Couto Thomaz Bittencourt, Farhat Sylvia C L, Geis Gary L, Olsen Orjan, Schvartsman Claudio
Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Clinics (Sao Paulo). 2015 Jun;70(6):393-9. doi: 10.6061/clinics/2015(06)02. Epub 2015 Jun 1.
To compare high-fidelity simulation with case-based discussion for teaching medical students about pediatric emergencies, as assessed by a knowledge post-test, a knowledge retention test and a survey of satisfaction with the method.
This was a non-randomized controlled study using a crossover design for the methods, as well as multiple-choice questionnaire tests and a satisfaction survey. Final-year medical students were allocated into two groups: group 1 participated in an anaphylaxis simulation and a discussion of a supraventricular tachycardia case, and conversely, group 2 participated in a discussion of an anaphylaxis case and a supraventricular tachycardia simulation. Students were tested on each theme at the end of their rotation (post-test) and 4-6 months later (retention test).
Most students (108, or 66.3%) completed all of the tests. The mean scores for simulation versus case-based discussion were respectively 43.6% versus 46.6% for the anaphylaxis pre-test (p=0.42), 63.5% versus 67.8% for the post-test (p=0.13) and 61.5% versus 65.5% for the retention test (p=0.19). Additionally, the mean scores were respectively 33.9% versus 31.6% for the supraventricular tachycardia pre-test (p=0.44), 42.5% versus 47.7% for the post-test (p=0.09) and 41.5% versus 39.5% for the retention test (p=0.47). For both themes, there was improvement between the pre-test and the post-test (p<0.05), and no significant difference was observed between the post-test and the retention test (p>0.05). Moreover, the satisfaction survey revealed a preference for simulation (p<0.001).
As a single intervention, simulation is not significantly different from case-based discussion in terms of acquisition and retention of knowledge but is superior in terms of student satisfaction.
通过知识后测、知识保留测试以及对教学方法满意度的调查，比较高保真模拟教学与基于案例讨论教学在医学生儿科急诊教学中的效果。
本研究采用非随机对照研究，对教学方法采用交叉设计，并进行多项选择题问卷调查和满意度调查。将医学专业最后一年的学生分为两组：第1组参与过敏反应模拟和室上性心动过速病例讨论，相反，第2组参与过敏反应病例讨论和室上性心动过速模拟。学生在轮转结束时（后测）和4至6个月后（保留测试）对每个主题进行测试。
大多数学生（108名，占66.3%）完成了所有测试。过敏反应预测试中，模拟教学与基于案例讨论教学的平均得分分别为43.6%和46.6%（p = 0.42），后测中分别为63.5%和67.8%（p = 0.13），保留测试中分别为61.5%和65.5%（p = 0.19）。此外，室上性心动过速预测试的平均得分分别为33.9%和31.6%（p = 0.44），后测中分别为42.5%和47.7%（p = 0.09），保留测试中分别为41.5%和39.5%（p = 0.47）。对于两个主题，预测试和后测试之间均有提高（p < 0.05），后测试和保留测试之间未观察到显著差异（p > 0.05）。此外，满意度调查显示学生更倾向于模拟教学（p < 0.001）。
作为单一干预措施，模拟教学在知识获取和保留方面与基于案例讨论教学无显著差异，但在学生满意度方面更具优势。
