Instructional Design and Its Usability for Branching Model as an Educational Strategy.

INTRODUCTION: Serious Games (SG) are an educational strategy used in the health professions with positive results in teaching diagnosis and facilitating the application of concepts and knowledge transfer. A type of SG is the branching scenario, which has the potential for a linear story or multiple options to achieve learning goals. There must be evidence for this type of SG's instructional design (InD) and usability. OBJECTIVE: Propose an InD for the branching scenario and rate its usability. MATERIALS AND METHODS: We conducted a two-phase study. In the first phase, we drafted an InD based on the literature review, and then, we applied an expert validation process through a modified Delphi technique. With the consent of InD, we built five branching scenarios. In the second phase, we apply an instrument to measure the SG usability of the branching scenarios in a cross-sectional study with 216 undergraduate medical students. RESULTS: A proposal for an InD for branching scenarios was elaborated. This InD has five dimensions with steps and definitions that help the designer fulfill the requirements for the SG. With the InD, we developed five branching scenarios for undergraduate medical students. Finally, the rates for the usability of the branchings had high scores. The branching SG with multiple options offers different outcomes for the same clinical problem in a single activity. DISCUSSION: The proposal of a specific InD for branching scenarios considered SG theory and was tested, at least in user usability. The steps proposed include the specificity of the requirements of an SG, such as levels, checkpoints, avatars, and gameplay characteristics, among others, in contrast to the other InD that do not explicitly consider them. One of the limitations of this study is that we applied it only using the H5P software to develop branching scenarios with no other evidence of the performance of the InD in different contexts or platforms. CONCLUSIONS: We propose using an InD to construct branching scenarios. This kind of SG has specific characteristics for its correct operation. Using structured steps in developing SG improves the probability of developing decision-making skills. Using an instrument to assess the usability of at least one dimension of the SG is also recommended to identify opportunity areas.

Who Can Debriefing Assessment for Simulation in Healthcare? Different Perspectives on Teledebriefing Assessments.

INTRODUCTION: Virtual debriefing is a cardinal element to achieve the effectiveness of telesimulation. There are different instruments to assess face-to-face debriefing to determine the degree of effectiveness of debriefing; Debriefing Assessment for Simulation in Healthcare (DASH) instrument is one of them. This study aims to describe and compare the evaluation of raters, instructors, and students during a virtual debriefing using the DASH. METHODS: A cross-sectional study was performed evaluating the virtual debriefing of 30 instructors after a heart failure telesimulation scenario. The evaluation was conducted by 30 instructors, 338 undergraduate students in the seventh semester, and 7 simulation raters. The 3 versions of the DASH instrument in Spanish were applied, respectively. RESULTS: Two comparisons were made, student versus instructor and rater versus instructor. Cronbach α was 0.97 for each version. The averages of the results on the DASH instrument were: 6.61 (3.34-7.0), 5.95 (4.65-7.0), and 4.84 (2.68-6.02) for student, rater, and instructor versions, respectively. The size effect between student and debriefer perspectives was 0.42. In contrast, the size effect between instructor and rater was 0.72. All differences were significant. CONCLUSIONS: There are different rates between the persons who use the DASH. In this study, from the perspective of the instructor and rater, the difference was 1 point with a wide range, in contrast with the difference between instructor and student, which is relatively minor. It is necessary to consider the perspectives of experts in the subject to achieve a virtual debriefing of high quality and improve a debriefing by using the DASH.

Propuesta metodológica para mejorar la calidad en el diseño de un objeto virtual de aprendizaje: una experiencia con el equipo de protección personal / Methodological proposal to improve the quality of a virtual learning object: an experience with personal protection equipment

Introducción: Los objetos virtuales de aprendizaje (OVA) son una herramienta del proceso enseñanza-aprendizaje. En la bibliografía hace falta una evidencia del proceso de creación de un OVA de calidad. El objetivo de este manuscrito es realizar una propuesta metodológica para diseñar un OVA con el modelo de ADDIE y evaluar su calidad con el Learning Object Review Instrument (LORI). Material y métodos: Se diseñó un OVA con el objetivo de capacitar a estudiantes y personal de salud en la colocación y la retirada del equipo de protección personal. El diseño se realizó por medio del modelo ADDIE y posteriormente se evaluó con el LORI. Resultados: El promedio obtenido del total de respuestas de 355 estudiantes fue de 4,66, con una moda de 5 y una mediana de 4,75. El elemento mejor evaluado fue el dos, que está relacionado con el logro de las metas y objetivos, con una media de 4,73, y el elemento peor evaluado fue el cinco, relacionado con la presentación del OVA, con una media de 4,6. Conclusiones: El uso de una metodología que incluye el diseño y la evaluación de un OVA asegura la reproducibilidad, la sistematización y la mejora continua de la herramienta didáctica.(AU)

Introduction: Virtual learning objects (VLO) are tools in the teaching-learning process. In the literature poor evidence of the process of creating a quality VLO is found. The objective of this manuscript is to build up a methodological proposal to design a VLO with the ADDIE model and evaluate its quality with the Learning Object Review Instrument (LORI). Material and methods: A VLO was designed with the objective of training students and health personnel in the placement and removal of personal protective equipment, the design was carried out through the ADDIE model, later it was evaluated with the LORI. Results: The average obtained from the total responses of 355 students was 4.66 with a mode of 5 and a median of 4.75, the best evaluated element was two with a mean of 4.73 that is related to the achievement of goals and objectives, the worst evaluated element was five with a mean of 4.60 related to the presentation of the VLO. Conclusions: The use of a methodology that includes the design and evaluation of an VLO ensures the reproducibility, systematization, and continuous improvement of the teaching tool.(AU)

Implementation Barriers in Telesimulation as an Educational Strategy: An Interpretative Description.

Introduction Telesimulation is one of the different methodologies for distance learning to promote competency in medical trainees. This methodology needs to have professors, students, and standardized patients in one session to perform a teleconsultation. Telesimulation could lead to multiple implementation barriers. This study aims to describe the implementation barriers through the perspective of the professors, students, and standardized patients in a telesimulation scenario in undergraduate medical education. Method We designed and applied a telesimulation scenario in undergraduate medical students. Then we conducted an online questionnaire with the critical incidents technique. The study sample was 18 professors, 26 standardized patients, and 407 students Results We describe a taxonomy with five categories and each one with different subcategories: knowledge (clinical simulation, theoretical over the clinical case, and use of simulators), facilities (access, time of use, and functionality), financing (payment to staff and purchase of equipment), attitude (acceptance and emotion), and participants (communication, collaborative work, and debriefing). Conclusion The description of the implementation barriers through multiple perspectives generates a taxonomy that could improve the quality of the telesimulation. This taxonomy is a proposal to consider the design, implementation, and evaluation when a telesimulation is implemented. The taxonomy could generate a structured plan when the educators implement the telesimulations at their own institutions considering all the barriers proposed.