagadzirirwa kugadzirira vatori vechikamu mupfungwa uye kuwedzera kutora kwavo chikamu uye mari yavo panguva imwe chete vachivimbisa kuchengetedzeka kwepfungwa [36, 47]. Danho iri rinosanganisira sumo yechinangwa nezvinangwa; nguva inotarisirwa yeRLC; zvinotarisirwa nemufambisi nevatori vechikamu panguva yeRLC; kutungamirirwa kwenzvimbo uye kugadzwa kwemuenzaniso; kuve nechokwadi chekuvanzika munzvimbo yekudzidza, uye kuwedzera nekusimudzira kuchengetedzeka kwepfungwa. Mhinduro dzinotevera dzinobva kuboka revashandi vekugadzira pamwe chete dzakafungwa panguva yedanho rekutanga rekugadzirwa kwemuenzaniso weRLC. Mutori wechikamu 7: “Semukoti wekutarisira vana, dai ndaive ndichitora chikamu mumuenzaniso pasina mamiriro ezvinhu uye vakuru vakuru varipo, ndaizodzivisa kutora chikamu muhurukuro yekutevera mushure mekutevedzera kunze kwekunge ndanzwa kuti kuchengetedzeka kwangu kwepfungwa kuri kuremekedzwa. uye kuti ndaizodzivisa kutora chikamu muhurukuro mushure mekutevedzera. “Dzivirirwa uye hapana migumisiro.” Mutori wechikamu 4: “Ndinotenda kuti kutarisisa uye kugadza mitemo yekutanga pakutanga kuchabatsira vadzidzi mushure mekutevedzera. Kutora chikamu muhurukuro dzekudzidza dzinofungisisa.”
Matanho ekutanga emuenzaniso weRLC anosanganisira kuongorora manzwiro emutori wechikamu, kutsanangura maitiro aripo uye kuongorora mamiriro acho ezvinhu, uye kunyora zviitiko zvakanaka nezvakaipa zvemutori wechikamu, asi kwete kuongorora. Muenzaniso uri padanho rino wakagadzirwa kuitira kukurudzira vakwikwidzi kuti vazvitarisire vega uye vatarise mabasa avo, pamwe nekugadzirira mupfungwa kuongorora kwakadzama uye kufungisisa kwakadzama [24, 36]. Chinangwa ndechekuderedza njodzi inogona kuitika yekuwanda kwepfungwa [48], kunyanya kune avo vatsva kunyaya yekutevedzera uye vasina ruzivo rwekiriniki rwekare nehunyanzvi/nyaya yacho [49]. Kukumbira vatori vechikamu kuti vatsanangure muchidimbu nyaya yekutevedzera uye kupa mazano ekuongorora zvichabatsira mudzidzisi kuona kuti vadzidzi vari muboka vane kunzwisisa kwekutanga uye kwakajairika kwenyaya yacho vasati vaenda kuchikamu chekuongorora/kufungisisa. Pamusoro pezvo, kukoka vatori vechikamu padanho rino kuti vagovane manzwiro avo mumamiriro ezvinhu ekutevedzera kuchavabatsira kukunda kushushikana kwepfungwa kwemamiriro acho ezvinhu, nokudaro zvichivandudza kudzidza [24, 36]. Kugadzirisa nyaya dzemanzwiro kuchabatsirawo mudzidzisi weRLC kunzwisisa kuti manzwiro evatori vechikamu anokanganisa sei mashandiro emunhu neboka, uye izvi zvinogona kukurukurwa zvakadzama panguva yechikamu chekufungisisa/kuongorora. Nzira yePlus/Delta yakavakirwa muchikamu chino chemuenzaniso sedanho rekugadzirira uye rekupedzisira rechikamu chekufungisisa/kuongorora [46]. Uchishandisa nzira yePlus/Delta, vatori vechikamu