Skills Lab
A skills lab is understood to be a central training facility in which specific skills and abilities are practically imparted. The term Skills Lab comes from English and is made up of the words "skill" and the abbreviation "lab" for "laboratory" (test room).
The acquisition of professional competence that implies both theoretical and practical knowledge is the overarching goal of nursing training . Elisabeth Sittner (2011) emphasizes in this context that “practical training in nursing should be understood as a joint task of theory and practice”. A prerequisite for a successful theory-practice transfer is not only an appropriate transfer of knowledge and support in theory, but that the framework conditions in practice must also allow the transfer, that the knowledge is adequately conveyed and that the transfer of knowledge is also accompanied by appropriate supervision .
History of origin
In the health sector, the first skills labs for medical training were established in North America and the Netherlands in 1970. The International Nursing Association for Clinical Simulation and Learning (INACSL) also describes the beginnings of simulation in American nursing in the 1970s. The named association has published the journal Clinical Simulation in Nursing since 2005 . In the USA, Australia, New Zealand, Great Britain and Scandinavia, the simulation of nursing activities is part of nursing curricula (as of 2014). Skill training and simulation processes in nursing are so far not well established in Germany and are limited to a few projects. In contrast to this, skills labs in the field of medicine are nowadays represented in various sizes and shapes in medical faculties across Germany.
aims
The intention of the Skills Lab is to “minimize the gap between theory and practice, between thinking and acting”. Training in health care usually takes place centrally at two learning locations, the theory learning location and the practice learning location. The theory learning location is subdivided again into subject theoretical and subject practical lessons. Here, the students should learn not only theoretical basics but also practical aspects of the teaching topics in order to later integrate these findings into their practical activities. As a rule, lessons in practical subjects do not take place in the classroom but in training workshops or practice offices. In this context, the gap means that learners have to take a very large step from practicing with their classmates in practical lessons to treating patients in practical professional reality. The Skills Lab concept aims to build a bridge between the two learning locations and to promote the transfer between theoretical specialist knowledge and practical action. The aim is to gradually prepare the learners for the complexity of real job-typical situations. In this way, excessive demands or incorrect assessment should be avoided in everyday care.
In vocational training, a skills lab also aims to ensure that learners acquire and develop professional skills at an early stage . In the Skills Lab, in addition to technical and methodological skills, personnel and social skills can also be promoted by dealing with simulation patients. These competencies and manual abilities or skills can be acquired through exercises and application tasks. The following additional goals are set by the simulation network Education and Training in Nursing (SimNAT Pflege) :
• Enabling the acquisition of skills and knowledge in a risk-free learning environment (so-called skills)
• Improving the quality of nursing care
• Promoting patient safety and personal actions.
• Improvement of interprofessional learning
By integrating realistic situations into the training, which can be simulated in a skills lab, the interprofessional collaboration between doctors and nurses can increase their satisfaction with their work. In addition, the quality of health of the patients can be improved.
offer
The steady growth of Skills Labs led the Society for Medical Education (GMA Committee) to create a competency-based catalog of learning objectives for practical use in medical studies. During the course of study 289 practical skills are to be learned, “those in 12 organ systems (respiration, musculoskeletal system, blood / defense, endocrine system, Gl tract, urinary / gender organs, skin, cardiovascular system, nervous system, psyche, sensory organs, growth / aging ), 3 border areas to other competence areas (border area communication, border area emergency, border area soft skills) and an area with cross-organ system-wide skills have been subdivided ".
In principle, a distinction must be made between two types of offers: free practice on the model and participation in guided courses. While skills that have already been learned can be deepened in free practice, courses are offered by specially trained and professionally qualified student tutors or medical lecturers. The participants can thus learn new skills under guidance.
Offered such as practicing essential skills such as the blood , the laying of a peripheral IV catheter or basic measures of resuscitation , suturing and knotting techniques to gynecological examinations. On the one hand, the students have realistic models at their disposal, which can be used to examine and diagnose physiological findings for basic familiarity as well as the most common pathologies. On the other hand, certain scenarios take place in collaboration with simulation patients so that, for example, taking anamnesis or delivering bad news can be practiced.
