摘要:Background: As a conceptual review, this paper will debate relevant learning theories to inform the development,
design and delivery of an effective educational programme for simulated team training relevant to health
professionals.
Discussion: Kolb’s experiential learning theory is used as the main conceptual framework to define the sequence
of activities. Dewey’s theory of reflective thought and action, Jarvis modification of Kolb’s learning cycle and Schön’s
reflection-on-action serve as a model to design scenarios for optimal concrete experience and debriefing for challenging
participants’ beliefs and habits. Bandura’s theory of self-efficacy and newer socio-cultural learning models outline that
for efficient team training, it is mandatory to introduce the social-cultural context of a team.
Summary: The ideal simulated team training programme needs a scenario for concrete experience, followed by
a debriefing with a critical reflexive observation and abstract conceptualisation phase, and ending with a
second scenario for active experimentation. Let them re-experiment to optimise the effect of a simulated training
session. Challenge them to the edge: The scenario needs to challenge participants to generate failures and feelings of
inadequacy to drive and motivate team members to critical reflect and learn. Not experience itself but the inadequacy
and contradictions of habitual experience serve as basis for reflection. Facilitate critical reflection: Facilitators and group
members must guide and motivate individual participants through the debriefing session, inciting and empowering
learners to challenge their own beliefs and habits. To do this, learners need to feel psychological safe. Let the group talk
and critical explore. Motivate with reality and context: Training with multidisciplinary team members, with different
levels of expertise, acting in their usual environment (in-situ simulation) on physiological variables is mandatory to
introduce cultural context and social conditions to the learning experience. Embedding in situ team training sessions
into a teaching programme to enable repeated training and to assess regularly team performance is mandatory for a
cultural change of sustained improvement of team performance and patient safety.