nevadzidzi vanogona kugadzirisa/kunyora zvavakaona, manzwiro avo uye zvakaitika pakutevedzera, izvo zvinogona kukurukurwa pfungwa imwe neimwe panguva yechikamu chekufungisisa/kuongorora chemuenzaniso [46]. Izvi zvichabatsira vatori vechikamu kuwana mamiriro ekuchinja kuburikidza nemikana yekudzidza yakanangwa uye yakarongwa kuti ivandudze kufunga kwekiriniki [24, 48, 49]. Mhinduro dzinotevera dzinomiririrwa kubva kuboka revashandi vekugadzira pamwe chete dzakafungwa panguva yekutanga kwekugadzirwa kwemuenzaniso weRLC. Mutori wechikamu 2: "Ndinofunga kuti semurwere akambopinda muICU, tinofanira kufunga nezvemanzwiro nemanzwiro evadzidzi vakatevedzera. Ndinosimudza nyaya iyi nekuti panguva yekubvumidzwa kwangu ndakaona huwandu hwakawanda hwekushushikana nekuzvidya mwoyo, kunyanya pakati pevashandi vekuchengetedza varwere vane dambudziko guru. uye mamiriro ekukurumidza. Muenzaniso uyu unofanirwa kufunga nezvekutambudzika nemanzwiro ane chekuita nekutevedzera chiitiko." Mutori wechikamu 16: "Kune ini semudzidzisi, ndinoona zvichikosha kushandisa nzira yePlus/Delta kuitira kuti vadzidzi vakurudzirwe kutora chikamu nekutaura zvinhu zvakanaka nezvavaida panguva yekuenzanisa. Nzvimbo dzekuvandudza."
Kunyangwe matanho ekare emuenzaniso ari akakosha, danho rekuongorora/rekufungisisa ndiro rakakosha pakuwana kugona kwekufunga zvakanaka kwekiriniki. Rakagadzirirwa kupa ongororo yepamusoro/kugadzira uye ongororo yakadzama zvichibva paruzivo rwekiriniki, kugona, uye simba remisoro yakaenzanisirwa; maitiro eRLC uye chimiro; huwandu hweruzivo rwunopihwa kudzivirira kuwandisa kwepfungwa; kushandiswa kwakanaka kwemibvunzo yekufungisisa. nzira dzekuwana kudzidza kwakanangana nevadzidzi uye kushanda. Panguva ino, ruzivo rwekiriniki uye kujairana nemisoro yekufananidzira zvakakamurwa kuita zvikamu zvitatu kuti zvigamuchire mazinga akasiyana eruzivo nekugona: chekutanga: hapana ruzivo rwekiriniki rwekare/hapana ruzivo rwekare kumisoro yekufananidzira, chechipiri: ruzivo rwekiriniki rwehunyanzvi, ruzivo nehunyanzvi/hapana. kusangana misoro yemuenzaniso. Chechitatu: Ruzivo rwekiriniki rwehunyanzvi, ruzivo nehunyanzvi. Kusangana misoro yemuenzaniso kwehunyanzvi/kwakapfuura. Kupatsanurwa kunoitwa kuti kugamuchire zvinodiwa nevanhu vane ruzivo rwakasiyana uye mazinga ekugona mukati meboka rimwe chete, nokudaro kuenzanisa maitiro evashandi vasina ruzivo rwekushandisa kufunga kwekuongorora nemaitiro evashandi vane ruzivo rwekushandisa hunyanzvi hwekufunga husina kuongorora [19, 20, 34]. , 37]. Maitiro eRLC akarongwa zvichienderana nechirongwa chekurapa [10], chimiro chemuenzaniso wekufungisisa [47], uye dzidziso yekudzidza kuburikidza neruzivo [50]. Izvi zvinoitwa kuburikidza nemaitiro akati wandei: kududzira, kusiyanisa, kutaurirana, kufungidzira uye kugadzira.
