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医療シミュレーション教育
世界の動向とわが国の対応について
140719
池上敬一
獨協医科大学越谷病院救急医療科
医学教育学会@和歌山
日本医学教育学会大会
COI開示
筆頭演者名:池上 敬一
演題発表に関連し、開示すべきCOI関係にある
企業などはありません。
シミュレーション医療教育・1999−2013年
1999年 “To Err Is Human”
● フライトシミュレーターへの言及
● Patient Safety and Simulation(high-fidelity)
● 第一世代スタート(Gabaの定義)
2000年-2013年
● 「USシミュレーションセンター」モデルが増殖
● シミュレーションのテクニック先行
● ビジネスモデル化
第一世代のシミュレーション・トレーニング
See one, Do one, Teach one
↓
See one, Simulate many, Do one competency and Teach
everyone
シミュレーション医療教育・2014年
予想ほど普及していない
普及しない理由
● シミュレータ販売先行
● 成果がみえない
今後の方向性
● シミュレータ中心から教育
的シミュレーションへ
● 学習のパッケージ化
シミュレーション教育
従来:Gabaの定義
● シミュレーションは医療行為を再現するテクニック
● ベッドサイドティーチングの代用
これから:Gibbonsのモデル
● インストラクショナル・シミュレーション
● パフォーマンス能力を完全履修するモデル
● シミュレータはオプション
● 卒前教育・卒後研修で共有・役割分担
シミュレーション卒前教育・卒後研修
See one, Do one, Teach one
↓
See one, Simulate many, Do one competency and Teach
everyone
↓
構成主義主体の折衷主義・学習科学を応用
インストラクショナル・デザインで学習を処方
わが国におけるシミュレーション教育
前提
● 人がいない、時間がない、予算がない
● 米国型「シミュレーションセンター」は導入困難
方向
● 共通言語、テクノロジーの共有
● 卒前教育・卒後研修・生涯発達の共通システム構築
● 学習活動のパッケージ化
● テクノロジー応用と資格制度
テクノロジーとパッケージ
共通言語、テクノロジーの普及
● 教授システム学
● インストラクショナル・シミュレーション
卒前教育・卒後研修・生涯発達の共通システム構築
● 学習プログラムのパッケージ化と学習システム化
○ 「総合救急医療学習プログラム」
○ 「新人看護職員研修プログラム」
○ 「急性期看護実践能力学習プログラム」
○ 生涯発達共通プログラム
卒前教育・卒後研修で医療職の能力開発
教育パッケージの共有化
● 臨床から素材
● 教材としてデザイン
○ 知識ブック・クイズ
○ 手技のトレーニング
○ シミュレーション
○ シミュレーター
➢ スペック
➢ プログラム
卒前教育・卒後研修で医療職の能力開発
教育パッケージの共有化
● 臨床から素材
● 教材としてデザイン
○ 知識ブック・クイズ
○ 手技のトレーニング
○ シミュレーション
○ シミュレーター
➢ スペック
➢ プログラム
学習者の成長を支援するイン
ストラクション
● インストラクショナル・デザ
イナー
○ 教材の構成・意図を理解
● インストラクター
○ インストラクター・コンピテン
シー
卒前教育・卒後研修で医療職の能力開発
教育パッケージの共有化
● 臨床から素材
● 教材としてデザイン
○ 知識ブック・クイズ
○ 手技のトレーニング
○ シミュレーション
○ シミュレーター
➢ スペック
➢ プログラム
インストラクション
● インストラクショナル・デザ
イナー
○ 教材の構成・意図を理解
● インストラクター
○ インストラクター・コンピテン
シー
医療者教育認定資格
まとめ・シミュレーション教育モデル
基盤となるテクノロジー
● 教授システム学(インストラクショナル・デザイン)
インストラクショナル・シミュレーション
● Gibbons, 1997
教材パッケージと学習システム(卒前教育・卒後研修)
● 必要なツールのスペック指定・プログラム提供
医療者教育認定資格(デザイナー・インストラクター)

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発表版140719シミュレーション・医学教育学会