Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Camillians Saint Mary's Hospital, Luodong, Yilan, Taiwan, ROC.
J Chin Med Assoc. 2018 Aug;81(8):747-753. doi: 10.1016/j.jcma.2017.06.028. Epub 2018 May 18.
Failure to transfer procedural skills learned in a laboratory to the bedside is commonly due to a lack of peer support/stimulation. A digital platform (Facebook) allows new clinical clerks to share experiences and tips that help augment their procedural skills in a peer-assisted learning/teaching method. This study aims to investigate the effectiveness of the innovation of using the digital platform to support the transfer of laboratory-trained procedural skills in the clinical units.
Volunteer clinical clerks (n = 44) were enrolled into the peer-assisted learning (PAL) group, which was characterized by the peer-assisted learning of procedural skills during their final 3-month clinical clerkship block. Other clerks (n = 51) did not join the procedural skills-specific Facebook group and served as the self-directed learning regular group. The participants in both the PAL and regular groups completed pre- and post-intervention self-assessments for general self-assessed efficiency ratings (GSER) and skills specific self-assessed efficiency ratings (SSSER) for performing vein puncture, intravenous (IV) catheter and nasogastric (NG) tube insertion. Finally, all clerks received the post-intervention 3-station Objective Structured Clinical Skills Examination (OSCE) to test their proficiency for the abovementioned three procedural skills.
Higher cumulative numbers of vein punctures, IV catheter insertions and NG tube insertions at the bedside were carried out by the PAL group than the regular group. A greater improvement in GSERs and SSSERs for medical procedures was found in the PAL group than in the regular group. The PAL group obtained higher procedural skills scores in the post-intervention OSCEs than the regular group.
Our study suggested that the implementation of a procedural skill-specific digital platform effectively helps clerks to transfer laboratory-trained procedural skills into the clinical units. In comparison with the regular self-directed learning group, the peer-assisted learning characteristics of Facebook give additional benefits to the PAL group by enhancing their procedural skills.
未能将在实验室中习得的操作技能转移到临床实际中，通常是由于缺乏同伴的支持和激励。一个数字平台（Facebook）允许新的临床学员分享经验和技巧，以帮助他们以同伴辅助学习/教学的方式提高操作技能。本研究旨在探讨利用数字平台支持将实验室培训的操作技能转移到临床科室的创新效果。
招募了 44 名志愿临床学员进入同伴辅助学习（PAL）组，该组的特点是在最后 3 个月的临床实习期间进行同伴辅助操作技能学习。其他学员（n=51）没有加入特定的操作技能 Facebook 群组，作为自主学习的常规组。PAL 组和常规组的参与者都在干预前后完成了一般自我评估效率评分（GSER）和进行静脉穿刺、静脉（IV）导管和鼻胃（NG）管插入术的特定技能自我评估效率评分（SSSER）的自我评估。最后，所有学员都接受了干预后的三站客观结构化临床技能考试（OSCE），以测试他们在上述三种操作技能方面的熟练程度。
PAL 组在床边进行的静脉穿刺、IV 导管插入和 NG 管插入的累积次数高于常规组。PAL 组在 GSER 和 SSSER 方面的提高也明显大于常规组。PAL 组在干预后的 OSCE 中获得了更高的操作技能分数。
我们的研究表明，实施特定操作技能的数字平台有助于学员将实验室培训的操作技能转移到临床科室。与常规自主学习组相比，Facebook 的同伴辅助学习特点通过增强学员的操作技能，为 PAL 组带来了额外的益处。
