Pade Kathryn H, Seik-Ismail Sophia T, Chang Todd P, Wang Vincent J
a Department of Emergency Medicine and Transport , Children's Hospital Los Angeles , Los Angeles , CA , USA.
J Asthma. 2018 Jul;55(7):811-815. doi: 10.1080/02770903.2017.1366507. Epub 2017 Oct 13.
Just-in-time training (JITT) has been used to teach and re-teach known medical techniques, but has not been used to teach novel techniques. We aimed to assess the performance retention of JITT on a novel asthma exacerbation severity assessment technique known as Los Angeles (LA) Phonospirometry.
This was a prospective cohort study using a convenience sample of pediatric emergency department registered nurses (RNs) who were asked to watch a brief instructional digital video on LA Phonospirometry, and then asked to practice the technique on a research assistant (RA). A checklist was used to evaluate proficiency with the primary outcome being the number correct on the checklist. The secondary outcome included whether or not they could identify a common error demonstrated by the RA. RNs were re-tested after 4-6 months to assess skill retention.
Forty RNs were enrolled in the study and six were lost to follow-up. The mean time from the first to second testing was 5.4 months ± 0.5 months. The mean score of the first part of the checklist on the initial testing was 4.6 ± 0.7 and on second testing was 3.8 ± 1.5 (p = 0.008). This represented a drop in scores and thus minimal knowledge decay of 18% (from 91% to 73%). The mean values for number of errors picked up for the first test and second test were 1.3 and 1.5, respectively (p = 0.2).
JITT demonstrated feasibility as a rapid instructional tool for RNs, with a limited decay in cognitive knowledge surrounding the LA Phonospirometry technique.
即时培训(JITT)已被用于教授和重新教授已知的医学技术,但尚未用于教授新技术。我们旨在评估JITT对一种名为洛杉矶(LA)呼吸音测定法的新型哮喘加重严重程度评估技术的操作技能保持情况。
这是一项前瞻性队列研究,使用儿科急诊科注册护士(RN)的便利样本,要求他们观看一段关于LA呼吸音测定法的简短教学数字视频,然后要求他们在一名研究助理(RA)身上练习该技术。使用一份检查表来评估熟练程度,主要结果是检查表上的正确项目数。次要结果包括他们是否能识别RA展示的一个常见错误。RN在4 - 6个月后重新测试以评估技能保持情况。
40名RN参与了研究,6名失访。从第一次测试到第二次测试的平均时间为5.4个月±0.5个月。检查表第一部分在初始测试时的平均得分是4.6±0.7,第二次测试时是3.8±1.5(p = 0.008)。这代表得分下降,因此知识衰减最小,为18%(从91%降至73%)。第一次测试和第二次测试中发现的错误数量的平均值分别为1.3和1.5(p = 0.2)。
JITT证明了作为RN快速教学工具的可行性,围绕LA呼吸音测定法技术的认知知识衰减有限。