The training takes place in small groups, which creates a relaxed atmosphere and enables concentrated practice. Tutors and lecturers strive to continuously develop and expand the range of courses and always ensure the latest clinical level.
The course offers are based on the catalog of learning objectives, which reflects which competencies a medical student must have acquired by a certain point in time. Thus, in addition to written and oral exams, the practical skills of university lecturers can also be measured objectively.
Special days of action
In some Skills Labs, special promotions take place at more or less regular intervals. Here, for example, a night shift in everyday hospital life is simulated, in which patient cases are discussed from 9 p.m. to 3 a.m. and techniques such as injection , sonography and resuscitation are practiced.
Special training weeks to prepare for the internship and practical year can also be part of the offer, as well as language training tailored to the needs of medical students.
Skills Lab Symposium
Every year there is a meeting of managers and employees from various skills labs across Germany. The organizer is the “Practical Skills” committee of the Society for Medical Education in cooperation with a skills lab at a medical university. The symposia focus on scientific and practical exchange as well as personal training, alongside various lectures and poster sessions, workshops are often held. In addition, the symposia are a welcome opportunity to make new contacts and get to know the organization and equipment of other institutions.
Pedagogical involvement
Since vocational training always includes general educational aspects, Klafki's classic educational theory approaches must first be taken into account for the pedagogical integration of skills labs. Klafki sees the emancipatory ideal as one of three constitutive characteristics for education (cf. Klafki 2007, p. 52). Through education, people can use their intellect and thus independently detach themselves from external control on an individual or social level (cf. ibid. P. 19). In addition to self-determination, the ability to participate is also a fundamental educational goal of Klafki. In addition, the third basic ability that should be achieved through education is the ability to show solidarity (cf. Klafki 2007, p. 52). In order to achieve education, according to Klafki, “key problems typical of the epoch” must be brought into the focus of efforts (ibid.). Transferred to the use of the Skills Lab, special care is required when creating the learning sequences. For the many possible individual cases in the nursing context, an individual case must be used for learning that bundles universal key problems (cf. Rebmann / Schlosser 2019, p. 89). Klafki's principle of exemplarity was also adopted by Darmann-Finck's nursing didactics. The importance of the selection of the key problem in the nursing profession for training is emphasized (cf. Darmann 2005, p. 329). Due to the different scenarios and the realistic environment, Skills Lab has the opportunity to offer learning arrangements in different ways. Due to the possibilities of representing realistic situations in the exercise room, experience-based learning is particularly suitable (cf. Rebmann / Schlosser 2019, p. 88). The four-phase model from Kolb, for example, serves as a didactic experience model.
Remmers, Hartmut: On the relationship between general and vocational education. In: Kaufhold, Marisa / Rosowski, Elke / Schürmann, Mirko (ed.): Education in the health sector. Research and development for professional and university education. Berlin: Lit Verlag, pp. 29-50.
In relation to learning in the Skills Lab, this could look like this: In the first phase, the focus is on the learners' own experiences, which they experience through real situations in the practice room. In the second phase these experiences are reflected on. The experience is shown again. In the third phase, these experiences are classified and concepts are created from them. Only through this step do the insights gained from experience become knowledge. In the fourth step, what has been learned so far and the newly acquired concepts are implemented in practice or in other skills lab scenarios (see Breuer 2018, 76f.). However, situational learning can also be used as a learning arrangement for learning in the Skills Lab. For example, a learning environment is created that reflects a practical experience. This realistic situation in the Skills Lab gives the learners the opportunity to play through or simulate this situation in order to collect learning experiences and thus prepare for everyday practice (see Rebmann / Schlosser 2019, p. 88).
