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感知和适应学习模块对麻醉住院医师经食管超声心动图解读的影响。

The impact of a perceptual and adaptive learning module on transoesophageal echocardiography interpretation by anaesthesiology residents.

机构信息

Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9068, USA

Department of Physiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1751, USA.

出版信息

Br J Anaesth. 2016 Oct;117(4):477-481. doi: 10.1093/bja/aew295.

Abstract

BACKGROUND

The role of transoesophageal echocardiography (TOE) in anaesthetic practice is expanding. We evaluated the effect of a TOE perceptual and adaptive learning module (PALM) on first-yr anaesthesiology residents' performance, in diagnosing cardiac pathology by TOE.

METHODS

First-yr residents were assigned to a group (n = 12) that used a TOE PALM or a control group that did not (n = 12). Both groups received a TOE pretest that measured their accuracy and response times. The PALM group completed the PALM and a posttest within 30 min and a delayed test six months later. The control group received a delayed test six months after their pretest. Accuracy and fluency (accurate responses within 10 s) were measured.

RESULTS

The PALM group had statistically significant improvements for both accuracy and fluency (P < 0.0001) in diagnosing cardiac pathology by TOE. After six months, the PALM group's performance remained significantly higher than their pretest values for accuracy (P = 0.0002, d = 2.7) and fluency (P < 0.0001, d = 2.3).

CONCLUSIONS

In this pilot study, exposure to a PALM significantly improved accuracy and fluency in diagnosing TOE cardiac pathology, in a group of first-year anaesthesiology residents. PALMs can significantly improve learning and pattern recognition in medical education.

摘要

背景

经食管超声心动图(TOE)在麻醉实践中的作用正在扩大。我们评估了 TOE 感知和适应学习模块(PALM)对第一年麻醉学住院医师通过 TOE 诊断心脏病理学表现的影响。

方法

将第一年住院医师分配到使用 TOE PALM 的组(n = 12)或未使用 TOE PALM 的对照组(n = 12)。两组均接受了一项 TOE 预测试,以衡量他们的准确性和反应时间。PALM 组在 30 分钟内完成了 PALM 和后测,并在六个月后进行了延迟测试。对照组在预测试六个月后进行了延迟测试。测量准确性和流畅性(在 10 秒内准确回答)。

结果

TOE 诊断心脏病理学时,PALM 组的准确性和流畅性均有统计学显著提高(P < 0.0001)。六个月后,PALM 组的表现仍然明显高于其预测试的准确性(P = 0.0002,d = 2.7)和流畅性(P < 0.0001,d = 2.3)。

结论

在这项试点研究中,暴露于 PALM 显著提高了第一年麻醉学住院医师通过 TOE 诊断心脏病理学的准确性和流畅性。PALM 可以显著提高医学教育中的学习和模式识别。

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