Cash Thomas, Brand Eleanor, Wong Emma, Richardson Jay, Athorn Sam, Chowdhury Faiza
Academic Unit of Medical Education, The University of Sheffield Medical School, Sheffield, UK.
Clinical Skills Department, Royal Hallamshire Hospital, Sheffield, UK.
Clin Teach. 2017 Jun;14(3):175-179. doi: 10.1111/tct.12558. Epub 2016 Aug 3.
There is growing concern that medical students are inadequately prepared for life as a junior doctor. A lack of confidence managing acutely unwell patients is often cited as a barrier to good clinical care. With medical schools investing heavily in simulation equipment, we set out to explore if near-peer simulation training is an effective teaching format.
Medical students in their third year of study and above were invited to attend a 90-minute simulation teaching session. The sessions were designed and delivered by final-year medical students using clinical scenarios mapped to the Sheffield MBChB curriculum. Candidates were required to assess, investigate and manage an acutely unwell simulated patient. Pre- and post-simulation training Likert scale questionnaires were completed relating to self-reported confidence levels. There is growing concern that medical students are inadequately prepared for life as a junior doctor RESULTS: Questionnaires were completed by 25 students (100% response rate); 52 per cent of students had no prior simulation experience. There were statistically significant improvements in self-reported confidence levels in each of the six areas assessed (p < 0.005). Thematic analysis of free-text comments indicated that candidates enjoyed the practical format of the sessions and found the experience useful.
Our results suggest that near-peer medical student simulation training benefits both teacher and learner and that this simplistic model could easily be replicated at other medical schools. As the most junior members of the team, medical students are often confined to observer status. Simulation empowers students to practise independently in a safe and protected environment. Furthermore, it may help to alleviate anxiety about starting work as a junior doctor and improve future patient care.
人们越来越担心医学生对成为初级医生的生活准备不足。缺乏管理急重症患者的信心常被认为是优质临床护理的障碍。随着医学院校在模拟设备上投入大量资金，我们着手探讨近龄同伴模拟培训是否是一种有效的教学形式。
邀请三年级及以上的医学生参加一场90分钟的模拟教学课程。这些课程由即将毕业的医学生根据谢菲尔德医学学士课程的临床情景进行设计和授课。要求学员对一名急重症模拟患者进行评估、检查和管理。在模拟培训前后完成了与自我报告的信心水平相关的李克特量表问卷。结果：25名学生完成了问卷（回复率100%）；52%的学生此前没有模拟经验。在评估的六个领域中，自我报告的信心水平均有统计学意义的提高（p < 0.005）。对自由文本评论的主题分析表明，学员们喜欢课程的实践形式，并认为这种体验很有用。
我们的结果表明，近龄同伴医学生模拟培训对教师和学员都有益，而且这种简单的模式可以很容易地在其他医学院校复制。作为团队中最年轻的成员，医学生往往只能处于观察者的地位。模拟使学生能够在安全且受保护的环境中独立练习。此外，它可能有助于减轻对开始担任初级医生工作的焦虑，并改善未来的患者护理。
