Context When learning clinical skills in simulation, fidelity and transfer are traditionally considered key concepts: transfer because that is what gives purpose to the simulation, and fidelity because this is thought important to the transfer process. However, both fidelity and transfer, and the relationship between them, are poorly understood concepts.
This presentation reports on a qualitative study with dental and dental therapy students with little previous clinical experience in transition from simulation (the “dental phantom head”) to patient care.
Methodology Data collection consisted of 12 focus group interviews with four different student groups, followed across an academic year from a simulated to a clinical setting. Focus group data were subjected to content analysis.
Outcomes The study highlighted the role of authenticity as more significant than that of fidelity in skill transfer. It did so for two principal reasons:
In the context of the study, transfer to a clinical setting appeared to create a psychological overhead, no matter how extensive the preparation. Exposing the learner to an authentic clinical setting appeared help diminish cognitive load, because it helped the student prepare psychologically to deliver patient care.
The second importance component of authenticity was the affordance of implicit learning opportunities. These did not just relate to clinical skills, but also to the ability to function within the clinical environment, another issue that added to cognitive load.
Impact A degree of tension exists between the need for authenticity and the nature of simulation. Herrington et al .1 identify “[t]he capacity of authentic learning settings to promote students’ willing suspension of disbelief” as important. An effective simulation is one which is absorbing enough for the learner to behave as though the simulation were real.
Herrington J, Oliver R, Reeves TC. Patterns of engagement in authentic online learning environments. Aust J Educ Tech 2003;19(1):59–71
Available from: http://ascilite.org.au/ajet/submission/index.php/AJET/article/view/1701. Accessed 30/07/2012
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