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评估使用尸体标本进行关节复位教学的效用。

Evaluation of the utility of teaching joint relocations using cadaveric specimens.

机构信息

The University of Adelaide, Frome Road, Adelaide, South Australia, SA 5005, Australia.

Discipline of Anatomy and Pathology, Adelaide Medical School, The University of Adelaide, Frome Road, Adelaide, South Australia, SA 5005, Australia.

出版信息

BMC Med Educ. 2018 Mar 20;18(1):41. doi: 10.1186/s12909-018-1151-0.

Abstract

BACKGROUND

Like other procedural skills, the ability to relocate a joint is an important aspect of junior doctor education. Changes in the approach to teaching and learning from the traditional apprenticeship-style model have made the teaching of practical skills more difficult logistically. Workshops utilising cadaveric specimens offer a solution to this problem.

METHODS

One hundred forty-six fourth year medical students were randomly divided into 5 groups. Each group received a different teaching intervention based on ankle, patella and hip relocation. The interventions consisted of online learning modules, instructional cards and workshops using skeleton models and cadaveric dislocation models. Following the intervention students were given a test containing multiple choice and true/false style questions. A 13-item 5-point Likert scale questionnaire was also delivered before and after the intervention. The data was analysed using one-way analysis of variance (ANOVA) and the Bonferroni post-hoc test.

RESULTS

Compared to the instructional cards group, the other 4 groups showed a 10.8-19.2% improvement in total test score (p < 0.01) and an 18.4-25.3% improvement in self-reported understanding and confidence in performing joint relocations (P < 0.01). There was no significant difference in total test scores between groups exposed to cadaveric instruction on the relocation of one-, two- or all three- joints, nor any significant difference between all the cadaveric dislocation groups and the group receiving instruction on the skeleton model.

CONCLUSION

The results of the present study suggest that workshops utilising cadaveric dislocation models are effective in teaching joint relocation. In addition, the finding that lower fidelity models may be of equal utility may provide institutions with flexibility of delivery needed to meet financial and resource constraints.

摘要

背景

与其他程序性技能一样,关节复位能力是医学生教育的重要方面。传统学徒式教学模式的改变使得实践技能的教学在后勤方面更加困难。利用尸体标本的研讨会为解决这个问题提供了一种方法。

方法

将 146 名四年级医学生随机分为 5 组。每组接受基于踝关节、髌骨和髋关节复位的不同教学干预。干预措施包括在线学习模块、教学卡片以及使用骨骼模型和尸体脱位模型的研讨会。干预后,学生接受了包含多项选择题和是非题的测试。在干预前后还提供了一份包含 13 个项目的 5 分李克特量表问卷。使用单因素方差分析(ANOVA)和 Bonferroni 事后检验对数据进行分析。

结果

与教学卡片组相比,其他 4 组的总测试分数提高了 10.8-19.2%(p<0.01),自我报告理解和对关节复位的信心提高了 18.4-25.3%(P<0.01)。在接受尸体指导进行一个、两个或三个关节复位的 4 个组之间,以及在接受骨骼模型指导的所有尸体脱位组与接受尸体指导的组之间,总测试分数没有显著差异。

结论

本研究结果表明,利用尸体脱位模型的研讨会在教授关节复位方面是有效的。此外,发现低保真度模型可能同样有效,这可能为机构提供了满足财务和资源限制所需的交付灵活性。

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