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基于视频的翻转课堂皮肤科手术模拟课程:一项前瞻性、多机构研究。

A video-based, flipped classroom, simulation curriculum for dermatologic surgery: A prospective, multi-institution study.

机构信息

Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

University of Massachusetts Medical School, Worcester, Massachusetts.

出版信息

J Am Acad Dermatol. 2019 Dec;81(6):1271-1276. doi: 10.1016/j.jaad.2019.03.078. Epub 2019 Apr 3.

Abstract

BACKGROUND

Medical education is evolving to emphasize trainee engagement. The impact of a flipped classroom curriculum and surgical simulation on dermatology resident education has not been evaluated.

OBJECTIVE

To assess the impact of video education and surgical simulation on dermatology resident procedural skills.

METHODS

We created a curriculum on foundational surgical skills for 31 first- and second-year dermatology residents at 3 institutions. The flipped classroom approach replaces traditional in-person lectures with at-home viewing of instructional videos. After this self-directed learning, trainees had 3 hands-on sessions using simulated skin models. The Objective Structured Assessment of Technical Skills (OSATS) instrument was used to assess residents performing a simulated elliptical excision with intermediate repair before and after the curriculum. Residents completed precurriculum and postcurriculum surveys evaluating operative confidence and perceived value of the curriculum.

RESULTS

Residents' total OSATS score increased from a median of 27 (interquartile range, 22-38.5) before the curriculum to 46 (interquartile range, 39.5-51.5) after the curriculum (P < .001). Self-reported confidence in surgical performance significantly improved, and residents were highly satisfied.

LIMITATIONS

Limitations include the small sample size and potential influence from concurrent learning on surgical rotations.

CONCLUSIONS

Video education and simulation are effective for improving dermatology residents' procedural skills. We hope to serve as a template for other institutions and nondermatology trainees hoping to improve procedural skills.

摘要

背景

医学教育正在向强调学员参与度的方向发展。翻转课堂课程和手术模拟对皮肤科住院医师教育的影响尚未得到评估。

目的

评估视频教育和手术模拟对皮肤科住院医师手术技能的影响。

方法

我们为 3 个机构的 31 名第一和第二年的皮肤科住院医师创建了一个基础手术技能课程。翻转课堂方法用家庭观看教学视频代替传统的面授讲座。在这个自主学习之后,学员们使用模拟皮肤模型进行了 3 次动手操作。客观结构化评估技术技能(OSATS)工具用于评估学员在课程前后进行模拟椭圆形切除和中级修复的技能。住院医师在课程前和课程后完成了关于手术信心和对课程价值的感知的调查问卷。

结果

住院医师的 OSATS 总分从课程前的中位数 27 分(四分位距,22-38.5)增加到课程后的 46 分(四分位距,39.5-51.5)(P<.001)。自我报告的手术表现信心显著提高,且住院医师非常满意。

局限性

局限性包括样本量小和手术轮转中同时学习的潜在影响。

结论

视频教育和模拟对于提高皮肤科住院医师的手术技能是有效的。我们希望为其他机构和希望提高手术技能的非皮肤科住院医师提供模板。

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