Wittels Kathleen A, Takayesu James K, Nadel Eric S
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Emerg Med. 2012 Jul;43(1):134-8. doi: 10.1016/j.jemermed.2011.05.086. Epub 2012 Jan 4.
Human Patient Simulation (HPS) is increasingly used in medical education, but its role in Emergency Medicine (EM) residency education is uncertain.
The objective of this study was to evaluate the perceived effectiveness of HPS when fully integrated into an EM residency didactic curriculum.
The study design was a cross-sectional survey performed in 2006, 2 years after the implementation of an integrated simulation curriculum. Fifty-four residents (postgraduate year [PGY] 1-4) of a 4-year EM residency were surveyed with demographic and curricular questions on the perceived value of simulation relative to other teaching formats. Survey items were rated on a bipolar linear numeric scale of 1 (strongly disagree) to 9 (strongly agree), with 5 being neutral. Data were analyzed using Student t-tests.
Forty residents responded to the survey (74% response rate). The perceived effectiveness of HPS was higher for junior residents than senior residents (8.0 vs. 6.2, respectively, p<0.001). There were no differences in perceived effectiveness of lectures (7.8 vs. 7.9, respectively, p=0.1), morbidity and mortality conference (8.5 vs. 8.7, respectively, p=0.3), and trauma conference (8.4 vs. 8.8, respectively, p=0.2) between junior and senior residents. Scores for perceptions of improvement in residency training (knowledge acquisition and clinical decision-making) after the integration of HPS into the curriculum were positive for all residents.
Residents' perceptions of HPS integration into an EM residency curriculum are positive for both improving knowledge acquisition and learning clinical decision-making. HPS was rated as more effective during junior years than senior years, while the perceived efficacy of more traditional educational modalities remained constant throughout residency training.
人体患者模拟（HPS）在医学教育中的应用越来越广泛，但其在急诊医学（EM）住院医师教育中的作用尚不确定。
本研究的目的是评估将HPS完全融入EM住院医师理论课程后的感知效果。
本研究设计为一项横断面调查，于2006年进行，即综合模拟课程实施2年后。对一所为期4年的EM住院医师培训项目中的54名住院医师（研究生一年级至四年级）进行了调查，询问了他们的人口统计学信息和课程相关问题，内容涉及模拟相对于其他教学形式的感知价值。调查项目采用1（强烈不同意）至9（强烈同意）的双极线性数字量表进行评分，5分为中性。使用学生t检验对数据进行分析。
40名住院医师回复了调查（回复率为74%）。初级住院医师对HPS的感知效果高于高级住院医师（分别为8.0和6.2，p<0.001）。初级和高级住院医师在讲座（分别为7.8和7.9，p=0.1）、发病率和死亡率会议（分别为8.5和8.7，p=0.3）以及创伤会议（分别为8.4和8.8，p=0.2）的感知效果方面没有差异。对于所有住院医师而言，将HPS融入课程后，他们对住院医师培训（知识获取和临床决策）改善的感知得分均为正数。
住院医师对将HPS融入EM住院医师课程的看法是积极的，认为这有助于提高知识获取和学习临床决策能力。HPS在低年级时的评分比高年级时更高，而在整个住院医师培训期间，更传统教育方式的感知效果保持不变。
