LeClair Renée J, Binks Andrew P
Associate Professor, Department of Basic Science Education, Virginia Tech Carilion School of Medicine; Chair, Department of Basic Science Education, Virginia Tech Carilion School of Medicine.
Associate Professor, Department of Basic Science Education, Virginia Tech Carilion School of Medicine; Director of Faculty Development, Department of Basic Science Education, Virginia Tech Carilion School of Medicine.
MedEdPORTAL. 2019 Jan 10;15:10793. doi: 10.15766/mep_2374-8265.10793.
It is important to deliver acid-base balance concepts in the context of multiple physiological systems and metabolic processes that influence acid-base homeostasis. This activity combines the interactions of the respiratory, gastrointestinal, and renal systems in conjunction with basic metabolism to generate an integrated activity for first-year medical students.
We developed four concise case scenarios around various presentations of acid-base disturbance along with five sets of arterial blood gases (ABGs) and five different metabolic lab panels. M1 students were given class time to match the three different types of data in order to address how the underlying biochemistry and physiology of a scenario translated into ABG and metabolic laboratory values.
Although not statistically significant, the students' performance on acid-base questions was marginally higher than on standardized National Board of Medical Examiners questions on other topics covered in the same exam, and the improvement over national average scores on the same questions increased. Student evaluation of the activity was positive, with general appreciation of its application and integration of concepts.
The incorporation of this activity into the M1 year was positively received and enhanced integration of content related to acid-base balance. The activity is flexible and can be adapted to most any curricular structure, with the potential to include additional content depending on the level of the learner.
在影响酸碱平衡的多个生理系统和代谢过程的背景下讲授酸碱平衡概念非常重要。本活动结合了呼吸、胃肠和肾脏系统的相互作用以及基础代谢，为一年级医学生生成了一个综合活动。
我们围绕酸碱紊乱的各种表现形式开发了四个简明病例场景，以及五套动脉血气（ABG）和五组不同的代谢实验室检查指标。我们给一年级医学生课堂时间来匹配这三种不同类型的数据，以探讨一个病例的基础生物化学和生理学如何转化为动脉血气和代谢实验室检查值。
尽管无统计学意义，但学生在酸碱问题上的表现略高于在同一考试中涵盖的其他主题的美国国家医学考试委员会标准化问题上的表现，并且在相同问题上相对于全国平均分数的提高有所增加。学生对该活动的评价是积极的，普遍赞赏其对概念的应用和整合。
将该活动纳入一年级课程受到了积极的欢迎，并加强了与酸碱平衡相关内容的整合。该活动具有灵活性，可以适应几乎任何课程结构，并且有可能根据学习者的水平纳入额外的内容。