Kuti tidzivise kuwandisa kwepfungwa, kukurudzira maitiro ekutaura anotarisa mudzidzi uye anofunga nezvepfungwa ane nguva yakakwana nemikana yekuti vatori vechikamu vafungisise, vaongorore, uye vagadzire pfungwa dzavo kuti vazvivimbe zvakafungwa. Maitiro ekufunga nezvepfungwa panguva yeRLC anoshandiswa kuburikidza nekubatanidza, kusimbisa, kuumba, uye kubatanidza pfungwa zvichibva pachimiro chedouble-loop [37] uye dzidziso yekufunga nezvepfungwa [48]. Kuva nehurongwa hwekukurukurirana hwakarongeka uye kubvumira nguva yakakwana yekufungisisa, tichifunga nezvevatori vechikamu vane ruzivo nevasina ruzivo, zvichaderedza njodzi inogona kuitika yekufunga nezvepfungwa, kunyanya mukuenzanisa kwakaoma nezviitiko zvakasiyana-siyana zvekare, kuratidzwa uye mazinga ehunyanzvi evatori vechikamu. Mushure mechiitiko. Maitiro ekufunga nezvepfungwa emuenzaniso akavakirwa pamuenzaniso weBloom's taxonomic [51] uye nzira dzekuongorora dzinofadza (AI) [45], umo murayiridzi wemuenzaniso anosvika kumunhu wacho nenzira yeSocratic, uye yekufungisisa. Bvunza mibvunzo, uchitanga nemibvunzo yakavakirwa paruzivo, uye kugadzirisa hunyanzvi nematambudziko ane chekuita nekufunga. Iyi nzira yekubvunza ichavandudza kugadziriswa kwekufunga kwekiriniki nekukurudzira kutora chikamu kwevatori vechikamu uye kufunga kunofambira mberi nenjodzi shoma yekufunga nezvepfungwa. Mhinduro dzinotevera dzinobva kuboka revashandi vekugadzira pamwe chete dzakafungwa panguva yekuongorora/kufungisisa kwekugadzirwa kwemuenzaniso weRLC. Mutori wechikamu 13: “Kuti tidzivise kuwanda kwepfungwa, tinofanira kufunga nezvehuwandu nekufamba kwemashoko patinenge tichiita hurukuro dzekudzidza mushure mekufananidzira, uye kuti tiite izvi, ndinofunga zvakakosha kupa vadzidzi nguva yakakwana yekufungisisa nekutanga nepfungwa dzekutanga. Ruzivo. runotanga hurukuro nehunyanzvi, rwobva rwaenda kumazinga epamusoro eruzivo nehunyanzvi kuti ruwane ruzivo rwakadzama.” Mutori wechikamu 9: “Ndinotenda zvakasimba kuti nzira dzekubvunza mibvunzo dzinoshandisa matekiniki eAppreciative Inquiry (AI) uye kubvunza kwekufungisisa uchishandisa muenzaniso weBloom’s Taxonomy zvichakurudzira kudzidza nekushingaira uye kutarisisa mudzidzi uku zvichideredza mukana wengozi yekuwanda kwepfungwa.” Chikamu chekutsanangura chemuenzaniso chinovavarira kupfupisa pfungwa dzekudzidza dzakasimudzwa panguva yeRLC uye kuona kuti zvinangwa zvekudzidza zvazadzikiswa. Mutori wechikamu 8: “Zvakakosha kuti mudzidzi nemudzidzisi vabvumirane pane pfungwa dzakakosha uye zvinhu zvakakosha zvekufunga nezvazvo pavanenge vachitanga kuita.”
