Department of Pediatrics, Boston Medical Center & Boston University School of Medicine, Boston, Mass.
Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania & The Children's Hospital of Philadelphia, Philadelphia, Pa.
Acad Pediatr. 2018 Jul;18(5):535-541. doi: 10.1016/j.acap.2017.12.010. Epub 2018 Jan 8.
Effective self-directed educational tools are invaluable. Our objective was to determine whether a self-directed, web-based oral case presentation module would improve medical students' oral case presentations compared to usual curriculum, and with similar efficacy as structured oral presentation faculty feedback sessions.
We conducted a pragmatic multicenter cluster randomized controlled trial among medical students rotating in pediatric clerkships at 7 US medical schools. In the clerkship's first 14 days, subjects were instructed to complete an online Computer-Assisted Learning in Pediatrics Program (CLIPP) oral case presentation module, an in-person faculty-led case presentation feedback session, or neither (control). At the clerkship's end, evaluators blinded to intervention status rated the quality of students' oral case presentations on a 10-point scale. We conducted intention-to-treat multivariable analyses clustered on clerkship block.
Study participants included 256 CLIPP (32.5%), 263 feedback (33.3%), and 270 control (34.2%) subjects. Only 51.1% of CLIPP subjects completed the assigned presentation module, while 98.5% of feedback subjects participated in presentation feedback sessions. Compared to controls, oral presentation quality was significantly higher in the feedback group (adjusted difference in mean quality, 0.28; 95% confidence interval, 0.08, 0.49) and trended toward being significantly higher in the CLIPP group (0.19; 95% confidence interval, -0.006, 0.38). The quality of presentations in the CLIPP and feedback groups was not significantly different (-0.10; 95% confidence interval, -0.31, 0.11).
The quality of oral case presentations delivered by students randomized to complete the CLIPP module did not differ from faculty-led presentation feedback sessions and was not statistically superior to control.
有效的自我指导教育工具是非常宝贵的。我们的目的是确定自我指导的基于网络的口头病例呈现模块是否会提高医学生的口头病例呈现能力,与常规课程相比,以及与结构化的口头呈现教师反馈会议具有相似的效果。
我们在美国 7 所医学院的儿科实习轮转医学生中进行了一项实用的多中心集群随机对照试验。在实习的前 14 天,学生被指导完成在线儿科计算机辅助学习计划(CLIPP)口头病例呈现模块、面对面的教师主导的病例呈现反馈会议或两者都不参加(对照组)。在实习结束时,评估者对学生口头病例呈现的质量进行了 10 分制的盲法评估。我们对实习块进行了意向治疗多变量分析。
研究参与者包括 256 名 CLIPP(32.5%)、263 名反馈(33.3%)和 270 名对照组(34.2%)。只有 51.1%的 CLIPP 学生完成了指定的演示模块,而 98.5%的反馈学生参加了演示反馈会议。与对照组相比,反馈组的口头演示质量显著更高(调整后的平均质量差异,0.28;95%置信区间,0.08,0.49),并且在 CLIPP 组中呈趋势更高(0.19;95%置信区间,-0.006,0.38)。CLIPP 和反馈组的演示质量没有显著差异(-0.10;95%置信区间,-0.31,0.11)。
被随机分配完成 CLIPP 模块的学生的口头病例呈现质量与教师主导的呈现反馈会议没有差异,也没有统计学上优于对照组。