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Does the sequence of instruction matter during simulation?

Jill E Stefaniak¹, Carman L Turkelson

¹From the Instructional Design and Technology Program (J.E.S.), Department of STEM Education & Professional Studies, Old Dominion University, Norfolk, VA; and Beaumont Health System (C.L.T.), Royal Oak, MI.

Simulation in Healthcare : Journal of the Society for Simulation in Healthcare

|October 8, 2013

Summary

For novice learners, engaging in simulation exercises before a didactic lecture significantly improves performance outcomes. This sequencing enhances knowledge acquisition compared to the reverse order, despite learner preference for lecture-first approaches.

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Area of Science:

Medical Education
Simulation-Based Learning
Cognitive Science

Background:

Balancing instructional strategies is crucial in full-immersion simulation to prevent cognitive overload and maintain learner engagement.
Optimizing the sequence of learning activities is essential for effective knowledge transfer in medical education.

Purpose of the Study:

To investigate the impact of sequencing instructional strategies on novice learners' performance.
To determine if simulation-first or lecture-first approach yields better outcomes in a workshop setting.

Main Methods:

Twenty-nine novice learners were divided into two groups.
Group 1 experienced simulation exercises followed by a lecture; Group 2 experienced the lecture first, then simulation.
Cognitive performance was assessed using a multiple-choice test post-workshop.

Main Results:

Learners in the simulation-first group demonstrated significantly higher performance on postassessments (P<0.0001).
A repeated-measures analysis of variance confirmed statistically significant model fit (F(4.54)=176.07).
Despite improved performance, 76% of simulation-first participants preferred a lecture-first sequence.

Conclusions:

The order of instructional components significantly impacts learner knowledge acquisition.
Simulation exercises preceding didactic lectures enhance knowledge for novice learners.
Learner preference does not always align with optimal learning outcomes.