Dominelli Giulio S, Dominelli Paolo B, Rathgeber Steven L, Webster Sheila B
Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.
J Asthma. 2012 May;49(4):434-9. doi: 10.3109/02770903.2012.672609.
Pressurized metered dose inhalers (pMDIs) remain important therapeutic options for obstructive lung diseases. The ability to instruct and evaluate inhaler technique is a crucial skill that all medical professionals should possess; unfortunately, many professionals lack proficiency with pMDIs. We aimed to determine if brief education interventions of differing modalities can positively affect medical students' skills over the long term.
The baseline ability of medical students and first year residents to use pMDIs was scored via a 10-point scoring system. Students were randomized to receive no education, one-on-one instruction, or video instruction. Students were then retested immediately after the education and at the 3-month mark for retention of acquired skills.
Video, one-on-one and the placebo groups modalities statistically improved the average medical student's score in the immediate retesting (7.5 and 7.4 vs. 4.7, p < .01, respectively). Moreover, the proportion of passing grades at the immediate recall significantly improved for both modalities. During retention testing, only video education had a statistically significant improvement in pass rate over the control group, as defined by an average score of 7 or better (8 vs. 1, p < .05).
One-on-one teaching and video education were able to improve medical students' ability to use pMDIs in short-term testing. However, only video education retained significant improvement compared with control after 3 months. This suggests that compared with traditional one-on-one teaching, video education is an effective means of teaching medical students how to improve their pMDI technique.
压力定量吸入器(pMDIs)仍然是阻塞性肺病的重要治疗选择。指导和评估吸入器使用技术的能力是所有医学专业人员都应具备的关键技能;不幸的是,许多专业人员在使用pMDIs方面并不熟练。我们旨在确定不同形式的简短教育干预措施能否长期对医学生的技能产生积极影响。
通过10分制评分系统对医学生和一年级住院医师使用pMDIs的基线能力进行评分。学生被随机分为不接受教育、一对一指导或视频指导三组。在教育结束后立即以及在3个月时对学生进行重新测试,以评估所获得技能的保留情况。
视频指导、一对一指导和安慰剂组在即时重新测试中均显著提高了医学生的平均得分(分别为7.5分和7.4分,而对照组为4.7分,p < 0.01)。此外,两种指导方式在即时回忆时的及格率均显著提高。在保留测试中,只有视频教育组与对照组相比,通过率有统计学显著提高,定义为平均得分7分或更高(8比1,p < 0.05)。
一对一教学和视频教育能够在短期测试中提高医学生使用pMDIs的能力。然而,与对照组相比,只有视频教育在3个月后仍保持显著的提高。这表明,与传统的一对一教学相比,视频教育是一种有效的教学手段,可以教医学生如何改进他们使用pMDIs的技术。