title: Examining Residents' Strategic Mindfulness During Self-Regulated Learning of a Simulated Procedural Skill.
abstract: BACKGROUND
  Simulation-based training is currently embedded in most health professions education curricula. Without evidence for how trainees think about their simulation-based learning, some training techniques may not support trainees' learning strategies.
  
  
  OBJECTIVE
  This study explored how residents think about and self-regulate learning during a lumbar puncture (LP) training session using a simulator.
  
  
  METHODS
  In 2010, 20 of 45 postgraduate year 1 internal medicine residents attended a mandatory procedural skills training boot camp. Independently, residents practiced the entire LP skill on a part-task trainer using a clinical LP tray and proper sterile technique. We interviewed participants regarding how they thought about and monitored their learning processes, and then we conducted a thematic analysis of the interview data.
  
  
  RESULTS
  The analysis suggested that participants considered what they could and could not learn from the simulator; they developed their self-confidence by familiarizing themselves with the LP equipment and repeating the LP algorithmic steps. Participants articulated an idiosyncratic model of learning they used to interpret the challenges and successes they experienced. Participants reported focusing on obtaining cerebrospinal fluid and memorizing the "routine" version of the LP procedure. They did not report much thinking about their learning strategies (eg, self-questioning).
  
  
  CONCLUSIONS
  During simulation-based training, residents described assigning greater weight to achieving procedural outcomes and tended to think that the simulated task provided them with routine, generalizable skills. Over this typical 1-hour session, trainees did not appear to consider their strategic mindfulness (ie, awareness and use of learning strategies).
authors.forename: Ryan
authors.initials: R
authors.lastname: Brydges
authors.forename: Rose
authors.initials: R
authors.lastname: Hatala
authors.forename: Maria
authors.initials: M
authors.lastname: Mylopoulos
mesh_terms: D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D007858:Learning; D064866:Mindfulness; D016544:Patient Simulation; D013129:Spinal Puncture