Complexity Learning Theory And Simulation Based Medical Education

“..the System includes the Situation, but it is more enduring, more widespread, involving extensive networks of people, their expectations, norms, policies, and, perhaps, laws. Over time, Systems come to have a historical foundation and sometimes also a political and economic power structure that governs and directs the behavior of many people within its sphere of influence. Systems are the engines that run situations that create behavioral contexts that influence the human action of those under their control. At some point, the System may become an autonomous entity, independent of those who initially started it or even those in apparent authority within its power structure. Each System

Patricia, you have brought the valuable discussion with expressive slides on simulation as one of the innovative technological application in nursing education. I had the experience in my nursing school to learn the basic nursing skills such as bed bath, urinary catheterization, administering enema, and pretend for IV insertion techniques. Since I started working in this hospital, we have a simulation lab for nurses to demonstrate any advanced techniques with new protects and technological equipments to gain hands on experiences. The use mannequins in the BLS class room provided me the confidence in chest compressions and prepared me function efficiently in real life situation.

Complex Systems is a new science study about what is relationship between the individual parts and how the parts emerge the collective behaviors and interact with the environment and the system (Bar-Yam, Y., 2015). If the behaviors that the system behave hard to predict, we can describe the system as a complex system. While facing the complexity, people usually senses the difficulty to have the solutions to handle the problems, it also implies that the problems in the complex system often with the high degree of difficulty. The complexity situations are full of environment around us, such as the natural environment, the economics, the social issues, politic issues and so on. The above issues are all consisting by lots different small components, the relationships and the interactions will make a significant effect to the overall system perform.

Learning is a process that depends on experience and leads to long-term changes in behavior potential. Behavior potential designates the possible behavior of an individual, not actual behavior. The main assumption behind all learning psychology is that the effects of the environment, conditioning, reinforcement, etc. provide psychologists with the best information from which to understand human behavior.

The main aim of the systems approach is to show how to consider the wholes as well as parts, see interrelationships rather than linear causes and thinking not in straight lines but in casual loops. (Blockley & Godfrey, 2000)

Explain what Simulation Theory is and evaluate Ravenscroft’s claim that it is superior to Theory-Theory?

For the last decade, simulation labs and debriefing have become the norm in the teaching-learning continuum. The phase of debriefing is a critical component of the process. The

This is where the theory of intelligent design comes in. Fundamentally speaking is says that because the system is so complex it must be the result of an intelligent agent. If in nature such complex systems were seen under other circumstances and could not be explain, we would attribute it to intelligence. To prove their theory proponents point to two types of signs of intelligence, irreducible complexity and specified complexity.

simulating the entire learning environment, to be used for formative evaluation of new learning approaches and interventions designed to support doctoral learners [71].

All this leads into another important aspect of simulation fidelity; Instructional Systems Design (ISD). ISD is definitively linked to training effectiveness and is relative to the way in which simulator based training is designed for the target audience. Recently there has been considerable research which suggests that there is not a straightforward relationship between the increased realism of high fidelity simulation and any significant enhancement in training effectiveness (National Center for Simulation, 2007). In fact, the research actually shows that increases in both efficiency and transfer of training do occur through the careful process of ISD, and in particular the design of simulation based scenarios that are responsive to the real operational needs of the target learner. These research results provide the first facet that high fidelity simulation is not necessarily required for airline pilot training.

"When the same action has dramatically different effects in the short run and the long, there is dynamic complexity. When an action has one set of consequences locally and a very different set of consequences in another part of the system, there is dynamic complexity. When obvious interventions produce nonobvious consequences, there is dynamic

Learning can sometimes appear to be a very simple thing, understanding how we learn is not as straightforward as it may seem. Numerous definitions and theories of learning indicate the complexity of the process.

Typically, when thinking of the world in 2017, technology is one of the first things that people associate with modernity. In a world that is linked-in and almost everyone is part of an online global village, technology has provided us with several opportunities. For example, in nursing, as discussed by Robyn P. Cant et al (2010) and Sharon Decker et al (2008), there are several advantages to simulation-based learning (SBL). These simulations, specifically manikins used for clinical training, provide opportunities for nursing students to practice and train in a safer and low-risk environment before treating living patients. Cant et al (2010, pg. 1) This scaffolded practice allows nursing students to learn at their own pace and ensure they are confident before entering the workforce. Decker et al (2008) goes on to explain that there are three types of simulators, “low-, medium-, and high- fidelity.” (p. 76) These are the stages at which each interaction with a simulation is rated. For example, Decker et al (2008) in figure 1 (appendix A) describes that a low-fidelity simulator is something like the “insertion of an intravenous catheter [into a prosthetic arm].” (p.76) This is something that first year students get to experience in their first few clinical classes. Medium and high-fidelity simulators are more realistic. For example, using the whole manikin to find audible sounds and altering their chest movements. (Decker et al, 2008, figure 2, Appendix A). These audible sounds can now be replicated in the classroom which contributes to a more positive learning environment. SBL is advantageous over the teaching methods of the past where students needed to apply knowledge taught on paper to a living patient. This was a more stressful form of training and most likely caused more mistakes than the SBL method. (Cant et al, 2010, p.3). Both articles do state that some students still learn just as well when using other learning criteria (Cant et al, 2010), however, Cant et al (2010) discussed the results of her study, which claim that 6 of 12 groups being recorded felt they gained more knowledge with each simulation compared to another learning processes. While there are many other technological advances that have

Problem based learning is more advantageous than traditional learning in many aspects. Academically, PBL medical students place more emphasis on meaning than on memorizing, use journals and on-line databases as sources of information, and use a more in-depth approach of learning. Unlike PBL, conventional teaching separates the basic science from the clinical practice. In the conventional curriculum, teaching is tutor-centered and comprises large group lectures, tutorials, structured laboratories experience, and periodic tests of achievement. Students passively absorb information rather than actively acquiring knowledge (2).

As we can understand and seen, "system" depends on one’s perspective, and the “integrated set of elements