Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
BMC Med Educ. 2010 Nov 8;10:77. doi: 10.1186/1472-6920-10-77.
Simulation is increasingly used for teaching medical procedures. The goal of this study was to assess learner preferences for how simulators should be used in a procedural curriculum.
A 26-item survey was constructed to assess the optimal use of simulators for the teaching of medical procedures in an internal medicine residency curriculum. Survey domains were generated independently by two investigators and validated by an expert panel (n = 7). Final survey items were revised based on pilot survey and distributed to 128 internal medicine residents.
Of the 128 residents surveyed, 106 (83%) responded. Most responders felt that simulators should be used to learn technical skills (94%), refine technical skills (84%), and acquire procedural teaching skills (87%). Respondents felt that procedures most effectively taught by simulators include: central venous catheterization, thoracentesis, intubation, lumbar puncture, and paracentesis. The majority of learners felt that teaching should be done early in residency (97%). With regards to course format, 62% of respondents felt that no more than 3-4 learners per simulator and an instructor to learner ratio of 1:3-4 would be acceptable.The majority felt that the role of instructors should include demonstration of technique (92%), observe learner techniques (92%), teach evidence behind procedural steps (84%) and provide feedback (89%). Commonly cited barriers to procedural teaching were limitations in time, number of instructors and simulators, and lack of realism of some simulators.
Our results suggest that residents value simulator-based procedural teaching in the form of small-group sessions. Simulators should be an integral part of medical procedural education.
模拟教学在医学教学中应用越来越广泛。本研究旨在评估学习者对模拟教学在医学程序教学课程中的应用偏好。
构建了一个包含 26 个项目的调查，以评估模拟器在内科住院医师课程中教授医学程序的最佳使用方法。调查领域由两名调查人员独立生成，并由专家小组（n=7）进行验证。根据试点调查修订了最终的调查项目，并分发给 128 名内科住院医师。
在接受调查的 128 名住院医师中，有 106 名（83%）做出了回应。大多数受访者认为模拟器应该用于学习技术技能（94%）、提高技术技能（84%）和获得程序教学技能（87%）。受访者认为最适合通过模拟器教授的程序包括：中心静脉导管插入术、胸腔穿刺术、插管术、腰椎穿刺术和腹腔穿刺术。大多数学习者认为教学应该在住院医师培训早期进行（97%）。关于课程格式，62%的受访者认为每个模拟器不超过 3-4 名学员和 1:3-4 的学员与指导员比例是可以接受的。大多数人认为指导员的角色应包括演示技术（92%）、观察学员技术（92%）、教授程序步骤背后的证据（84%）和提供反馈（89%）。程序教学的常见障碍包括时间、指导员和模拟器的数量有限，以及一些模拟器缺乏真实性。
我们的结果表明，住院医师重视以小组形式进行基于模拟器的程序教学。模拟器应该是医学程序教育的一个组成部分。
