一种医学生在线学习 X 光片解读的提示策略。

The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.

Med Educ. 2013 Sep;47(9):877-87. doi: 10.1111/medu.12182.

CONTEXT

We examined whether a 'hint' manoeuvre increases the time novice medical learners spend on reviewing a radiograph, thereby potentially increasing their interpretation accuracy.

METHODS

Senior year medical students were recruited into a randomised control, three-arm, multicentre trial. Students reviewed an online 50-case learning set that varied in degree of 'hint' intervention. The 'hint' was a dialogue box that appeared after a student submitted an answer, encouraging the student to re-evaluate their interpretation. The students in the control group received no hints. In the weak intervention group, students received 'hints' with 66% of their incorrect interpretations and 33% of those that were correct. In the strong intervention group, the incorrect interpretation hint frequency was 80%, whereas for correct responses it was 20%. All students completed a 20-case post-test immediately and 2 weeks after the 50 cases. The primary outcome was student performance on the immediate post-test, measured as the ability to discriminate between normal and abnormal films (dPrime). Secondary outcomes included the probability of considering the hint, time spent on learning cases and knowledge retention at 2 weeks.

RESULTS

We enrolled 117 medical students from three sites into the three study groups: control (36), weak intervention (40) and strong intervention (41) groups. The mean (standard deviation) dPrime in the control, weak and strong groups were 0.4 (1.1), 0.7 (1.1) and 0.4 (0.9), respectively (P = 0.4). In the weak and strong groups, participants reconsidered answers in 556 of 1944 (28.6%) hinting opportunities, and those who reconsidered their answers spent a mean (95% confidence interval) of 13.9 (11.9, 16.0) seconds longer on each case. There were no significant differences in knowledge retention at 2 weeks between the groups (P = 0.2).

CONCLUSIONS

Although the implemented hinting strategy did result in students spending more time considering a proportion of the cases, overall it was not effective in improving student performance.

背景

我们研究了“提示”操作是否会增加新手医学学习者审查 X 光片的时间，从而潜在地提高他们的解释准确性。

方法

我们招募了高年级医学生参与一项随机对照、三臂、多中心试验。学生在线查看了一个 50 例学习集，其中的“提示”干预程度不同。“提示”是在学生提交答案后出现的一个对话框，鼓励学生重新评估他们的解释。对照组的学生没有收到提示。在弱干预组中，学生收到了 66%的错误解释和 33%的正确解释的提示。在强干预组中，错误解释的提示频率为 80%，而正确答案的提示频率为 20%。所有学生在学习完 50 例后立即和 2 周后完成了一个 20 例的后测。主要结局是学生在即时后测中的表现，用区分正常和异常 X 光片的能力（dPrime）来衡量。次要结局包括考虑提示的可能性、学习案例所花费的时间和 2 周后的知识保留率。

结果

我们从三个地点招募了 117 名医学生进入三组研究：对照组（36 人）、弱干预组（40 人）和强干预组（41 人）。对照组、弱干预组和强干预组的平均（标准差）dPrime 分别为 0.4（1.1）、0.7（1.1）和 0.4（0.9）（P=0.4）。在弱干预组和强干预组中，参与者在 1944 次提示机会中有 556 次（28.6%）重新考虑了答案，而那些重新考虑答案的人在每个病例上平均花费了 13.9（11.9，16.0）秒。在 2 周后的知识保留率方面，各组之间没有显著差异（P=0.2）。