Basically, the performance evaluation in the Skills Lab should be carried out using the grading system used in general and vocational institutions, from very good to unsatisfactory, since this grading system will also be included in the future training and examination regulations for nursing professions (cf. Schlosser / Rebmann 2019, P. 79). The performance evaluation in the Skills Lab should also be competence-oriented so that it corresponds to the overarching goal of vocational training - the acquisition of professional competence (cf. ibid.). For this purpose, the competencies to be achieved for the corresponding teaching and learning sequence in the skills lab, so-called learning outcomes, must be formulated and made transparent to the trainees (cf. Schlosser / Rebmann 2009, p. 79f.). The learning outcomes are checked using an observation sheet, the individual items of which are assigned to the competence dimensions of professional, personal and social competence (cf. ibid., P. 82). It should be noted that some outcomes can be observed during the entire scenario, while others are only related to certain situations or courses of action (cf. ibid., P. 82f.). In addition, it is important that the examinee and all subsequent examinees are unfamiliar with the exam scenario, apart from their own role, in order to avoid evaluation distortions (cf. ibid., P. 82).
There is currently no legal obligation to use skills labs in training (see Rebmann / Schlosser 2019, p. 88). Pedagogical institutions involved in nursing training can freely decide on the curricular anchoring of lessons (Section 2, Paragraph 3 of the PflAPrV), taking into account the applicable framework curriculum (Section 51, Paragraph 3 of the PflAPrV). This also applies to the use of skills labs (see Rebmann / Schlosser 2019, p. 88). There are requirements for a mandatory implementation of skills labs at nursing schools to promote skills, for example expressed by the German Society for Nursing Science (cf. 2015, p. 2). The deployment is discussed against the background of the acquisition of professional competence (see Rebmann / Schlosser 2019, p. 88 ff.), Which is the overriding goal of nursing training (cf. Niedersächsisches Kultusministerium 2003, p. 3).
Distribution in Germany
* As of January 2020
Distribution in Switzerland
| Location | place | Canton | Skills Lab | opening |
|---|---|---|---|---|
| Lucerne Cantonal Hospital | Lucerne | Lucerne | yes, exclusively with human preparations | 2017 |
Distribution in Austria
| University | place | designation | opening |
|---|---|---|---|
| MedUni Vienna | Vienna | Skills Lab Sonography | 2014 |
| Medical University Innsbruck | innsbruck | Skills Lab ILTIS | 2014 |
| Medical University of Graz | Graz | Clinical Skills Center | 2002? |
| University of Salzburg | Salzburg | CRCS | ?
|
Skills lab in care, equipment and construction
The structure of the laboratory is based on the construction plan belonging to the respective simulation scenario. When equipping and furnishing the room, the aim of the room to support the educational process must be taken into account. Thus, the rooms are set up in such a way that the furnishings and equipment support the educational task. A camera with a tripod can be used to record the simulation. In some institutions, additional video and screen technology is available so that the recordings can be transferred to other rooms. Furthermore, make-up material, for example to show wounds or the like, can be used to prepare the simulation patient. The equipment includes a wide variety of props that are required to simulate the respective scenario.Depending on the simulation scenario, a simulation phantom may be required, for example to protect the privacy of the person in need of care.In the HAW Hamburg, the Skills Lab is equipped with a speaking simulation phantom. Lecturers take over the speaking of the phantoms from the control room, this enables difficult learning situations to be simulated. Technical devices such as home ventilation machines are also part of the equipment
Exemplary equipment of a skills lab: • Nursing cupboards • Wash basin • Nursing bed (s) • Bedside cabinet • Nursing trolley (nursing trolley with various nursing utensils) • Infusion stand • Paravents • Mobile patient cabinet • Function bars with patient call system and oxygen connection • Simulation defibrillator • Night chair • Baby doll • Simulation arm (for blood collection ) • Resuscitation torso • Simulation phantom with additional parts • If necessary, chairs and a table • Various storage aids • First aid equipment • If necessary, loaner equipment from the respective care area • Other exercise and demonstration material typical for the care context • Documentation forms
