Halm Brunhild M, Lee Meta T, Franke Adrian A
Emergency Department, Kapi'olani Medical Center for Women and Children, Honolulu, HI 96826, USA.
Hawaii Med J. 2010 Jan;69(1):4-7.
Learning medicine without placing patients at increased risk of complications is of utmost importance in the medical profession. High-fidelity patient simulators can potentially achieve this and are therefore increasingly used in the training of medical students. Preclinical medical students have minimal exposure to clinical rotations and commonly feel anxious and apprehensive when starting their clinical years.
The objective of this pilot study was to determine if toxicology knowledge and confidence of preclinical second-year medical students could be augmented with simulation training.
We designed and implemented a simulation exercise for second-year medical students to enhance learning of Basic Life Support, toxidromes, and management of a semiconscious overdose victim. Groups of 5-6 students were tasked to identify abnormal findings, order tests, and initiate treatment on a mannequin. Faculty observers provided video-assisted feedback immediately afterwards. On-line pre- and posttests were completed in the simulation lab before and after the exercise.
This simulation exercise, completed by 52 students, increased test scores on average from 60% to 71% compared to a pre-test. Among the topics tested, students scored worst in identifying normal/abnormal vital signs. Mean confidence increased from 2.0 to 2.6 using a 5-point Likert scale (1-very low to 5-very high).
This study suggests that simulation exercises for second-year medical students may be a valuable tool to increase knowledge and student self-confidence at a key transition period prior to beginning clerkship experiences. Further research is needed to prove long-term educational benefits of simulation interventions in the preclinical setting.
在医学专业中，在不增加患者并发症风险的情况下学习医学至关重要。高保真患者模拟器有可能实现这一点，因此越来越多地用于医学生的培训。临床前医学生很少有机会参加临床轮转，在开始临床学习时通常会感到焦虑和不安。
本试点研究的目的是确定模拟培训是否可以增强临床前二年级医学生的毒理学知识和信心。
我们为二年级医学生设计并实施了一项模拟练习，以加强对基本生命支持、中毒综合征和半昏迷药物过量受害者管理的学习。每组5至6名学生负责在人体模型上识别异常发现、安排检查并开始治疗。教员观察员随后立即提供视频辅助反馈。在模拟实验室中，学生在练习前后分别完成了在线预测试和后测试。
52名学生完成了这项模拟练习，与预测试相比，测试成绩平均从60%提高到了71%。在测试的主题中，学生在识别正常/异常生命体征方面得分最差。使用5点李克特量表（1 - 非常低至5 - 非常高），平均信心从2.0提高到了2.6。
本研究表明，针对二年级医学生的模拟练习可能是一种有价值的工具，可以在开始临床实习前的关键过渡时期增加知识和学生的自信心。需要进一步研究以证明模拟干预在临床前环境中的长期教育益处。
