擬真教學之回顧—分析—總結法

Simulation-Based Learning Using the GAS Tool

近年來，以擬真為基礎的學習（simulation-based learning）在醫學及護理教育中越來越受重視。事後回饋（debriefing）是指老師在擬真情境演練後引導學員對過程進行省思、分析，並給予回饋。事後回饋被認為是擬真教學是否成功之關鍵，但以往對於如何進行事後回饋之探討非常有限。回顧-分析-總結法（Gather-Analyze-Summarize, GAS）是美國心臟協會（AHA）與美國賓州匹茲堡大學的溫特擬真教育研究機構（WISER）所發展的結構性事後回饋工具，目前廣泛運用在急重症教學如高級心臟救命術的指導員訓練。GAS 回饋法將事後回饋架構分為回顧（gather，G）、分析（analyze，A）、總結（summarize，S）三階段，每個階段都有其明確之時間分配、目標、重點及建議使用之例句。此回饋法內容簡單扼要、容易應用，可讓老師在具系統性的架構下提供高品質的事後回饋，值得推廣。

Simulation-based learning plays an increasing role in modern medical and nursing education. Debriefing is a guided post-experience reflection and analysis after a simulation scenario. Debriefing is considered to be one of the most important elements in providing effective learning in simulation-based training. There are limited data in the literature to address how to conduct an effective debriefing. The Structured and Supported Debriefing (SSD) model using the GAS (Gather, Analyze, and Summarize) tool helps instructors to structure their debriefing and helps them to understand the use of support elements during debriefing. The model was developed by the American Heart Association (AHA) in conjunction with the Winter Institute for Simulation, Education and Research (WISER) in 2009. The SSD model and GAS tool have been used successfully in instructor training for Advanced Cardiac Life Support and Pediatric Advanced Life Support. The GAS tool divides the debriefing process into three phases: Gather, Analyze, and Summarize. Each phase has its goal, actions, suggested questions and suggested time elements. The model provides a simple structure for clinical teachers to follow during debriefing.