International comparison
The change in care and nursing - away from disease-oriented action towards patient-oriented action - led to changed conditions to which the actors involved in the healthcare system had to react. This change presents the actors with the challenge that new skills and abilities had to be learned. The shift described led to simulations and subsequently also the use of skills labs becoming more important. The general trend and the reputation of skills labs were promoted by the fact that it became clear that working with or on real patients seemed increasingly unsuitable and that it was difficult to find suitable patients for the work of trainees / young professionals or the like. The reasons given led to the opening of the first Skills Lab in Maastricht in 1975 . The Faculty of Health, Medicine and Life Sciences (FHML) at Maastricht University . The Dutch university describes the
Development as particularly necessary, as students were dissatisfied with the traditional form of teaching. The Skills Lab gave the students the opportunity to be confronted with different problems and to cope with the challenges independently so that problem-solving skills could be developed. The (health) nursing faculty at Drexel University in Philadelphia in the US state of Pennsylvania anchored training with and on simulation patients in the curriculum in 2002 . The success of this addition led to the fact that a skills lab was established a short time later under the name “digital-video standardized patient laboratory”. Space for simulations was created on over 200 square meters. Among other things, group and family therapies, ethics meetings, childbirth and the observation of serious illnesses could be simulated and practiced with the help of computers in a safe environment. In the USA, skills labs are a constant part of nursing training in 2019 and are not only used to train pure nursing staff, but are also used to train teams from different areas of the health sector, such as nursing , medicine , physiotherapy or Occupational therapy used. The aim here is to promote multi- professionalism in the health professions. A change in basic and advanced training in nursing can also be seen in the West African state of Ghana . In 2014, an investigation into nursing and midwifery in Ghana initiated by the Maternal Child Survival Program (MCSP) came to the conclusion that the training centers were inadequately equipped with anatomical models and skills labs, which are seen as central to training are. In order to be able to guarantee the quality of training and safety for care and treatment, an extensive program was developed, which provided for a multi-step implementation of the Skills Labs as well as the professional training of 330 so-called Skills Labs tutors. Subsequent studies show that the implementation has not yet taken place in a sufficient manner, which becomes clear from the fact that the skills labs are used comparatively rarely and irregularly, some tutors do not know how to use models and simulations, or there are not enough materials and models be available. At the same time, statistical studies show that since the introduction of the skills labs at the training centers, the number of successful apprenticeships has increased by 35 percent and that the graduates are better prepared for the demands of real everyday work. In 2019, we will continue to work on the nationwide distribution of the skills labs in Ghana and other African countries. Furthermore, an improvement in the training of tutors and an integration of the Skills Lab into curricular requirements is aimed at. In many European countries, including the Netherlands, England, Ireland and Switzerland, Skills Labs are integrated almost everywhere into the requirements of nursing training and are therefore an integral part of these. Studies come to the conclusion that the rooms differ greatly in size and equipment, which means that in an international comparison, one can only speak of a uniform definition of the term to a limited extent. The use of skills labs in nursing training has arrived in Germany, but in comparison with international results and standards, it cannot be described as being implemented across the board. A decisive reason for this is the German training system, which, unlike many other countries, is not academic and thus differs from international conditions in key points, such as financing, systematic