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分心静脉穿刺(DIVA)测试。

The distracted intravenous access (DIVA) test.

作者信息

Smith Samantha, Tallentire Victoria, Wood Morwenna, Cameron Helen

机构信息

Centre for Medical Education, University of Edinburgh, UK.

出版信息

Clin Teach. 2012 Oct;9(5):320-4. doi: 10.1111/j.1743-498X.2012.00543.x.

Abstract

BACKGROUND

The General Medical Council states that all medical graduates must be able to carry out practical procedures, including peripheral venous cannulation, safely and effectively. Teaching and assessments within primary medical training tend to focus on safety rather than 'effectiveness' or technical competence. This study aimed to develop and evaluate a test of automaticity of peripheral venous cannulation skill, appropriate to the level of a medical student.

METHODS

Two researchers developed the distracted intravenous access (DIVA) test. Three components are assessed simultaneously: ability to cannulate a plastic arm manikin, performance in an arithmetic test and speed of completion. Volunteers were recruited from three groups: novices (fourth-year medical students), intermediates (foundation year-1 doctors) and experts (anaesthetic and emergency medicine consultants and trainees). Immediately following the test, volunteers completed a questionnaire.

RESULTS

Mean scores differed between the three groups: novices (47.7%), intermediates (73.4%), experts (84.4%). Differences were statistically significant (p < 0.0005). The majority of participants found the test to be enjoyable (78%) and useful (76%). More students agreed that the test was fair (78%) than doctors (38%), but this difference was not statistically significant.

DISCUSSION

This study presents a feasible method of testing medical students' automaticity when performing peripheral venous cannulation. It has provided evidence of the construct validity and acceptability of the test. The authors suggest that clinical tutors consider offering the test as a formative assessment to final-year medical students in order to familiarise them with the level of proficiency required to perform peripheral venous cannulation when distracted.

摘要

背景

英国医学总会指出,所有医学毕业生都必须能够安全、有效地进行包括外周静脉置管在内的实际操作。初级医学培训中的教学和评估往往侧重于安全性,而非“有效性”或技术能力。本研究旨在开发并评估一项适合医学生水平的外周静脉置管技能自动化测试。

方法

两名研究人员开发了分心静脉穿刺(DIVA)测试。同时评估三个部分:在塑料手臂人体模型上进行置管的能力、算术测试中的表现以及完成速度。从三组人员中招募志愿者:新手(四年级医学生)、中级人员(第一年住院医生)和专家(麻醉和急诊医学顾问及实习生)。测试结束后,志愿者立即填写一份问卷。

结果

三组的平均得分有所不同:新手(47.7%)、中级人员(73.4%)、专家(84.4%)。差异具有统计学意义(p < 0.0005)。大多数参与者认为该测试有趣(78%)且有用(76%)。更多学生(78%)认为测试公平,而医生中这一比例为38%,但这种差异无统计学意义。

讨论

本研究提出了一种可行的方法来测试医学生进行外周静脉置管时的自动化程度。它为该测试的结构效度和可接受性提供了证据。作者建议临床导师考虑将该测试作为对即将毕业的医学生的形成性评估,以使他们熟悉在分心状态下进行外周静脉置管所需的熟练程度。

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1
The distracted intravenous access (DIVA) test.分心静脉穿刺(DIVA)测试。
Clin Teach. 2012 Oct;9(5):320-4. doi: 10.1111/j.1743-498X.2012.00543.x.

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