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社会学文化对学习的贡献:为什么我的学生没有学会无菌非接触技术?医学生未能掌握这项技能所涉及的多维因素。

The sociocultural contribution to learning: why did my students fail to learn Aseptic Non-Touch Technique? Multidimensional factors involved in medical students' failure to learn this skill.

机构信息

Birmingham Children’s Hospital, Steelhouse Lane, Birmingham B4 6NH, USA.

出版信息

Med Teach. 2012;34(12):e800-7; quiz e808-12. doi: 10.3109/0142159X.2012.714874. Epub 2012 Aug 30.

Abstract

BACKGROUND

Infection control in the hospital environment is a topical issue in the UK. Aseptic Non-Touch Technique (ANTT) has been recommended as an example of best practice for clinical skills requiring aseptic technique. ANTT is taught to clinical staff and to medical students at a West Midlands teaching hospital.

AIMS

To determine the effectiveness of ANTT training within an undergraduate population and to explore the factors involved in medical students' failure to learn this skill Method: 132 Students underwent training and assessment in ANTT. A sample of 42 students underwent re-testing in ANTT 7-10 weeks later. Student questionnaires and semi-structured interviews with students and trainers were undertaken to determine students' daily practice of ANTT, and practice observed in staff.

RESULTS

Student performance deteriorated significantly 10 weeks after initial ANTT training (p < 0.001). Qualitative data demonstrates an emphasis on assessment, poor observed practice in staff, and a lack of resources in the clinical setting. Further themes include acceptance of hierarchy, and a lack of belief in ANTT amongst students.

CONCLUSION

In order to bring about effective training in ANTT, we must look to the sociocultural contribution of the hospital environment alongside formal ANTT training.

摘要

背景

医院环境中的感染控制是英国的一个热门话题。无菌非接触技术(ANTT)已被推荐为需要无菌技术的临床技能的最佳实践范例。在西米德兰兹教学医院,为临床工作人员和医学生教授 ANTT。

目的

确定 ANTT 培训在本科生群体中的有效性,并探讨医学生未能学习这项技能的相关因素。

方法

132 名学生接受了 ANTT 培训和评估。42 名学生的样本在 7-10 周后接受了 ANTT 的重新测试。学生问卷和学生及教师的半结构化访谈旨在确定学生日常的 ANTT 实践,以及观察到的工作人员的实践情况。

结果

学生在初始 ANTT 培训 10 周后表现明显下降(p < 0.001)。定性数据表明,评估受到重视,工作人员的实际操作不佳,临床环境中资源匮乏。其他主题还包括对等级制度的接受,以及学生对 ANTT 的缺乏信任。

结论

为了实现有效的 ANTT 培训,我们必须考虑医院环境的社会文化贡献,同时进行正式的 ANTT 培训。

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