Department of Anesthesiology, Perioperative Medicine and Pain Management, Royal University Hospital, University of Saskatchewan, G525-103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.
Department of Emergency Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada.
Can J Anaesth. 2020 Jun;67(6):715-725. doi: 10.1007/s12630-020-01570-2. Epub 2020 Jan 22.
Combined video modeling (VM) and video feedback (VF) may be more beneficial than traditional feedback when teaching procedural skills. This study examined whether repeated VM and VF compared with VM alone reduced the time required for medical students to perform peripheral intravenous (IV) cannulation.
Twenty-five novice medical students were randomly assigned to groups in a one-way blinded embedded mixed-methods study to perform IV cannulation. Participants received standardized instruction and performed IV cannulation on each other while being audio-video recorded. They were assigned to review a video of an expert performing IV cannulation (VM alone), or both the expert video and a video of their own most recent IV cannulation (VM+VF), before returning to perform another IV cannulation. This was repeated for a total of four IV cannulation encounters and three video reviews. A post-test interview was also conducted and analyzed qualitatively using thematic content analysis.
The median [interquartile range] time required to perform IV cannulation in the final encounter was significantly different between the VM+VF group vs VM alone group (126 [93-226] sec vs 345 [131-537] sec, respectively; median difference, 111 sec; 95% confidence interval, 8 to 391; P = 0.02). There was no significant difference in IV cannulation success between VM alone and VM+VF in the final encounter (75% vs 85% respectively; P = 0.65). For the VM+VF group, the time to perform IV cannulation was reduced after the final encounter compared with the baseline encounter (P = 0.002), which was not true of the VM alone group (P = 0.35).
Video modeling and feedback shortened time to IV skill completion, reduced complications, and improved satisfaction in novice medical students.
在教授程序性技能时，与传统反馈相比，结合视频建模（VM）和视频反馈（VF）可能更有益。本研究探讨了与单独使用 VM 相比，重复使用 VM 和 VF 是否可以减少医学生进行外周静脉（IV）置管所需的时间。
25 名新手医学生被随机分配到单向盲法嵌入式混合方法研究的组中，以进行 IV 置管。参与者接受标准化指导，并在进行音频-视频录制的同时互相进行 IV 置管。他们被分配在进行另一次 IV 置管之前，查看专家进行 IV 置管的视频（仅 VM），或查看专家视频和他们自己最近的 IV 置管视频（VM+VF）。这总共重复了四次 IV 置管和三次视频复习。还进行了一次后测访谈，并使用主题内容分析进行定性分析。
在最后一次置管时，VM+VF 组与仅 VM 组相比，完成 IV 置管所需的中位数[四分位距]时间差异具有统计学意义（分别为 126[93-226]秒和 345[131-537]秒；中位数差异为 111 秒；95%置信区间，8 至 391；P = 0.02）。在最后一次置管时，VM 单独组和 VM+VF 组的 IV 置管成功率没有显著差异（分别为 75%和 85%；P = 0.65）。对于 VM+VF 组，与基线相比，最后一次置管后的 IV 置管时间减少（P = 0.002），而单独使用 VM 组则没有（P = 0.35）。
视频建模和反馈缩短了 IV 技能完成时间，减少了并发症，并提高了新手医学生的满意度。
