Berjano Pedro, Villafañe Jorge Hugo, Vanacker Gerard, Cecchinato Riccardo, Ismael Maryem, Gunzburg Robert, Marruzzo Daniele, Lamartina Claudio
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
IRCCS Don Gnocchi Foundation, Milan, Italy.
Eur Spine J. 2017 Oct;26(10):2660-2665. doi: 10.1007/s00586-016-4860-2. Epub 2016 Nov 14.
This investigation aimed to examine the extent to which case-based discussion with experts could influence the audience's opinions on the treatment of patients during a continuing medical education event for spine surgeons.
We conducted a prospective controlled crossover study of 90 surgeons. During a continuing medical education activity using case-based discussion, quiz questions were used which asked participants (attendants and faculty group) their opinions on the best choices about diagnosis and treatment in a number of cases. No answer was considered correct, but we evaluated the number of participants choosing each specific answer among a number of valid options. Quiz questions were collected with an automated response system at the entry and at the end of each case discussion. Change in participant's opinions was estimated from the change in the preferred answers between the entry and exit quizzes. Chi-square analysis was performed to determine significance.
Sixty-two attendants out of eighty three (75%) and six faculties out of twelve (50%) responded to the survey. After the case discussion, 68.2% (p < 0.04, Chi-square test) of the attendants changed their opinion on the appropriate treatment. The faculty answers, however, showed no significant change in opinions regarding the identification of the appropriate treatment.
On the basis of our results, case-based discussion driven by experts, as a form of teaching, has a measurable effect in terms of changes in the learners' opinions.
本研究旨在探讨在脊柱外科医生继续医学教育活动中,与专家进行基于病例的讨论对受众关于患者治疗意见的影响程度。
我们对90名外科医生进行了一项前瞻性对照交叉研究。在一次使用基于病例讨论的继续医学教育活动中,使用了问答问题,询问参与者(参会人员和教员组)对于多个病例中诊断和治疗最佳选择的意见。没有答案被认为是正确的,但我们评估了在多个有效选项中选择每个特定答案的参与者数量。在每个病例讨论开始和结束时,通过自动应答系统收集问答问题。根据开始和结束问答中首选答案的变化来估计参与者意见的变化。进行卡方分析以确定显著性。
83名参会人员中有62名(75%)和12名教员中有6名(50%)回复了调查。病例讨论后,68.2%的参会人员(卡方检验,p < 0.04)改变了他们对适当治疗的意见。然而,教员的答案在关于确定适当治疗方面没有显示出意见的显著变化。
根据我们的结果,由专家推动的基于病例的讨论作为一种教学形式,在学习者意见变化方面具有可衡量的效果。