Situated learning as a model for the design of an interactive multimedia program on medication administration for nurses.

指導教授： Ming-puu,Chen

報 告 者： Yun-fang,Chou

報告日期： 2006/12/12

Stillman, G. & Alison, J. & Croker, F. & Tonkin, C. & White, B. (1998).Situated learning as a model for the design of an interactive multimedia program on medication administration for nurses. Innovations in Education and Training International, 35 (4), 329-335

Background

Nurses are one occupational group involved in the common occurrence of medication errors (Wolf, 1994).

Proactive action by nursing educators is therefore necessary in order to reduce the likelihood of such mistakes occurring in practice.

Background

The need exists for nursing education to create ways of improving students’ abilities to conceptualize what they are required to do when administering a particular drug dosage (Haker and Napthine,1994).

Nursing students practice drug administration in simulated situations in clinical laboratories but this does not achieve the realism of the clinical setting which can be simulated using interactive multimedia (IMM) technology.

Background

In the School of Nursing Sciences at James Cook University (JCU) decided to develop alternative teaching strategies to

enhance students’ learning of drug administration.

Medication calculation was identified as a problem area by both teachers and students.

Steps taken to remedy the situation

Following a needs assessment of basic mathematical skills metric conversion and decimalization

Identified students were offered extra tuition to assist them in developing appropriate learning strategies or medication calculations before applying them in a nursing context.

Steps taken to remedy the situation

A computer-assisted learning (CAL) package was developed and made available on the World Wide Web (Stillman et al.. 1999). The program afforded students repeated practice i

n carrying out the necessary calculations but did not incorporate the skill into a realistic context as it was possible to use only a verbal description of the situations.

An IMM program was developed. Clinical situations which realistically reflect the Australian scene were portrayed using video and digital photography.

In addition to medication calculation, this program incorporated principles medication administration and addressed other categories of potential sources of error.

Steps taken to remedy the situation

Theoretical framework

The IMM program was designed using the situated learning model (Brown et at. 1989;Young,1993) as a theoretical framework.

Advocates of the situated learning model contend that knowing is inextricably situated in the physical and social context of its acquisition and use’ (Brown et at. 1988. p1)

Learning is thus seen as a situated phenomenon (Lave and Wenger,1991).

The key elements of the model that were used as guidelines for the design of the learning environment are presented below, together with the design considerations for each.

Theoretical framework

Guideline 1: Use of authentic contexts that reflect the way knowledge is

used in real life.Guideline 2:

Use of authentic activities that learners will engage in during their future career roles.

Guideline 3: Provide access to expert performance and modeling of the

processes involved.Guideline 4:

Provide opportunities for students to reflect on their learning.

Guideline 1: Use of authentic contexts

Merely providing examples from real-world situations to illustrate the concept being taught is not sufficient for designing a learning environment with authentic contexts. Ignoring the situated nature of cognition would defeat our main

educational goal of providing useable, robust knowledge (Brown et at.. 1989).

If the program was to provide authentic contexts, it needed to incorporate a physical environment, in all its complexity, which would reflect the way the knowledge would he ultimately used. In addition, this environment had to be real to the student (Heckman and Weissglass. 1994).

An obvious design consideration that followed from this was the need for a non-linear design to preserve the complexity of the real-life setting.

Guideline 2: Use of authentic activities

The learning environment needed to provide activities for learners which have real-world relevance and present complex tasks from their future career role (Bruer, 1993; Collins et al., 1989).

These tasks should have to be completed over a sustained period of time rather than be a series of short disconnected tasks that have been sanitized of their real -world complexity (Cognition and Technology Group at Vanderbilt,1990).

Guideline 3: Provide access to expert performance

In order to ensure that the learning environment incorporated exemplars of expert performance, the program needed to provide access to expert thinking (for example, through voice-over) and modeling of the processes involved in the activities as well as the observation of real-life episodes as they occur (Collins et al.,1989;Silver,1994).

Video clips and digital photography would provide students with the opportunely to observe both simulated and authentic real-life episodes as they occurred.

Guideline 4: Provide opportunities

In order to enable students to reflect meaningfully on their learning, the program needed to provide authentic contexts and tasks with which students could readily identify.

A non-linear navigation system would allow students to move to any part of the program that was necessary to facilitate this reflection.

It was also desirable that students have access to examples of expert performance as a benchmark to reflect on their own performance (Collins and Brown. 1988).

Components of the IMM program

Figure 1 The main interface of the Medication Administration Program

Figure 2 The interface for the Medication Round

Figure 3 The interface for the Mediation calculation

Conclusion

The need to improve teaching strategies to facilitate students learning of drug calculations is of paramount importance at a time when there is increasing pressure for teaching staff to engage in research activities in a climate of ever contracting funding for staffing.

The suitability of interactive multimedia as a vehicle for such provision has been aptly demonstrated by the design, and the implementation, of the program examined in this paper.

Authentic tasks in authentic contexts engage students in activities which are meaningful to them.

Students, whatever their discipline, need to he brought into the practices and thinking processes of that discipline.

Situated learning has been shown to be an ideal framework for the design and implementation of learning environments to facilitate this.