Shirley Ryan AbilityLab, Northwestern University/Feinberg School of Medicine, Chicago, IL.
PM R. 2019 Dec;11(12):1272-1277. doi: 10.1002/pmrj.12148. Epub 2019 Mar 26.
Simulation technology is being increasingly adopted into medical education and is consistently associated with positive effects on knowledge, skills, and patient-related outcomes. There is little evidence on the use of simulation technology for the instruction of urgent medical complications to physical medicine and rehabilitation (PM&R) residents.
To examine whether a simulation-based educational program can improve PM&R resident confidence and knowledge in the assessment and management of urgent medical complications.
Pretest-posttest design.
Academic freestanding acute inpatient rehabilitation hospital.
Twelve Post-Graduate Year (PGY)-2 PM&R residents at the start of the academic year.
Residents completed an integrated didactic and simulation-based curriculum on the assessment and management of five urgent medical complications: seizures, agitation, ventricular assist device (VAD)-associated complications, sympathetic storming, and autonomic dysreflexia. Simulations were conducted using a high-fidelity manikin.
Surveys and knowledge assessments were completed at baseline and immediately following training. Survey responses were recorded on a Likert scale ranging from 1 = strongly disagree to 5 = strongly agree. Multiple-choice knowledge assessments were scored out of 100%. Within-group differences from baseline to postintervention were analyzed.
There was a positive correlation between baseline experience and baseline confidence scores (r = 0.877). Improved confidence was demonstrated in the assessment and management of all five topics (P < .05). Knowledge assessment scores significantly improved from 57.8% (95% confidence interval [CI] 50.6% to 65.4%) at baseline to 85.0% (95% CI 81.6% to 88.4%) following the course (P < .001). The education program was rated highly by both learners (mean satisfaction score, Likert score [LS] = 4.6) and instructors (mean satisfaction score, LS = 4.5).
Application of a simulation-based educational model to the instruction of urgent medical complications to PM&R residents resulted in increased knowledge with added benefits of confidence building and high levels of enjoyment.
II.
模拟技术越来越多地被应用于医学教育，并且一致与知识、技能和患者相关结果的积极影响相关联。关于模拟技术在物理医学与康复（PM&R）住院医师紧急医疗并发症教学中的应用，证据甚少。
研究基于模拟的教育计划是否可以提高 PM&R 住院医师对紧急医疗并发症评估和管理的信心和知识。
预测试-后测试设计。
学术性独立急性住院康复医院。
学术年开始时的 12 名 PGY-2 级 PM&R 住院医师。
住院医师参加了关于五个紧急医疗并发症评估和管理的综合理论课和基于模拟的课程：癫痫发作、激越、心室辅助装置（VAD）相关并发症、交感风暴和自主反射障碍。模拟使用高保真人体模型进行。
在基线和培训后立即完成调查和知识评估。调查结果记录在 1 分=强烈不同意到 5 分=强烈同意的李克特量表上。多项选择知识评估以 100 分为满分。分析了从基线到干预后的组内差异。
基线经验与基线信心评分之间存在正相关（r=0.877）。在评估和管理所有五个主题时，信心均有所提高（P<0.05）。知识评估得分从基线时的 57.8%（95%置信区间[CI]50.6%至 65.4%）显著提高至课程结束时的 85.0%（95% CI 81.6%至 88.4%）（P<0.001）。该教育计划受到学习者（平均满意度评分，Likert 评分[LS]=4.6）和教师（平均满意度评分，LS=4.5）的高度评价。
将基于模拟的教育模式应用于 PM&R 住院医师紧急医疗并发症教学可增加知识，增强信心，并获得高水平的乐趣。
II。
