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Teaching Surgical Model Development in Research by Using Situated Learning and Instructional Scaffolding

机译:运用情境学习和教学脚手架进行研究中的外科模型开发教学

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摘要

Resources detailing the scope, details, and duration for teaching and learning surgical model development in research are poorly described. Situated learning and instructional scaffolding are useful skill-building tools. Herein, we discuss educational theory in the context of a training paradigm for surgical researchers, using our experience with a nonunion femoral fracture model as an example. Stages of learning include cognitive, associative, and autonomous stages. In surgical training, the cognitive stage involves the acquisition of basic knowledge, including anatomy, surgical approach, instrumentation, and suturing, which can be taught by using books, videos, skeletons, and cadavers. To these basic skills, the associative stage adds advanced techniques—including anesthesia, asepsis, hemostasis, and the full surgical procedure—through mentored nonsurvival surgical experiences. After a mentor has assured competence, trainees perform supervised and then independent survival surgeries to complete the autonomous stage. Through these stages, instructional scaffolding is applied in the context of a situated learning environment in which trainees learn in a layered approach through their own experiences. Thus, the proposed training paradigm is structured to teach trainees how to think and act as surgeons so they can adapt and grow, rather than only to ensure technical competency in a specific model. Development and mastery of complex surgical models may require as long as 6 mo to achieve optimal outcomes, depending on the preexisting skill of the research surgeons, technical difficulty, and the stage of model evolution.
机译:很少详细描述用于教学和研究外科模型开发的范围,细节和持续时间的资源。现场学习和教学脚手架是有用的技能培养工具。在此,我们以针对外科研究人员的培训范式为背景,讨论教育理论,并以我们的不愈合股骨骨折模型为例。学习阶段包括认知阶段,联想阶段和自主阶段。在外科手术训练中,认知阶段涉及基础知识的获得,包括解剖学,外科手术方法,器械和缝合,这些知识可以通过使用书籍,视频,骨骼和尸体来教授。通过指导的非生存性手术经验,关联阶段在这些基本技能上增加了先进的技术(包括麻醉,无菌,止血和完整的手术程序)。导师确定能力后,受训人员将接受监督,然后进行独立的生存手术,以完成自主阶段。在这些阶段中,指导性脚手架被应用在一个局限的学习环境中,在该环境中,受训者可以根据自己的经验以分层的方式进行学习。因此,建议的培训范式旨在教会受训人员如何思考和充当外科医生,以便他们适应和成长,而不仅仅是确保特定模型的技术能力。复杂手术模型的开发和掌握可能需要长达6个月的时间才能达到最佳效果,这取决于研究外科医生的现有技能,技术难度以及模型演变的阶段。

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