模拟战对急诊医学住院医师整体评分量表及在职培训考试成绩的影响。
The Effect of Simulation Wars on EM Residents' Global Rating Scales and In-Training Examination Scores.
作者信息
Mendez Donna, Takenaka Katrin, Cardenas-Turanzas Marylou, Suarez Guillermo
机构信息
Department of Emergency Medicine, The University of Texas Health Science Center/McGovern Medical School, Houston, TX 77030, USA.
The University of Texas Health Science Center at Houston, School of Biomedical Informatics, Houston, TX, 77030, USA.
出版信息
Open Access Emerg Med. 2020 Feb 27;12:35-42. doi: 10.2147/OAEM.S223257. eCollection 2020.
PURPOSE
The Accreditation Council for Graduate Medical Education (ACGME) restricted the duty hours for residents training in 2004. With less time to learn medicine, residents may not develop the clinical reasoning skills needed. Simulation can provide a remedy for this lack of time by allowing residents to practice skills and develop clinical reasoning in a simulated environment. Simulation Wars (SimWars), a clinical reasoning simulation has been shown to improve clinical reasoning skills. The purpose of the study was to investigate the effect of Simulation Wars on In-Training Examination (ITE) Scores and Global Rating Scale (GRS) Scores in Emergency Medicine (EM) residents.
METHODS
The Quasi-Experimental design was used in this retrospective study. The main comparison was between historical controls, the residents who did not participate in the Simulation Wars, and the intervention group comprised of residents who participated in the SimWars.
RESULTS
A total of 127 residents were participants in this study including 70 from the intervention and 57 from the historical control group. There were no significant differences found in GRS scores between both groups except for Communication and Professionalism (p<0.001). No overall improvement in ITE scores for the control group and for the intervention group was found. Furthermore, within the intervention group, while comparing those residents who participated in certain subcategories of SimWars and those who did not, there was a significant improvement in ITE scores in the subcategories of Thoracic Disorders, Abdominal/Gastrointestinal, Trauma Disorders and OBGyn.
CONCLUSION
SimWars in the subcategories of Abdominal/Gastrointestinal, Thoracic, OBGyn and Trauma were found to be associated with improved ITE scores in those subcategories. Since Emergency Medicine utilizes extensive clinical reasoning skills, SimWars may provide better educational opportunities for EM residents.
目的
毕业后医学教育认证委员会（ACGME）于2004年对住院医师培训的值班时长进行了限制。由于学习医学的时间减少，住院医师可能无法培养所需的临床推理技能。模拟可以通过让住院医师在模拟环境中练习技能和培养临床推理能力来弥补时间的不足。模拟战（SimWars）是一种临床推理模拟，已被证明可以提高临床推理技能。本研究的目的是调查模拟战对急诊医学（EM）住院医师的在职考试（ITE）成绩和整体评分量表（GRS）成绩的影响。
方法
本回顾性研究采用准实验设计。主要比较对象是历史对照组（未参加模拟战的住院医师）和由参加模拟战的住院医师组成的干预组。
结果
本研究共有127名住院医师参与，其中干预组70名，历史对照组57名。除沟通和职业素养外，两组的GRS评分无显著差异（p<0.001）。未发现对照组和干预组的ITE成绩有整体提高。此外，在干预组中，比较参加模拟战某些子类别的住院医师和未参加的住院医师，发现胸部疾病、腹部/胃肠道、创伤疾病和妇产科等子类别的ITE成绩有显著提高。
结论
发现腹部/胃肠道、胸部、妇产科和创伤等子类别的模拟战与这些子类别中ITE成绩的提高有关。由于急诊医学需要广泛的临床推理技能，模拟战可能为急诊医学住院医师提供更好的教育机会。
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