A crucial component of instructional design for simulation-based training systems involves optimizing the presentation of complex material in order to maximize knowledge acquisition and application. One approach toward facilitating the learning of this complex information is to instantiate instructional strategies within the training systems themselves. However, there are few established guidelines in place which are meant specifically for real-time guidance strategies within simulation-based environments. Consequently, this study aims to apply findings from the literature on instructional information presentation to drive decisions for how to most effectively provide real-time feedback during training of simulated decision-making tasks. Research has shown that presenting text information in an auditory mode during direct instruction of operational tasks enhances learning and reduces the probability of learners experiencing cognitive overload. Similar effects have been found regarding the presentation modality of feedback during operational tasks. In the current study, this principle was extended by comparing text versus verbal real-time feedback presentation during learning of higher-level cognitive skills in a virtual environment. Participants were instructed on how to perform a simulated decisionmaking task, while receiving text, verbal or no instructional feedback in real-time, based on their performance. Participants then completed an assessment scenario in which no feedback was provided to any group. It was hypothesized that a linear relationship would exist across each of the three conditions, with the verbal group making the best decisions, followed by the text group, and then by the control group. Additionally, reduced cognitive load was expected throughout the instructional process for those receiving verbal feedback prompts compared to those receiving text prompts and the control. Analyses revealed several significant linear trends across iv conditions regarding measures of knowledge acquisition and application. The results provide support for the hypothesis that verbal real-time feedback is more effective than text during training of primarily visual tasks for the acquisition of higher-order cognitive skills such as decision making. There were no significant linear trends regarding the amount of cognitive load subjectively reported during training and assessment. The results of this study indicate that instructional systems intended to train primarily visual tasks should present real-time feedback in verbal rather than text form.

Thesis (MPhil)--Stellenbosch University, 2014. / INTRODUCTION: For this MPhil research assignment, I have chosen to write an article based on a small scale research project conducted in the Clinical Skills Centre (CSC) at Stellenbosch University. Medical students’ perceptions were gathered in order to evaluate the usefulness and relevance of the Clinical Skills module and the different components thereof as experienced by the students themselves. This in the end led to valuable feedback that were given to the course coordinators which in turn may lead to curricula changes being made to improve the overall teaching and learning experience for future medical students rotating through the CSC.