School of Medicine, University of Nottingham, Nottingham, UK.
Innovation, Technology and Operations Division, University of Leicester School of Business, University of Leicester, Leicester, UK.
Med Teach. 2020 Aug;42(8):886-895. doi: 10.1080/0142159X.2020.1748183. Epub 2020 Apr 17.
Medical school graduates in the UK consistently report feeling underprepared for the task of prescribing when embarking on practice. The effective application of self-regulated learning (SRL) approaches and feedback on complex tasks are associated with improved outcomes in practice-based clinical skills.: This study aimed to investigate the effectiveness of an educational intervention using SRL-enhanced video feedback for improving the prescribing competency of junior doctors. A prospective cohort study was designed to compare intervention and control cohorts of junior doctors undertaking simulated clinical encounters at the beginning and end of their 4-month rotation through renal medicine. The improvement in prescribing competency for the intervention cohort was significant ( < 0.001) with large effect size ( = 1.42). Self-efficacy improved in both cohorts with large (control cohort = 0.026, = 0.64) and medium (intervention cohort = 0.083, = 0.55) effect sizes. Goal setting and self-monitoring skills improved in the intervention cohort only with medium effect size ( = 0.096, = 0.53). SRL-enhanced video feedback is effective for improving prescribing competency and developing SRL processes such as goal setting and self-monitoring skills in simulated clinical encounters. Further research is required to evaluate transferability to other clinical sub-speciality contexts and investigate the effectiveness of the intervention for improving prescribing in non-simulated settings.
英国的医学院毕业生在开始实践时,总是报告自己在开处方方面准备不足。自我调节学习(SRL)方法的有效应用和对复杂任务的反馈与实践临床技能方面的改善结果相关。本研究旨在调查使用 SRL 增强型视频反馈的教育干预措施对提高初级医生处方能力的有效性。设计了一项前瞻性队列研究,以比较接受模拟临床接触的初级医生的干预组和对照组,这些初级医生在接受肾内科 4 个月轮转的开始和结束时进行模拟临床接触。干预组的处方能力有显著提高(<0.001),效果量较大(=1.42)。两个队列的自我效能都有所提高,对照组的效果量较大(=0.026,=0.64),干预组的效果量中等(=0.083,=0.55)。仅在干预组中,目标设定和自我监控技能有所提高,效果量为中等(=0.096,=0.53)。SRL 增强型视频反馈可有效提高处方能力,并在模拟临床接触中发展 SRL 过程,如目标设定和自我监控技能。需要进一步研究评估其在其他临床亚专科领域的可转移性,并调查该干预措施在非模拟环境中提高处方能力的效果。