structure and personnel density. Efforts that focus on national and international exchange show that there is great interest in the dissemination and further development of skills labs. Symposia on the topic in particular have found their way into nursing and research since the mid-2000s. In 2007 the first Skills Lab Symposium of the DA-CH region took place and was organized by the Training Center for Medical Skills (TÄF) of the Charité - Universitätsmedizin Berlin . This was followed annually by further symposia in Vienna (2007), Cologne (2008), Aachen (2009), Münster (2010), Würzburg (2011), Marburg (2012), Göttingen (2013), Bern (2014), Halle and Leipzig ( 2015), Essen (2016), Erlangen (2017), Maribor (2018) and Neuruppin and Brandenburg (2019). The aim of these symposia is to visit the existing skills labs at the respective locations and to exchange ideas about the methods and possibilities of these institutions and to make experiences for new or planned skills labs accessible. Faculties , employees and students who operate a skills lab or those who do not yet have their own skills lab, but are interested in it, are focused as target groups . While the first meetings of the Skills Lab Symposium mainly focused on the DA-CH region, i.e. Germany, Austria and Switzerland, and the thematic focus was on hospitals and their staff, the 9th symposium in 2014 was the first Times international and interprofessional in Bern. At the 10th International SkillsLab Symposium (ISLS) 2015 in Halle and Leipzig, in addition to the human medicine-oriented contributions, there were also contributions to veterinary medicine , occupational therapy , physiotherapy and care. After the symposia took place in the DA-CH region until 2017, the 13th International Skills Lab Symposium 2018 was held for the first time outside this region in Maribor (Slovenia). A year later, participants from Hungary continued to take part in the 14th International Skills Lab Symposium. Internationality is achieved above all through the (main) speakers and designers of the posters and workshops, who in recent years have come from Germany, Austria, the Netherlands, Switzerland, Australia, Slovenia, the USA, Great Britain, Sweden and Ireland, among others came. The International Skills Lab Symposia enables a constant international and interdisciplinary exchange between different institutions with Skills Lab, which promotes the further development of the Skills Labs on a national level. The 15th International Skills Lab Symposium will take place from March 27th. to 28.03.2020 at the Karl Landsteiner Private University for Health Sciences in Krems an der Donau (Austria). The main speakers are from Germany and Austria.
Individual evidence
- ↑ Andreas Fichtner: Learning for Practice. The skills lab. In: Michael St. Pierre, Georg Breuer: Simulation in Medicine. Basic Concepts - Clinical Application. Springer, Berlin, Heidelberg 2013. ISBN 978-3-662-54566-9 . Pp. 105-114; P. 106.
- ↑ Elisabeth Sittner: How does knowledge become ability? The practical training in nursing as a joint task of theory and practice. Facultas, Vienna 2011, ISBN 978-3-708-90673-7 ; P. 7
- ↑ Elisabeth Sittner: How does knowledge become ability? The practical training in nursing as a joint task of theory and practice. Facultas, Vienna 2011, ISBN 978-3-708-90673-7 , p. 8f.
- ↑ Christine Loewenhardt, Jörg Wendorff, Christa Bürker, Jan Johannes Keogh: Simulation Network Education and Training in Nursing eV- Simulation in Nursing Education. In: Pedagogy of the health professions. Issue 1, 2014, pp. 64–68; P. 65.
- ↑ Andreas Fichtner: Learning for Practice. The skills lab. In: Michael St. Pierre, Georg Breuer: Simulation in Medicine. Basic Concepts - Clinical Application. Springer, Berlin, Heidelberg 2013. ISBN 978-3-662-54566-9 . Pp. 105-114; P. 106; P. 106.
- ↑ Susanne Schewior-Popp: Planning and designing learning situations. Action-oriented teaching in a learning field context. Thieme-Verlag, Stuttgart 2005, ISBN 978-3-131-40751-1 ; P. 20.
- ↑ Annika Kruse, Beate Klemme: The skills lab concept - a useful bridge element in the training of physiotherapists. In: Beate Klemme, Gaby Siegmann: Clinical Reasoning. Learning therapeutic thought processes. 2nd Edition. Thieme, Stuttgart 2015. ISBN 978-3-131-98102-8 . Pp. 187-194; P. 188f.
- ↑ Annika Kruse, Beate Klemme: The skills lab concept - a useful bridge element in the training of physiotherapists. In: Beate Klemme, Gaby Siegmann: Clinical Reasoning. Learning therapeutic thought processes. 2nd Edition. Thieme, Stuttgart 2015. ISBN 978-3-131-98102-8 . Pp. 187-194; P. 190.
