MacDonald Jeannie, Williams Reed G, Rogers David A
Department of Surgery, Southern Illinois University School of Medicine, PO Box 19638, Springfield, IL 62794-9638, USA.
Am J Surg. 2003 Apr;185(4):319-22. doi: 10.1016/s0002-9610(02)01420-4.
Simulation-based training provides minimal feedback and relies heavily on self-assessment. Research has shown medical trainees are poor self-assessors. The purpose of this study was to examine trainees' ability to self-assess technical skills using a simulation-trainer.
Twenty-one medical students performed 10 repetitions of a simulated task. After each repetition they estimated their time and errors made. These were compared with the simulator data.
Task time (P < 0.0001) and errors made (P < 0.0001) improved with repetition. Both self-assessment curves reflected their actual performance curves (P < 0.0001). Self-assessment of time did not improve in accuracy (P = 0.26) but error estimation did (P = 0.01) when compared with actual performance.
Novices demonstrated improved skill acquisition using simulation. Their estimates of performance and accuracy of error estimation improved with repetition. Clearly, practice enhances technical skill self-assessment. These results support the notion of self-directed skills training and could have significant implications for residency training programs.
基于模拟的培训提供的反馈极少，且严重依赖自我评估。研究表明，医学实习生的自我评估能力较差。本研究的目的是检验实习生使用模拟训练器进行技术技能自我评估的能力。
21名医学生对一项模拟任务进行了10次重复操作。每次操作后，他们估计自己所用的时间和所犯的错误。将这些与模拟器数据进行比较。
任务时间（P < 0.0001）和所犯错误（P < 0.0001）随着重复操作而减少。两条自我评估曲线均反映了他们的实际表现曲线（P < 0.0001）。与实际表现相比，时间的自我评估准确性没有提高（P = 0.26），但错误估计的准确性提高了（P = 0.01）。
新手通过模拟训练展示了技能习得的提高。他们对表现的估计和错误估计的准确性随着重复操作而提高。显然，练习能增强技术技能的自我评估。这些结果支持了自我指导技能训练的理念，可能对住院医师培训项目产生重大影响。
