The Daily Dose • Sunday, April 29

Blended Learning, Simulation, and Serious Gaming: Innovation for Lifelong Learners

By Dr. Michael D. McDonald, from the IARS 2018 Annual Meeting*

Dr. Julia Sobol, panel moderator, introduced the speakers with an overview of educational resources for graduate medical education (GME). The objectives of the panel were to introduce the audience to educational model, learning theories, and barriers to implementing new technologies to anesthesiology resident education. Before transitioning to the panelists, Dr. Sobol introduced the audience to the current shift from the classic pedagogical learning model, or the passive transfer of knowledge from teacher to student via lecture, to andragogical learning, or self-directed and autonomous learning with the teacher overseeing and facilitating the learning process.

The andragogical learning model ties into adult learning theory and is enhanced by technological advanced. Dr. Sobol argued that while there is no debate that online learning is useful, the question remains on how to best integrate it most effectively. The flipped classroom model is a current attempt to implement blended learning of online and classroom learning, however compliance is key and non-compliance can undermine efficiency and quality of learning via this modality. Dr. Sobol emphasized that while new advances in GME have promise, there are many barriers to overcome. Residents have time constraints and learning preferences. Faculty require formal teaching development and often lack protected time or funding for education. New approaches require investment in resources, including equipment and training expenses. And finally, outcomes are difficult to measure and there is often a lack of consensus on content and sequence.

Dr. Glenn Woodworth focused his discussion on blended and social learning in the digital age. The GME model is still very grounded as an apprenticeship model, leading to a highly variable experience as clinical cases and clinical teaching vary. Trainees are seeking online learning for both skills and information regardless of whether faculty is supporting it. However, one survey of 67 YouTube videos on management of trauma found 9% contained errors1. Dr. Woodworth argued that blended learning should be embraced by the GME curriculum and programs should develop a guided blended experience by directing trainees to accurate resources versus allowing for trainees to randomly seek resources on their own. An additional approach to blended learning is through capturing community knowledge. Collaborative learning benefits both the weaker students and the stronger students, who end up teaching in the process allowing for information retention. A major challenge to building community learning is the volume of users required as less than 1% of users are likely to contribute to a database like Wiki cases.

Dr. Stiegler took over and shifted gears toward simulation in GME. Her goal was to show the audience how pervasive simulation is in medical education and how it should be embraced to help with many aspects of learning in medicine. Simulation can be beneficial as it allows the medical community to move from the see one – do one – teach one model with a highly variable learning experience to a more standardized approach to medical education. Additional benefits of simulation include that it can be on demand, it is low risk, and allows for repetition of training in rare events. Simulation is currently taken advantage of for training of everything from basic skills (IV and Central line placement), to high stress emergency events and crisis resource management, to aiding in the reduction of workplace burnout and facilitating provider wellness. Not only does simulation allow for repetition of rare emergencies, but also more importantly fosters skills in communication that are vital to every crisis scenario. Implementation of a simulation program requires financial investment and faculty training for successful use in GME, but these challenges can be overcome with planning.

Dr. Maniker finished the panel with a discussion on serious gaming in GME. A serious game is a game that includes 3 core aspects: challenging goals, a scoring system, and an engaging design. Dr. Maniker argued that as a subset of simulation, serious gaming can allow for an increased degree of repetition than resources allow for in person simulation. With this possible benefit, there are many challenges to serious gaming as development requires an extensive knowledge of medicine and technology, which are often mutually exclusive, as well as high cost and time commitment for development. These challenges can be overcome by motivated individuals and help to make scenarios more repeatable and make education more fun.

In summary, as technology evolves, introduction of blended learning, simulation, and serious gaming can elevate the learning process for not only GME, but also life long learning.

*Coverage from the Panel session, Innovations in Anesthesiology Resident Education