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一项关于研究SimMan®作为辅助工具在向医学生教授临床前技能方面有效性的研究。

A study to investigate the effectiveness of SimMan® as an adjunct in teaching preclinical skills to medical students.

作者信息

Swamy Meenakshi, Sawdon Marina, Chaytor Andrew, Cox David, Barbaro-Brown Judith, McLachlan John

机构信息

School of Medicine, Pharmacy and Health, Holliday Building, Durham University, Queen's Campus, University Boulevard, Stockton on Tees TS17 6BH, UK.

出版信息

BMC Med Educ. 2014 Nov 19;14:231. doi: 10.1186/1472-6920-14-231.

Abstract

BACKGROUND

Following the GMC's report on Tomorrow's Doctors, greater emphasis has been placed on training in clinical skills, and the integration of clinical and basic sciences within the curriculum to promote the development of effective doctors. The use of simulation in the learning environment has the potential to support the development of clinical skills in preclinical medical students whilst in a 'safe' environment, but currently there is little evidence on its effectiveness.

METHODS

Seventy nine year one medical students were divided into two groups. A pre-test was conducted by both groups, after which one group performed chest examination on their peers whilst the other group examined the SimMan® manikin. Both groups subsequently performed a mid-test and crossed over so that the group that conducted peer examination examined the manikin and vice-versa. Finally a post-test was conducted. The students were scored for formative feedback whilst performing examinations. Students completed a feedback questionnaire at the end of the session. Data were analysed using a one-way ANOVA, independent t-test and 2- proportion Z test.

RESULTS

When the two groups were compared, there was no significant difference in their pre-test and post-test knowledge scores, whereas mid-test knowledge scores increased significantly (P < 0.001), with the group using SimMan® initially scoring higher. A significant increase in the test scores was seen in both groups after using SimMan® (P < 0.001). Students' confidence increased significantly in differentiating between normal and abnormal signs (P < 0.001). Students highly valued the use of the manikin in the session with 96% of students reporting that it enhanced their learning experience.

CONCLUSIONS

The study demonstrated a significant improvement in the students' knowledge after examining the manikin and students also reported an increase in their confidence. Students' feedback was generally very positive and they perceived the incorporation of manikin-based examinations useful to prepare them for future patient contact. The use of simulation in this context supports an integrated learning approach when used as an adjunct to peer examination, and can benefit the acquisition of clinical skills in preclinical medical students.

摘要

背景

英国医学总会(GMC)发布关于《明日医生》的报告后,临床技能培训以及课程中临床科学与基础科学的整合受到了更多重视,以培养出更优秀的医生。在学习环境中使用模拟技术有潜力在“安全”环境下支持临床前医学生临床技能的发展,但目前关于其有效性的证据较少。

方法

79名一年级医学生被分为两组。两组都进行了预测试,之后一组对同伴进行胸部检查,另一组检查SimMan®模拟人。两组随后都进行了中期测试并交换,即之前进行同伴检查的组改为检查模拟人,反之亦然。最后进行了后测试。学生在进行检查时会得到形成性反馈评分。课程结束时,学生完成了一份反馈问卷。数据使用单因素方差分析、独立样本t检验和双比例Z检验进行分析。

结果

比较两组时,预测试和后测试的知识得分没有显著差异,而中期测试的知识得分显著提高(P < 0.001),最初使用SimMan®的组得分更高。两组在使用SimMan®后测试成绩都有显著提高(P < 0.001)。学生在区分正常和异常体征方面的信心显著增强(P < 0.001)。学生高度评价在课程中使用模拟人,96%的学生报告称这增强了他们的学习体验。

结论

该研究表明,检查模拟人后学生的知识有显著提高,学生也报告信心有所增强。学生的反馈总体非常积极,他们认为基于模拟人的检查有助于他们为未来与患者接触做好准备。在这种情况下,模拟技术作为同伴检查的辅助手段,支持了一种综合学习方法,并且可以有益于临床前医学生临床技能的获得。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/823b/4289028/8a52c20f967d/12909_2014_1068_Fig1_HTML.jpg

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