Workforce Education and Development Group, K01, The University of Sydney, NSW 2006, Australia.
BMJ Qual Saf. 2012 Oct;21(10):819-25. doi: 10.1136/bmjqs-2011-000702. Epub 2012 Jun 16.
To compare the effectiveness of two types of online learning methodologies for improving the patient-safety behaviours mandated in the Joint Commission National Patient Safety Goals (NPSG).
This randomised controlled trial was conducted in 2010 at Massachusetts General Hospital and Brigham and Women's Hospital (BWH) in Boston USA. Incoming interns were randomised to either receive an online Spaced Education (SE) programme consisting of cases and questions that reinforce over time, or a programme consisting of an online slide show followed by a quiz (SQ). The outcome measures included NPSG-knowledge improvement, NPSG-compliant behaviours in a simulation scenario, self-reported confidence in safety and quality, programme acceptability and programme relevance.
Both online learning programmes improved knowledge retention. On four out of seven survey items measuring satisfaction and self-reported confidence, the proportion of SE interns responding positively was significantly higher (p<0.05) than the fraction of SQ interns. SE interns demonstrated a mean 4.79 (36.6%) NPSG-compliant behaviours (out of 13 total), while SQ interns completed a mean 4.17 (32.0%) (p=0.09). Among those in surgical fields, SE interns demonstrated a mean 5.67 (43.6%) NPSG-compliant behaviours, while SQ interns completed a mean 2.33 (17.9%) (p=0.015). Focus group data indicates that SE was more contextually relevant than SQ, and significantly more engaging.
While both online methodologies improved knowledge surrounding the NPSG, SE was more contextually relevant to trainees and was engaging. SE impacted more significantly on both self-reported confidence and the behaviour of surgical residents in a simulated scenario.
比较两种在线学习方法在提高联合委员会国家患者安全目标（NPSG）规定的患者安全行为方面的效果。
本随机对照试验于 2010 年在美国波士顿的马萨诸塞州综合医院和布莱根妇女医院进行。新入职的住院医师被随机分配接受在线间隔教育（SE）计划或在线幻灯片演示加测验（SQ）计划。结果测量包括 NPSG 知识的提高、模拟场景中 NPSG 合规行为、对安全和质量的自我报告信心、计划的可接受性和相关性。
两种在线学习方法都提高了知识的保留率。在四项衡量满意度和自我报告信心的调查项目中，SE 组的住院医师中有比例显著高于 SQ 组（p<0.05）。SE 组住院医师表现出平均 4.79 项（占 13 项总分的 36.6%）NPSG 合规行为，而 SQ 组完成了平均 4.17 项（32.0%）（p=0.09）。在外科领域的住院医师中，SE 组住院医师表现出平均 5.67 项（占 43.6%）NPSG 合规行为，而 SQ 组完成了平均 2.33 项（17.9%）（p=0.015）。焦点小组数据表明，SE 比 SQ 更具情境相关性，也更具吸引力。
虽然两种在线方法都提高了对 NPSG 的了解，但 SE 对受训者更具情境相关性，也更具吸引力。SE 对自我报告的信心和模拟场景中外科住院医师的行为产生了更显著的影响。
