Mahidol University, Thailand.
Med Teach. 2013 Apr;35(4):308-13. doi: 10.3109/0142159X.2012.746453. Epub 2012 Dec 11.
Injection skill is one of procedural skills usually taught to medical students. Lack of experience and confidence in their ability creates nervousness, anxiety, and leads to poor performance in giving an injection to patient.
To evaluate the satisfaction on teaching method, perceptions of confidence and feeling of empathy to the patients, and performance in injection skill of medical students toward practicing injection skill using manikin only compared to additional training using themselves as surrogate patients.
Control group consisted of year 5 medical students, who completed studying injection skill from computer assistant instruction, demonstration, and practicing with manikin. The intervention group in addition to those conventional learning methods, directly experienced injection skill using themselves as surrogate patients and received direct feedback from their peers. Both group had a chance to perform injection to actual children and were assessed while performing the injection for their performance of injection procedures. Upon completion of the entire learning process, the students were asked to answer questionnaire presented with Likert-type scales.
There were 57 students in the control group and 32 in the intervention group who completed the study. The intervention group reported significantly higher satisfaction on the teaching method, higher level of confidence and empathy to the children who were given injection, and had significantly better performance in preparing the children and giving injection. Both groups are not different in checking accuracy of order, preparing vaccine, selecting injection site, sterile techniques, handling of instruments and injection site, documentation, and explaining to children/parents.
Direct experience by medical students themselves as surrogate patients is an appropriate option for learning injection skill and can enhance the student performance, and therefore should be encouraged.
注射技能是通常教授给医学生的一项程序性技能。由于缺乏经验和对自己能力的信心,学生在给患者注射时会感到紧张、焦虑,导致表现不佳。
评估仅使用模型进行注射技能练习的教学方法的满意度、对患者的信心和同理心的感知,以及医学生在注射技能方面的表现,与使用自身作为替代患者进行额外培训相比。
对照组由五年级医学生组成,他们通过计算机辅助教学、演示和使用模型来完成注射技能的学习。干预组除了常规的学习方法外,还直接使用自身作为替代患者体验注射技能,并从同学那里获得直接反馈。两组都有机会对实际儿童进行注射,并在进行注射时评估他们的注射程序执行情况。在整个学习过程完成后,学生被要求回答带有李克特量表的问卷。
对照组有 57 名学生,干预组有 32 名学生完成了研究。干预组报告说,对教学方法的满意度显著提高,对接受注射的儿童的信心和同理心水平更高,在准备儿童和进行注射方面的表现也明显更好。两组在检查医嘱准确性、准备疫苗、选择注射部位、无菌技术、器械和注射部位处理、记录和向儿童/家长解释方面没有差异。
医学生自身作为替代患者的直接体验是学习注射技能的一种合适选择,可以提高学生的表现,因此应予以鼓励。