Mvumo yetsika yakawanikwa pasi penhamba dzeprotocol (MRC-01-22-117) uye (HSK/PGR/UH/04728). Modhi iyi yakaedzwa mumakosi matatu ehunyanzvi ekutevedzera kuchengetedzwa kwakanyanya kuti vaongorore mashandisirwo uye kushanda kwemodhi. Kushanda kwechiso chemodhi kwakaongororwa neboka revashandi vekugadzira pamwe chete (N = 18) uye nyanzvi dzedzidzo dzinoshanda sevatungamiriri vedzidzo (N = 6) kugadzirisa nyaya dzine chekuita nechitarisiko, girama, uye maitiro. Mushure mekusimba kwechiso, kushanda kwechiso kwakaongororwa nevadzidzisi vakuru vevanamukoti (N = 6) avo vakanyoreswa neAmerican Nurses Credentialing Center (ANCC) uye vakashanda sevarongi vedzidzo, uye (N = 6) avo vaive nemakore anopfuura gumi ekudzidza nekudzidzisa. Ruzivo Rwebasa Ongororo iyi yakaitwa nevatungamiriri vedzidzo (N = 6). Ruzivo rwekutevedzera. Kusimba kwechiso kwakaongororwa uchishandisa Content Validity Ratio (CVR) uye Content Validity Index (CVI). Nzira yeLawshe [52] yakashandiswa kufungidzira CVI, uye nzira yaWaltz naBausell [53] yakashandiswa kufungidzira CVR. Mapurojekiti eCVR anodiwa, anobatsira, asi haasi madikanwa kana kuti asingamanikidzwi. CVI inopihwa mamakisi pachiyero che-four-point zvichibva pakukosha, nyore, uye kujeka, ne1 = isina basa, 2 = ine basa rakati wandei, 3 = ine basa, uye 4 = ine basa guru. Mushure mekusimbisa chokwadi chechiso nezviri mukati, kuwedzera kumaworkshop anoshanda, zvidzidzo zvekudzidzisa nekudzidzisa zvakaitirwa vadzidzisi vachashandisa modhi.
Boka rebasa rakakwanisa kugadzira nekuyedza modhi yeRLC mushure mekutevedzera kuti ivandudze hunyanzvi hwekufunga kwekiriniki panguva yekutora chikamu muSBE mumakamuri evarwere vane chirwere chakakomba (Mifananidzo 1, 2, uye 3). CVR = 1.00, CVI = 1.00, ichiratidza kushanda kwakakodzera kwechiso uye zviri mukati [52, 53].
Muenzaniso uyu wakagadzirwa kuboka reSBE, uko zviitiko zvinonakidza uye zvinonetsa zvinoshandiswa kune vatori vechikamu vane ruzivo rwakafanana kana rwakasiyana, ruzivo uye hukuru. Muenzaniso weRLC conceptual wakagadzirwa zvichienderana neINACSL flight simulation analysis standards [36] uye unotarisa mudzidzi uye unotsanangura wega, kusanganisira mienzaniso yakashanda (Mifananidzo 1, 2 ne3). Muenzaniso uyu wakagadzirwa nemaune uye wakakamurwa kuita zvikamu zvina kuti zvisvike pamatanho ekutevedzera: kutanga nekutaura, kuteverwa nekuongorora/kugadzira, uye kupedzisa neruzivo nepfupiso. Kuti udzivise njodzi inogona kuitika yekuwanda kwepfungwa, danho rega rega remuenzaniso rakagadzirwa nemaune sechinodiwa chedanho rinotevera [34].
