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一切为了打结:评估以熟练度为导向、基于模拟的打结和缝合课程在医学生三年级外科实习期间的效果。

All for knots: evaluating the effectiveness of a proficiency-driven, simulation-based knot tying and suturing curriculum for medical students during their third-year surgery clerkship.

作者信息

Pender Cianna, Kiselov Vladimir, Yu Qingzhao, Mooney Jennifer, Greiffenstein Patrick, Paige John T

机构信息

Department of Surgery, LSU Health New Orleans Health Sciences Center, 1542 Tulane Avenue, Room 734, New Orleans, LA 70112, USA.

School of Public Health, LSU Health New Orleans Health Sciences Center, New Orleans, LA, USA.

出版信息

Am J Surg. 2017 Feb;213(2):362-370. doi: 10.1016/j.amjsurg.2016.06.028. Epub 2016 Aug 22.

Abstract

BACKGROUND

We evaluated the effectiveness of implementing a proficiency-driven, simulation-based knot tying and suturing curriculum for medical students during their 3rd-year surgery clerkship.

METHODS

Medical students on the 3rd-year surgical clerkship completed a proficiency-driven, simulation-based knot tying and suturing curriculum consisting of 6 tasks. The effectiveness was evaluated by comparing the initial presession scores to the final postsession scores on an 8-item self-efficacy scale and evaluating pass rates on end of clerkship skills testing. A paired t test was used to analyze data.

RESULTS

Sixty-five students had matched preintervention and postintervention questionnaires for analysis. Pass rates approached 100% by the 3rd attempt on all tasks. Significant gains on all 8 items of the self-efficacy questionnaire from pretraining to post-training were noted. Timing of the general surgery rotation did not impact results.

CONCLUSIONS

Implementation of a simulation-based training, proficiency-driven knot tying and suturing curriculum for 3rd-year medical students during the surgery clerkship is feasible and effective in improving student self-efficacy and objective proficiency toward performance of the tasks taught.

摘要

背景

我们评估了在医学生三年级外科实习期间实施以熟练度为导向、基于模拟的打结和缝合课程的效果。

方法

三年级外科实习的医学生完成了一项由6项任务组成的以熟练度为导向、基于模拟的打结和缝合课程。通过在一个8项自我效能量表上比较课前初始分数和课后最终分数,并评估实习结束技能测试的通过率来评估效果。使用配对t检验分析数据。

结果

65名学生有配对的干预前和干预后问卷用于分析。所有任务在第三次尝试时通过率接近100%。自我效能量表的所有8项从训练前到训练后都有显著提高。普通外科轮转的时间不影响结果。

结论

在外科实习期间为三年级医学生实施基于模拟训练、以熟练度为导向的打结和缝合课程,对于提高学生对所学任务表现的自我效能和客观熟练度是可行且有效的。

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