基于模拟的临床关联课程作为解剖学课程辅助教学法的设计、实施与评估

Design, Implementation, and Evaluation of a Simulation-Based Clinical Correlation Curriculum as an Adjunctive Pedagogy in an Anatomy Course.

作者信息

Coombs Carmen M, Shields Ryan Y, Hunt Elizabeth A, Lum Ying Wei, Sosnay Patrick R, Perretta Julianne S, Lieberman Rhett H, Shilkofski Nicole A

机构信息

C.M. Coombs is assistant professor, Division of Emergency Medicine, Seattle Children's Hospital, Seattle, Washington. R.Y. Shields is a resident in obstetrics and gynecology, Yale University School of Medicine, New Haven, Connecticut. At the time of writing, R.Y. Shields was a medical student, Johns Hopkins University School of Medicine, Baltimore, Maryland. E.A. Hunt is associate professor, Departments of Anesthesiology and Critical Care Medicine, Pediatrics, and Health Informatics, Johns Hopkins University School of Medicine, Baltimore, Maryland. Y.W. Lum is assistant professor, Division of Vascular Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, and former course director for human anatomy, Perdana University Graduate School of Medicine, Kuala Lumpur, Malaysia. P.R. Sosnay is assistant professor, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, and former director, Genes to Society Curriculum, Perdana University Graduate School of Medicine, Kuala Lumpur, Malaysia. J.S. Perretta is instructor, Division of Anesthesia and Critical Care Medicine, Johns Hopkins University School of Medicine, and lead simulation educator, Johns Hopkins Medicine Simulation Center, Baltimore, Maryland. R.H. Lieberman is associate professor, Division of Pediatric Emergency Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. N.A. Shilkofski is assistant professor, Departments of Anesthesiology and Critical Care Medicine and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, and former vice dean for education, Perdana University Graduate School of Medicine, Kuala Lumpur, Malaysia.

出版信息

Acad Med. 2017 Apr;92(4):494-500. doi: 10.1097/ACM.0000000000001387.

DOI:10.1097/ACM.0000000000001387

PMID:27680320

Abstract

PROBLEM

Because reported use of simulation in preclinical basic science courses is limited, the authors describe the design, implementation, and preliminary evaluation of a simulation-based clinical correlation curriculum in an anatomy course for first-year medical students at Perdana University Graduate School of Medicine (in collaboration with Johns Hopkins University School of Medicine).

APPROACH

The simulation curriculum, with five weekly modules, was a component of a noncadaveric human anatomy course for three classes (n = 81 students) from September 2011 to November 2013. The modules were designed around major anatomical regions (thorax; abdomen and pelvis; lower extremities and back; upper extremities; and head and neck) and used various types of simulation (standardized patients, high-fidelity simulators, and task trainers). Several methods were used to evaluate the curriculum's efficacy, including comparing pre- versus posttest scores and comparing posttest scores against the score on 15 clinical correlation final exam questions.

OUTCOMES

A total of 81 students (response rate: 100%) completed all pre- and posttests and consented to participate. Posttest scores suggest significant knowledge acquisition and better consistency of performance after participation in the curriculum. The comparison of performance on the posttests and final exam suggests that using simulation as an adjunctive pedagogy can lead to excellent short-term knowledge retention.

NEXT STEPS

Simulation-based medical education may prove useful in preclinical basic science curricula. Next steps should be to validate the use of this approach, demonstrate cost-efficacy or the "return on investment" for educational and institutional leadership, and examine longer-term knowledge retention.

摘要

问题

由于临床前基础科学课程中模拟教学的应用报道有限，作者描述了在马来西亚博特拉大学医学院（与约翰·霍普金斯大学医学院合作）为一年级医学生开设的解剖学课程中，基于模拟的临床关联课程的设计、实施和初步评估。

方法

该模拟课程每周有五个模块，是2011年9月至2013年11月为三个班级（n = 81名学生）开设的非尸体人体解剖学课程的一部分。这些模块围绕主要解剖区域（胸部；腹部和骨盆；下肢和背部；上肢；以及头部和颈部）设计，并使用了各种类型的模拟（标准化病人、高保真模拟器和任务训练器）。采用了几种方法来评估该课程的效果，包括比较测试前和测试后的分数，以及将测试后的分数与15道临床关联期末考试题的分数进行比较。