Kupesvedzera kwehukuru uye zvinhu zvinowirirana muboka pakutora chikamu muRLC hakuna kumbodzidzwa kare [38]. Tichifunga nezvepfungwa dzinoshanda dzedouble loop uye cognitive overload theory mukuita simulation [34, 37], zvakakosha kufunga kuti kutora chikamu muboka reSBE rine ruzivo rwakasiyana uye mazinga ekugona kwevatori vechikamu muboka rimwe chete resimulation idambudziko. Kuregeredza huwandu hweruzivo, kufamba uye chimiro chekudzidza, pamwe nekushandiswa panguva imwe chete kwemaitiro ekufunga nekukurumidza uye anononoka nevadzidzi vechikoro chesekondari nevechidiki zvinopa njodzi yekuwedzeredza kwepfungwa [18, 38, 46]. Zvinhu izvi zvakafungwa nezvazvo pakugadzira modhi yeRLC kudzivirira kusakura zvakanaka uye/kana kusanyatsobudirira kwekufunga [18, 38]. Zvakakosha kufunga kuti kuita RLC nemazinga akasiyana ehukuru uye kugona kunokonzera mhedzisiro yekutonga pakati pevatori vechikamu vakuru. Izvi zvinoitika nekuti vatori vechikamu vepamusoro vanowanzo dzivisa kudzidza pfungwa dzekutanga, izvo zvakakosha kuti vatori vechikamu vadiki vasvike pakuziva uye kupinda mumaitiro ekufunga nekufunga epamusoro [38, 47]. Muenzaniso weRLC wakagadzirirwa kubatanidza vanamukoti vakuru nevadiki kuburikidza nekubvunza nekuonga uye nzira yekubatsira [45, 46, 51]. Uchishandisa nzira idzi, maonero evatori vechikamu vakuru nevadiki vane hunyanzvi hwakasiyana uye ruzivo rwakasiyana acharatidzwa chinhu nechimwe chinhu uye achakurukurwa nekufungisisa nemutongi wekukurukura pamwe nevatevedzeri vevamwe [45, 51]. Kuwedzera kune zvinopihwa nevatori vechikamu vekuenzanisa, murongi wekukurukura anowedzera zvavanopa kuti ave nechokwadi chekuti zvese zvakacherechedzwa pamwe chete zvinofukidza zvakakwana nguva yega yega yekudzidza, nokudaro zvichivandudza kunzwisisa kuti pave nekufunga kwakanaka [10].
Kufamba kwemashoko uye marongerwo ekudzidza uchishandisa RLC model zvinogadziriswa kuburikidza nenzira yakarongeka uye ine matanho akawanda. Izvi ndezvekubatsira kudzidzisa vatungamiri uye kuona kuti munhu wese anopinda muchirongwa anotaura zvakajeka uye nechivimbo padanho rega rega asati aenda kudanho rinotevera. Mutungamiriri achakwanisa kutanga hurukuro dzekufungisisa umo vatori vechikamu vese vanotora chikamu, uye kusvika padanho apo vatori vechikamu vane mazinga akasiyana-siyana ehukuru uye kugona vanobvumirana pane nzira dzakanakisa dzehurukuro yega yega vasati vaenda kune inotevera [38]. Kushandisa nzira iyi kuchabatsira vatori vechikamu vane ruzivo uye vane hunyanzvi kugovera mipiro/maonero avo, nepo mipiro/maonero evatori vechikamu vasina ruzivo uye vane hunyanzvi achaongororwa uye achakurukurwa [38]. Zvisinei, kuti vazadzise chinangwa ichi, vatungamiri vachafanira kutarisana nedambudziko rekuenzanisa hurukuro uye kupa mikana yakaenzana kune vatori vechikamu vakuru nevadiki. Kuti izvi zviitike, nzira yekuongorora yemuenzaniso yakagadzirwa nemaune uchishandisa Bloom's taxonomic model, iyo inosanganisa ongororo yekuongorora uye nzira yekuwedzera/delta [45, 46, 51]. Kushandisa matekiniki aya uye kutanga neruzivo nekunzwisisa mibvunzo inotarisa/hurukuro dzekufungisisa zvichakurudzira vatori vechikamu vasina ruzivo kuti vatore chikamu uye vatore chikamu muhurukuro, mushure mezvo mudzidzisi achaenda zvishoma nezvishoma padanho repamusoro rekuongorora nekubatanidza mibvunzo/hurukuro umo mapato ese ari maviri anofanira kupa vatori vechikamu veSenior neJunior mukana wakaenzana wekutora chikamu zvichibva pane zvavakasangana nazvo kare uye ruzivo nehunyanzvi hwekiriniki kana zviitiko zvakaedzwa. Maitiro aya achabatsira vatori vechikamu vasina ruzivo kuti vatore chikamu uye vabatsirwe nezviitiko zvinogovaniswa nevatori vechikamu vane ruzivo pamwe nepfungwa dzemurayiridzi wekukurukura. Kune rumwe rutivi, modhi iyi yakagadzirirwa kwete chete kune veSBE vane hunyanzvi hwakasiyana hwevatori vechikamu uye mazinga eruzivo, asiwo kune vatori vechikamu veSBE vane ruzivo rwakafanana uye mazinga ehunyanzvi. Modhi iyi yakagadzirirwa kubatsira kufamba kwakanaka uye kwakarongeka kweboka kubva pakutarisa paruzivo nekunzwisisa kuenda pakutarisa pakubatanidza nekuongorora kuti zvizadzise zvinangwa zvekudzidza. Maumbirwo emodhi uye maitiro akagadzirirwa kukodzera mapoka ekutevedzera hunyanzvi hwakasiyana uye hwakaenzana uye mazinga eruzivo.
