ISSN: 2146-8354 J Contemp Med Edu 2013;1(1):15-24
15
Journal of Contemporary
Medical Education
available at www.scopemed.org
Original Research
Transforming simulation in clinical education: is pre-
placement hybrid learning valuable to healthcare students?
Michael Harper
1
, Lesley-Jane Eales-Reynolds
2
, Christian Markham
1
1
School of Health Sciences & Social Work University of Portsmouth, Hampshire, UK
2
Kingston University, London, UK
Received: November 07, 2012
Accepted: November 29, 2012
Published Online: January 05 2013
DOI: 10.5455/jcme.20121129051301
Corresponding Author:
Michael Harper,
School of Health Sciences & Social Work
University of Portsmouth, Portsmouth,
UK
mick.harper@port.ac.uk
Keywords: Simulation, apprenticeship,
professionalism, learning, curriculum
ABSTRACT
Innovation in clinical learning is reported as being useful in preparing health and social care
students for clinical patient care, but historically these learners have relied on traditional pedagogies
including didactic classroom learning and apprenticeship „practice‟ on live patients in a clinical
environment. This paper investigates whether students find it useful to augment traditional learning
methods with simulation and video (hybrid learning) as a pre-junct to learning in clinical
placement. Replacing the usual initial clinical placement with a 12-week study block employing
hybrid-teaching techniques reformed the traditional curriculum for Operating Department
Practitioner students. An interpretative phenomenographic methodology was adopted for this study
and data was collected through anonymous focus group interviews. The data support two concepts
that 1) confidence and self-belief perpetuate the desire for new learning and 2) multi-professional
learning develops a professional approach in terms of communication, care intervention and
thinking processes. The data presented was obtained using a qualitative phenomenographic
approach and the results infer specific advantages of hybrid learning to the participants to
supplement traditional teaching methods by addressing theoretical limitations of learning and
inequity of placement experiential learning. Limitations to this study are the absence of a control
group to directly compare against apprenticeship learning methods alone and the sample group
being single site, single cohort.
© 2013 GESDAV
INTRODUCTION
Apprenticeship is an historic, popular method used to
teach skills to the health and social care workforce [1].
This is mainly due to the understanding that an
“expert” needs to have psychomotor skills, clinical
judgment, decision-making ability and patient-centred
interaction in order to communicate and treat patients
[2-4]. To attain these skills, a variety of methods are
employed to offer „clinical experience‟ including
practicing on animals, live and/or cadaver patients
and/or models [5]. Owen and Plummer [1] refer to
these learners being “allowed” to practice on live
patients who are in deep comas, or on the recently
deceased should clinical placement allow, by following
the consultant physician and attempting to emulate the
master in order to attain and develop skill. Thankfully
these practices are now deemed unethical unless there
is no other way to obtain the training or if the patient‟s
family specifically consents to such practice [6-9]. An
obvious limitation to this approach to teaching medical
or clinical skills (these terms are used interchangeably)
is that there is a perceived risk to the patient‟s welfare
physically or mentally (if alive) where the student is
practicing a skill or technique and that holistic patient
care cannot be at the forefront of this method of
education [9]. Instead the “expert” was trained in
mastering a series of skills and techniques or schema in
order to have a repertoire of experience that could be
used to treat a patient [1]. However, these approaches
have been considered to be ineffective and/or unethical
[10, 11] thus, there has been a pressing need to replace