Bjerrum Anne Sofie, Eika Berit, Charles Peder, Hilberg Ole
Department of Respiratory Diseases, Aarhus University Hospital, Aarhus, Denmark.
Med Educ. 2014 Jul;48(7):705-12. doi: 10.1111/medu.12398.
Medical simulation training requires effective and efficient training strategies. Dyad practice may be a training strategy worth pursuing because it has been proven effective and efficient in motor skills learning. In dyad practice two participants collaborate in learning a task they will eventually perform individually. In order to explore the effects of dyad practice in a medical simulation setting, this study examined the effectiveness and efficiency of dyad practice compared with individual practice in the learning of bronchoscopy through simulation-based training.
A total of 36 students of medicine were randomly assigned to either individual practice or dyad practice. The training setting included video-based instruction, 10 bronchoscopy simulator cases and instructor feedback. Participants in the dyad practice group alternated between physical and observational practice and hence physically undertook only half of the training cases undertaken by participants who practised individually. Pre-, post- and delayed (3 weeks) retention tests were used to assess skills according to previously validated simulator measures. Data were analysed using repeated-measures analysis of variance (anova) on each dependent measure.
A significant main effect of test was found for all measures (F2,67 > 23.32, p < 0.001), indicating improvement in performance from pre-tests to post-tests and retention tests. No interaction was found between test and group (F2,67 < 0.26, p > 0.49), indicating parallel learning curves. Most importantly, no main effect of group was found for any of the measures, indicating no difference between learning curves (F1,34 = 2.08, p < 0.16).
Individual practice and dyad practice did not differ in their effectiveness for the acquisition of bronchoscopy skills through supervised simulation training. However, dyad practice proved more efficient than individual practice because two participants practising in dyads learned as much as one participant practising individually but required the same instructor resources and training time as the single learner.
医学模拟训练需要有效且高效的训练策略。双人练习可能是一种值得探索的训练策略，因为它在运动技能学习中已被证明是有效且高效的。在双人练习中，两名参与者合作学习一项最终将各自独立执行的任务。为了探究双人练习在医学模拟环境中的效果，本研究通过基于模拟的训练，考察了双人练习与单人练习在支气管镜检查学习中的有效性和效率。
总共36名医科学生被随机分配到单人练习组或双人练习组。训练设置包括视频教学、10个支气管镜模拟器病例以及教师反馈。双人练习组的参与者在实际操作练习和观察练习之间交替进行，因此实际操作的训练病例数量仅为单人练习参与者的一半。根据先前经验证的模拟器测量方法，通过课前、课后和延迟（3周）留存测试来评估技能。对每个因变量使用重复测量方差分析（anova）进行数据分析。
所有测量指标均发现显著的测试主效应（F2,67 ＞ 23.32，p ＜ 0.001），表明从课前测试到课后测试以及留存测试，表现有所提高。未发现测试与组间的交互作用（F2,67 ＜ 0.26，p ＞ 0.49），表明学习曲线平行。最重要的是，任何测量指标均未发现组间主效应，表明学习曲线无差异（F1,34 = 2.08，p ＜ 0.16）。
通过有监督的模拟训练获取支气管镜检查技能，单人练习和双人练习在有效性方面没有差异。然而，双人练习比单人练习更高效，因为两名以双人形式练习的参与者学到的内容与一名单独练习的参与者一样多，但所需的教师资源和训练时间与单独学习者相同。