Pamusoro pezvo, kunyange zvazvo SBE muhutano pamwe chete neRLC ichishandiswa kukudziridza kufunga kwekiriniki uye kugona kwevashandi [22,30,38], zvisinei, zvinhu zvakakosha zvinofanirwa kufungwa nezvazvo zvine chekuita nekuoma kwenyaya uye njodzi dzinogona kuitika dzekuwanda kwepfungwa, kunyanya kana Vatori vechikamu vaisanganisira zviitiko zveSBE zvakatevedzera varwere vakanyanya kuoma, vanorwara zvakanyanya vanoda kupindira nekukurumidza uye kuita sarudzo dzakakomba [2,18,37,38,47,48]. Kuti izvi zviitike, zvakakosha kufunga nezvemaitiro evatori vechikamu vane ruzivo nevasina ruzivo rwekuchinja panguva imwe chete pakati pemasisitimu ekuongorora neasiri ekuongorora pavanenge vachitora chikamu muSBE, uye kugadzira nzira yakavakirwa pauchapupu inobvumira vadzidzi vakuru nevadiki kutora chikamu mukudzidza. Saka, modhi yakagadzirwa nenzira yekuti, pasinei nekuoma kwenyaya yakaedzwa, mudzidzisi anofanira kuona kuti zvikamu zveruzivo nekunzwisisa kwemashure kwevatori vechikamu vepamusoro nevechidiki zvinotanga zvafukidzwa uye zvozogadzirwa zvishoma nezvishoma uye zvine hungwaru kuti zvive nyore kuongorora. Izvi zvichabatsira vadzidzi vadiki kuvaka nekubatanidza zvavakadzidza, uye kubatsira vadzidzi vakuru kugadzira nekuvandudza ruzivo rutsva. Izvi zvichazadzisa zvinodiwa pakufunga, zvichifunga nezveruzivo rwekare nehunyanzvi hwemumwe nemumwe anenge atora chikamu, uye zvichave nechimiro chakajairika chinotarisa maitiro evadzidzi vechikoro chesekondari nevechikoro chesekondari ekuchinja panguva imwe chete pakati pemasisitimu ekuongorora neasingaongorore, nokudaro zvichiita kuti pave nekugadziriswa kwekufunga kwekiriniki.
Pamusoro pezvo, vabatsiri/vanoongorora zvekufungidzira vanogona kunetseka nehunyanzvi hwekuongorora zvekufungidzira. Kushandiswa kwemagwaro ekuongorora zvekuziva kunofungidzirwa kuti kunoshanda mukuvandudza ruzivo nehunyanzvi hwemaitiro evadzidzisi zvichienzaniswa neavo vasingashandisi zvinyorwa [54]. Zviitiko chishandiso chekuziva chinogona kubatsira basa revadzidzisi rekugadzira mienzaniso uye kuvandudza hunyanzvi hwekuongorora, kunyanya kune vadzidzisi vachiri kubatanidza ruzivo rwavo rwekuongorora [55]. kuwana mukana wekushandisa zvakanyanya uye kugadzira mamodheru ari nyore kushandisa. (Mufananidzo 2 neMufananidzo 3).
