Bäwert Andjela, Holzinger Anita
Medical University of Vienna, Teaching Center, Assessment and Skills, Vienna, Austria.
Medical University of Vienna, Teaching Center, Research Unit for Curriculum-Development, Vienna, Austria.
GMS J Med Educ. 2019 Mar 15;36(2):Doc16. doi: 10.3205/zma001224. eCollection 2019.
In 2012 safety strategies were defined in five intervention areas to improve patient safety in Austria. Regarding policy development, patient safety should be mandatory part of education of all healthcare sectors, and measures to improve hygiene standards are to be included in organizational development. The aim of this project was to achieve sustained improvement in routine procedures and anchor patient safety in the undergraduate medical curriculum by making online instructional videos on clinical skills and hygiene procedures permanently available as preparation for the first clinical clerkship. Short films explaining how to insert urinary catheters in women and men were produced and provided online. These videos were shown to medical students shortly before the practical Objective Structured Clinical Examination (OSCE). After viewing the videos, all of the students were surveyed using an online questionnaire with 15 questions regarding quality and acceptance. The effect of the videos on learning success was determined by the assessment outcome through red cards in the practical exam. A red card for behavior endangering the doctor or others meant zero points and discontinuation of the assessment at that particular OSCE station. A total of 647 students viewed one of the two videos on urinary catheters, 623 responded to the online Moodle questionnaire completly. 551 (85.2%) reported being better able to recall individual steps and procedures, 626 students (96.7%) positively rated the fact that instructional videos were available on the Medical University of Vienna's website. More than half of the respondents (56.6%) were better able to remember critical hygiene practices. The comparison of the assessment outcomes on the OSCE for 2016 and 2013, a year in which the instructional videos were not yet available, shows no significant (chi=3.79; p>0.05) but a trend towards improvement. The chance of getting a red card in 2013 was 3.36 times higher than in 2016. Even if our study was unable to show significant improvements in the OSCE as a result of viewing the videos, it appears that clearly imparting medical skills and hygiene standards-including in visual form-is still important prior to the first clerkship to ensure the highest level of patient safety possible. The combination of teaching and learning formats, such as videos on online platforms with textbooks or lecture notes, is well suited to increase effectiveness and efficiency in learning. There is a need for further studies to investigate and analyze the effects of instructional videos in more detail.
2012年，奥地利确定了五个干预领域的安全策略，以提高患者安全。在政策制定方面，患者安全应成为所有医疗保健部门教育的必修内容，提高卫生标准的措施应纳入组织发展。该项目的目的是通过永久提供关于临床技能和卫生程序的在线教学视频，作为首次临床实习的准备，实现常规程序的持续改进，并将患者安全融入本科医学课程。制作了关于如何为女性和男性插入导尿管的短片并在线提供。这些视频在实践客观结构化临床考试（OSCE）前不久播放给医学生观看。观看视频后，所有学生都通过一份包含15个关于质量和接受度问题的在线问卷进行了调查。视频对学习成效的影响通过实践考试中的红牌评估结果来确定。行为危及医生或他人的红牌意味着得零分，并在该特定OSCE站点停止评估。共有647名学生观看了关于导尿管的两个视频之一，623名学生完整回复了在线Moodle问卷。551名（85.2%）学生报告能够更好地回忆各个步骤和程序，626名学生（96.7%）对维也纳医科大学网站上有教学视频这一事实给予了积极评价。超过一半的受访者（56.6%）能够更好地记住关键卫生操作。对2016年和2013年（尚未提供教学视频的一年）OSCE评估结果的比较显示，虽无显著差异（卡方=3.79；p>0.05），但有改善趋势。2013年获得红牌的几率比2016年高3.36倍。即使我们的研究未能表明观看视频会使OSCE有显著改善，但在首次实习前明确传授医学技能和卫生标准（包括以视觉形式）似乎对于确保尽可能高的患者安全水平仍然很重要。教学和学习形式的结合，如在线平台上的视频与教科书或讲义，非常适合提高学习的有效性和效率。需要进一步研究以更详细地调查和分析教学视频的效果。
