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Simul Healthc. 2017 Nov 8. doi: 10.1097/SIH.0000000000000268. [Epub ahead of print]

The Application of Observational Practice and Educational Networking in Simulation-Based and Distributed Medical Education Contexts.

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From the Department of Kinesiology (A.W., L.E.M.G.), McMaster University, Hamilton; Department of Medicine (D.R.), University of Toronto, Toronto; Faculty of Business and Information Technology (Z.K., B.K.), Ontario University Institute of Technology, Oshawa; Departments of Surgery (L.V.), Family Medicine (L.E.M.G.), Community and Rural Education Program (Mac-CARE) (L.E.M.G.), Program for Educational Research and Development (L.E.M.G.), and Michael G. DeGroote School of Medicine (L.E.M.G., A.W., L.V), McMaster University, Hamilton, Ontario, Canada.



Research has revealed that individuals can improve technical skill performance by viewing demonstrations modeled by either expert or novice performers. These findings support the development of video-based observational practice communities that augment simulation-based skill education and connect geographically distributed learners. This study explores the experimental replicability of the observational learning effect when demonstrations are sampled from a community of distributed learners and serves as a context for understanding learner experiences within this type of training protocol.


Participants from 3 distributed medical campuses engaged in a simulation-based learning study of the elliptical excision in which they completed a video-recorded performance before being assigned to 1 of 3 groups for a 2-week observational practice intervention. One group observed expert demonstrations, another observed novice demonstrations, and the third observed a combination of both. Participants returned for posttesting immediately and 1 month after the intervention. Participants also engaged in interviews regarding their perceptions of the usability and relevance of video-based observational practice to clinical education.


Checklist (P < 0.0001) and global rating (P < 0.0001) measures indicate that participants, regardless of group assignment, improved after the intervention and after a 1-month retention period. Analyses revealed no significant differences between groups. Qualitative analyses indicate that participants perceived the observational practice platform to be usable, relevant, and potentially improved with enhanced feedback delivery.


Video-based observational practice involving expert and/or novice demonstrations enhances simulation-based skill learning in a group of geographically distributed trainees. These findings support the use of Internet-mediated observational learning communities in distributed and simulation-based medical education contexts.

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