Kubatanidzwa kwakafanana kwe plus/delta, ongororo inonzwisisika, uye nzira dzekuongorora dzeBloom's Taxonomy hazvisati zvataurwa mukuongorora kwekufananidzira kuripo parizvino uye ma modheru ekufungisisa akatungamirirwa. Kubatanidzwa kwenzira idzi kunoratidza hunyanzvi hwemuenzaniso weRLC, umo nzira idzi dzakabatanidzwa muchimiro chimwe chete kuti zvibudirire pakugadzirisa kufunga kwekiriniki uye kutarisisa kwevadzidzi. Vadzidzisi vezvekurapa vanogona kubatsirwa neboka reSBE remuenzaniso vachishandisa muenzaniso weRLC kuvandudza nekuvandudza kugona kwekufunga kwekiriniki kwevatori vechikamu. Mamiriro ezvinhu emuenzaniso anogona kubatsira vadzidzisi kugona maitiro ekufungisisa nekusimbisa hunyanzvi hwavo kuti vave vabatsiri vekutaura nechivimbo uye vane hunyanzvi.
SBE inogona kusanganisira nzira dzakasiyana siyana uye matekiniki, kusanganisira asi kwete kungogumira kuSBE yakavakirwa pamannequin, masimulators emabasa, masimulators evarwere, varwere vakajairwa, virtual uye augmented reality. Tichifunga kuti kushuma ndeimwe yenzira dzakakosha dzemuenzaniso, modhi yeRLC inotevedzera inogona kushandiswa semodhi yekushuma kana uchishandisa nzira idzi. Uyezve, kunyangwe modhi iyi yakagadzirwa yechikoro chevanamukoti, ine mukana wekushandiswa muSBE yehutano hwevashandi vehunyanzvi, zvichiratidza kudiwa kwezvirongwa zvekutsvagisa mune ramangwana kuyedza modhi yeRLC yedzidzo yevashandi vehunyanzvi.
Kugadzira uye kuongorora modhi yeRLC mushure mekutevedzera yekuchengetedza vakwegura mumakamuri eSBE ekuchengetwa kwakanyanya. Kuongororwa/kusimbiswa kwemodhi mune ramangwana kunokurudzirwa kuwedzera kugona kwemodhi kushandiswa mune mamwe mabasa ehutano uye SBE yehunyanzvi.
Muenzaniso uyu wakagadzirwa neboka rekushanda pamwe chete rakavakirwa padzidziso nepfungwa. Kuti pave nekushanda uye kugona kwemuenzaniso uyu, kushandiswa kwematanho ekuvimbika akawedzerwa pakuongorora kwekuenzanisa kunogona kufungwa nezvawo mune ramangwana.
Kuti vaderedze zvikanganiso zvekudzidzira, varapi vanofanirwa kuve nehunyanzvi hwekufunga kwekiriniki hunoshanda kuti vave nechokwadi chekuti vanokwanisa kuita sarudzo dzekiriniki dzakachengeteka uye dzakakodzera. Kushandisa SBE RLC senzira yekukurukura kunosimudzira kukura kweruzivo nehunyanzvi hunoshanda hunodiwa kuti vagadzire kufunga kwekiriniki. Zvisinei, hunhu hwakawanda hwekufunga kwekiriniki, hune chekuita neruzivo rwekare uye kuratidzwa, shanduko mukugona, huwandu uye kuyerera kweruzivo, uye kuoma kwezviitiko zvekufananidzira, zvinoratidza kukosha kwekugadzira mamodheru eRLC ekutevera kufananidzira ayo kufunga kwekiriniki kunogona kushandiswa zvinobudirira. Kuregeredza zvinhu izvi kunogona kukonzera kusagadzirwa zvakanaka uye kusanyatsogadzirwa zvakanaka kwekufunga kwekiriniki. Muenzaniso weRLC wakagadzirwa kugadzirisa zvinhu izvi kuti uvandudze kufunga kwekiriniki pakutora chikamu muzviitiko zvekuenzanisa kweboka. Kuti uzadzise chinangwa ichi, muenzaniso uyu unobatanidza panguva imwe chete kubvunza kwekuwedzera/kusiya kuongorora uye kushandiswa kwetaxonomy yaBloom.
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Nguva yekutumira: Ndira-08-2024