Developing a facilitated reflection tool using video technology, during a laparoscopic simulation activity, for doctors in postgraduate obstetrics & gynaecology training


The evidence for laparoscopic simulation as an effective educational intervention is well established with benefits such as shortening the learning curve, increased learner self-efficacy and developing surgical skills without compromising patient safety. What has not been explored widely in the literature is what are the educational mechanisms that facilitate this effective learning in laparoscopic simulation. Lack of curriculum, limited simulation design or insufficient understanding of learner’s needs may not achieve cost effective educational outcomes or lead to a principle goal of laparoscopic simulation - translation of learning into the operating theatre. Reflection has been postulated in the literature to be the most important educational mechanism that enhances effective learning in simulation. Thematic analysis from the literature review, exploring reflection in surgical simulation, uncovered four important phenomena. Firstly reflection in surgical simulation can be enhanced through facilitated reflection with a teacher, secondly the use of video technology synergistically amplifies this process, thirdly the centrality of emotion to the simulation learning environment and finally integrating learning frameworks can theoretically structure facilitated reflection in surgical simulation. Through the theoretical research conducted in this thesis, a facilitated reflection educational tool has been constructed, using video technology, that can be applied in a laparoscopic simulation context. The design of the facilitated reflection tool has been theoretically scaffolded from Mezirow’s works on critical reflection and transformative learning and is discussed in this thesis along with the justification for selecting this theoretical orientation. An instructional programme for the integration of the facilitated reflection tool using video technology is developed in this thesis, along with elaboration of the technical and theoretical steps to pragmatically implement the tool during a laparoscopic simulation activity. It is believed that this facilitated reflection tool, in conjunction with video technology, will lead to an improvement in laparoscopic procedural skill performance through the development and enhancement of learner reflection. A paradigm shift resulting in the development of learning interventions based on educational theory is much needed in the Obstetrics & Gynaecology training armamentarium and the facilitated reflection tool is one step towards that direction

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    This paper was published in Nottingham ePrints.

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