Chapter 40: Medical Education and Simulation-Based Training

INTRODUCTION

Ongoing education and team training are paramount to the provision of safe obstetrical care. The burden of evidence pointing toward this continues to grow (Satin, 2018). The paradigm of “see one, do one, teach one” has given way to deliberate practice in simulated and native contexts.

This chapter aims to provide practical information that may facilitate departmental educational mandates. For this purpose, the chapter includes four sections: fundamental aspects of educational theory, curriculum design, team training and simulation-based education, and current and future directions in education.

FUNDAMENTAL ASPECTS OF EDUCATIONAL THEORY

This section describes three theoretical lenses that can serve to inform medical education and team development.

Andragogy—Adult Learning

As learners progress from children to adults, they bring with them a growing set of skills, experiences, and values. Although there is overlap, andragogy—“the art and science of helping adults learn”—possesses some distinct assumptions and principles from those of pedagogy (Knowles, 1984). Malcolm Knowles identified assumptions and principles of adult learning that can be used to inform curricular initiatives. Such initiatives acknowledge, build on, or even challenge learner’s existing knowledge and skills (Mukhulalati and Taylor, 2019).

Principles of andragogy serve to guide the creation of educational interventions for adult learners in several ways (Knowles, Kauffman):

• The learning environment should be safe and empower learners to express themselves

• Curriculum should be learner-centered, and learners should be involved in curriculum planning

• Learners should help in assessing their own learning needs, create their own objectives, and identify resources/strategies that will assist in accomplishing these objectives

• Teachers should support learners in carrying out their devised plans to accomplish their learning objectives

• Learners should reflect on their experience and evaluate their own learning

Experiential Learning—Learning by Doing

Experiential learning emphasizes the importance of actual experience in the process of education. Kolb’s experiential learning cycle describes four stages in an ongoing cycle of learning (see Fig. 40-1). This “begins” with a concrete experience that could take place in a real clinical environment or in a simulated context. The learners then go through a process of reflection that leads to forming new ideas or modifying existing ones. Learners then actively test these new ideas, which leads to new experiences and the cycle starts over.