Little-Wienert Kim, Hsu Deborah, Torrey Susan, Lemke Daniel, Patel Binita, Turner Teri, Doughty Cara
From the *Baylor College of Medicine, Texas Children's Hospital, Houston, TX; and †New York University School of Medicine, New York, NY.
Pediatr Emerg Care. 2017 Nov;33(11):713-717. doi: 10.1097/PEC.0000000000000679.
Shift work on a pediatric emergency medicine (PEM) rotation makes didactic scheduling difficult, thereby limiting teaching opportunities. These constraints make this rotation an ideal setting to supplement resident education with an online curriculum. We aimed to determine if implementation of an online curriculum during a resident PEM rotation improves posttest performance and increases satisfaction with resident educational experience.
This was a prospective before/after study of pediatric and emergency medicine residents on a 1-month rotation in a tertiary care pediatric emergency department. A curriculum was developed consisting of 17 online modules. In the first 5 months of the study, 42 control residents received traditional bedside teaching. In the last 12 months, 80 intervention residents completed at least 8 modules during their rotation. Both groups completed a pretest at rotation start and a posttest and end-of-rotation survey at rotation end.
Control group pretest and posttest scores were not significantly different. In the intervention group, posttest scores were significantly increased compared with pretest scores (68 vs 59, P < 0.01). A low percentage of residents completed the study. Only 42% of the 189 residents enrolled in the intervention group completed the posttest and 28% completed the survey.
Implementing an online PEM curriculum significantly improved knowledge. As residency programs face new duty hour requirements, online curricula may provide an effective way to supplement teaching. However, to capitalize on this self-directed curriculum, the low participation rates in this study suggest we must first determine and establish ways to overcome barriers to online learning.
儿科急诊医学(PEM)轮转中的轮班工作使得教学安排困难,从而限制了教学机会。这些限制使得该轮转成为用在线课程补充住院医师教育的理想环境。我们旨在确定在住院医师PEM轮转期间实施在线课程是否能提高测试后成绩,并提高对住院医师教育体验的满意度。
这是一项对在三级医疗儿科急诊科进行为期1个月轮转的儿科和急诊医学住院医师的前瞻性前后对照研究。开发了一个由17个在线模块组成的课程。在研究的前5个月,42名对照住院医师接受传统床边教学。在最后12个月,80名干预组住院医师在轮转期间至少完成了8个模块。两组在轮转开始时都进行了预测试,并在轮转结束时进行了后测试和轮转结束调查。
对照组的预测试和后测试成绩没有显著差异。在干预组中,后测试成绩与预测试成绩相比显著提高(68分对59分,P<0.01)。完成研究的住院医师比例较低。在干预组登记的189名住院医师中,只有42%完成了后测试,28%完成了调查。
实施在线PEM课程显著提高了知识水平。随着住院医师培训项目面临新的值班时间要求,在线课程可能提供一种有效的教学补充方式。然而,为了充分利用这种自主学习课程,本研究中的低参与率表明我们必须首先确定并建立克服在线学习障碍的方法。