Ruesseler M, Sterz J, Bender B, Hoefer S, Walcher F
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, Theodor Stern Kai 7, 60590, Frankfurt/Main, Germany.
Centre of Surgery, University Hospital Frankfurt, Goethe University, Theodor Stern Kai 7, 60590, Frankfurt/Main, Germany.
Eur J Trauma Emerg Surg. 2017 Aug;43(4):461-466. doi: 10.1007/s00068-016-0734-x. Epub 2016 Oct 11.
Feedback can significantly improve future performance. Reviewing one's performance by video is discussed as useful adjunct to debriefing, particularly for non-technical skills. Communicative competencies are an essential part of daily clinical practice; thus should be taught and assessed during undergraduate training. The aim of this study was to compare the educational value of video-assisted feedback versus oral feedback in communicative competencies in the surgical context.
Fourth-year medical students completed a 210-min training unit of 'taking patient's history and obtaining informed consents prior to surgery' using role plays. Oral feedback was received directly thereafter using agenda-led, outcome-based guidelines (ALOBA). In the study group, the role plays were video-taped and reviewed thereafter. Afterwards, students completed two OSCE stations, where they were assessed regarding their communicative competencies and the content of the clinical scenario.
One-hundred students (49 receiving video-assisted feedback, 51 oral) participated in the study. Those receiving video-assisted feedback performed significantly better in overall score in both OSCE stations (p < 0.001), in all five assessed communicative competencies at taking patient history (p = 0.029 or better), and in 2 of 5 items at obtaining informed consent (p = 0.008, <0.001). The educational effect size for both tasks was large.
Using our methodology, video-assisted feedback offered a significant educational benefit over oral feedback alone during a simulated patient encounter in a surgical context.
反馈可显著提高未来表现。通过视频回顾自己的表现被认为是对总结汇报有用的辅助手段，尤其对于非技术技能而言。沟通能力是日常临床实践的重要组成部分；因此在本科培训期间应进行教授和评估。本研究的目的是比较视频辅助反馈与口头反馈在外科环境中沟通能力方面的教育价值。
四年级医学生通过角色扮演完成了一个210分钟的“术前询问患者病史并获得知情同意”培训单元。之后直接使用以议程为导向、基于结果的指南（ALOBA）接受口头反馈。在研究组中，角色扮演被录像并随后进行回顾。之后，学生们完成了两个客观结构化临床考试（OSCE）站点，在那里他们在沟通能力和临床场景内容方面接受评估。
100名学生（49名接受视频辅助反馈，51名接受口头反馈）参与了研究。接受视频辅助反馈的学生在两个OSCE站点的总分（p < 0.001）、询问患者病史时所有五项评估的沟通能力（p = 0.029或更好）以及获得知情同意的五项内容中的两项（p = 0.008，<0.001）方面表现明显更好。两项任务的教育效果量都很大。
使用我们的方法，在外科环境中模拟患者接触期间，视频辅助反馈比单纯的口头反馈提供了显著的教育益处。