- ↑ Christine Loewenhardt, Jörg Wendorff, Christa Bürker, Jan Johannes Keogh: Simulation Network Education and Training in Nursing eV- Simulation in Nursing Education. In: Pedagogy of the health professions. Issue 1, 2014, pp. 64–68; P. 65.
- ^ Christiane Luderer, Dietrich Stoevesandt, Patrick Jahn, Christiane Ludwig: In focus. Interprofessional learning in the skills lab. Together instead of next to each other. In: Care magazine. Vol. 67, Issue 8, 2014, pp. 474-477; P. 474.
- ^ A b c Kai P. Schnabel, Patrick D. Boldt, Georg Breuer, Andreas Fichtner, Gudrun Karsten, Sandy Kujumdshiev, Michael Schmidts, Christoph Stosch: Consensus statement "Practical skills in medical studies" - a position paper of the GMA committee for practical skills . tape 28 , no. 4 , p. 1-12 .
- ↑ Clinical Skills Summer School - preparatory course for the practical year. Marburger Bund, archived from the original on November 24, 2012 ; accessed on February 7, 2016 .
- ↑ Aachen Skills Lab AIXTRA: Language training: English - French - Spanish ( Memento of the original from September 21, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Uni-Marburg.de: Seventh SkillsLab symposium at the Philipps University of Marburg
- ↑ Hartmut Remmers: On the relationship between general and vocational education. In: Marisa Kaufhold, Elke Rosowski, Mirko Schürmann (eds.): Education in the health sector. Research and development for professional and university education. LIT Verlag, Berlin 2014, pp. 29–50.
- ↑ Skills Lab . In: Lucerne Cantonal Hospital . ( luks.ch [accessed on September 13, 2018]).
- ↑ (see Reintke / Hurzelmeier 2014, p. 494f.).
- ↑ (see Jaki / St.Pierre / Breuer 2018, p. 26).
- ↑ (see Reintke / Hurzelmeier 2014, p. 494f.).
- ↑ (cf. ibid.).
- ↑ (see Reintke / Hurzelmeier 2014, p. 494f.).
- ↑ (see HAW 2017).
- ↑ (see Reintke / Hurzelmeier 2014, p. 494f.)
- ↑ cf. Al Yousuf 2004, p. 549
- ↑ cf. Al Yousuf 2004, p. 550
- ↑ cf. van Dalen 2012, p. 3
- ↑ cf. Wilson / Rockstraw 2012 p. XIII
- ↑ cf. Maestre / Felpate 2012, p. 343ff.
- ↑ cf. Maternal and Child Survival Program 2019, pp. 1ff.
- ↑ cf. Houghton et al. 2012, p. 29f.
- ↑ cf. Sanko 2017, p. 24f.
- ↑ cf. Pscheidl 2015, p. 29f.
- ↑ cf. Schnabel undated
- ↑ cf. Society for Medical Education eVo J.
- ↑ cf. Schnabel undated; Cologne Interprofessional Skills Lab (KIS) 2008; Medical Faculty Münster 2010; University Hospital Würzburg o. J .; Philipps University of Marburg o. J .; University Hospital Göttingen o. J.
- ↑ cf. University of Bern o. J.
- ↑ cf. Rotzoll / Stoevesandt o.J.
- ↑ cf. Faculty of Medicine. University of Maribor o.J.
- ↑ cf. Brandenburg Medical School CAMPUS GmbH o. J.
- ↑ cf. u. a. Cologne Interprofessional Skills Lab (KIS) 2008, p. 3
- ↑ cf. u. a. University Hospital Würzburg o. J.
- ↑ cf. University Hospital Göttingen n.d., pp. 10, 15
- ↑ cf. University of Bern o. J.
- ↑ cf. Rotzoll, Daisy / Stoevesandt, Dietrich o. J., p. 3
- ↑ cf. SkillsLab Karl Landsteiner Private University for Health Sciences oYes
- ↑ cf. SkillsLab Karl Landsteiner Private University for Health Sciences oJb
