Gradl-Dietsch Gertraud, Hitpaß Lea, Gueorguiev Boyko, Nebelung Sven, Schrading Simone, Knobe Matthias
Kinder- und Jugendpsychiatrie, Universität Essen - LVR Klinik, Essen.
Klinik für Radiologie, Universitätsklinikum RWTH Aachen, Aachen.
Z Orthop Unfall. 2019 Jun;157(3):270-278. doi: 10.1055/a-0715-2435. Epub 2018 Oct 12.
The aim of this study was to assess the impact of Peyton's 4-step approach on musculoskeletal ultrasound skills in a peer-teaching environment as compared to traditional "see one, do one" training and to evaluate students' acceptance of the training strategy.
A total of 491 second year medical students (342 women, 149 men) completed a compulsory curricular course on musculoskeletal ultrasound. We randomly assigned students to receive traditional peer teaching or peer teaching using Peyton's four-step approach in small groups. All groups received theoretical and practical hands-on training of selected views of the knee and shoulder. We assessed differences in practical skills (objective structured practical examination, OSPE) and evaluation results with respect to teaching strategy.
There were no relevant differences between the two teaching interventions regarding the OSPE results. Students scored significantly higher in the knee view (knee 6.5 ± 1.7 points, shoulder 6.0 ± 1.9 points; p < 0.001), needed less time to display the required image (knee 36 ± 21 s, shoulder 43 ± 20 s; p < 0.001) and more students obtained the cut-off mark of 60% to pass the exam (knee 73%, shoulder 61%; p < 0.001). Acceptance of the peer-teaching concept was high, and the overall rating of the instructors was good. The majority of students enjoyed the course and rated it highly.
Traditional teaching and Peyton's 4-step approach seem to be equally effective for teaching basic musculoskeletal ultrasound skills to undergraduate medical students. Qualitative analysis revealed high acceptance of both peer teaching strategies. Differences in course content complexity and degree of difficulty need to be addressed in future courses.
本研究旨在评估在同伴教学环境中，与传统的“看一个，做一个”培训相比，佩顿四步法对肌肉骨骼超声技能的影响，并评估学生对该培训策略的接受程度。
共有491名二年级医学生（342名女生，149名男生）完成了一门关于肌肉骨骼超声的必修课程。我们将学生随机分为接受传统同伴教学或采用佩顿四步法进行小组同伴教学。所有小组都接受了关于膝关节和肩关节选定视图的理论和实践操作培训。我们评估了教学策略在实践技能（客观结构化实践考试，OSPE）和评估结果方面的差异。
两种教学干预在OSPE结果方面没有显著差异。学生在膝关节视图中的得分显著更高（膝关节6.5±1.7分，肩关节6.0±1.9分；p<0.001），显示所需图像所需时间更少（膝关节36±21秒，肩关节43±20秒；p<0.001），并且更多学生获得了60%的及格分数以通过考试（膝关节73%，肩关节61%；p<0.001）。对同伴教学概念的接受度很高，对教师的总体评价也很好。大多数学生喜欢这门课程并给予了高度评价。
传统教学和佩顿四步法在向本科医学生教授基本肌肉骨骼超声技能方面似乎同样有效。定性分析显示对两种同伴教学策略的接受度都很高。未来的课程需要解决课程内容复杂性和难度方面的差异。
