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本科医学教育中实践关节穿刺术工作坊的影响

The impact of a hands-on arthrocentesis workshop in undergraduate medical education.

作者信息

Ladurner Andreas, Nijman Thomas, Gill Tiffany K, Smitham Peter J

机构信息

Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia.

Adelaide Medical School, Adelaide, SA, Australia.

出版信息

BMC Med Educ. 2020 Aug 10;20(1):260. doi: 10.1186/s12909-020-02174-6.

Abstract

BACKGROUND

To evaluate the impact of a training programme for arthrocentesis on procedural skills enhancement and self-confidence in medical students.

METHODS

Participants were provided a structured workshop on injection models. A self-confidence questionnaire and medical knowledge assessment were performed. Retention of knowledge and skills were assessed at a later time point during a formal OSCE examination and compared to participants who had not attended a lecture and clinical attachments only. P-values, 95% confidence intervals about the mean, standard error of the mean, and standard deviations of the differences were calculated.

RESULTS

All participants gained self-confidence, and improvement of their skills was significant. The mean self-confidence with performing an arthrocentesis procedure increased from 1.3 pre- to 5.9 points post-workshop (10-point Likert scale). The knee was the joint students felt most confident with (1.3 to 6.5 points). Knowledge on the selection of corticosteroid preparations (1.2 to 5.8 points) gained substantially, as well as confidence in providing post-injection advice (1.9 to 6.6 points). Upon the OSCE examination, attendance to the workshop resulted in a significant higher total score (16.2 vs 14.8 points, p < 0.05).

CONCLUSIONS

A workshop for arthrocentesis procedures, in conjunction with other learning activities, is well suited to increasing skills and self-confidence in fourth year medical students and allows for developing important baseline knowledge and practicing invasive techniques without risk to a patient.

TRIAL REGISTRATION

This trial has been approved by the human research ethics committee of the University of Adelaide (Ethics approval No H-2019-134).

摘要

背景

评估关节穿刺培训项目对医学生操作技能提升和自信心的影响。

方法

为参与者提供关于注射模型的结构化工作坊。进行自信心问卷调查和医学知识评估。在正式的客观结构化临床考试的稍后时间点评估知识和技能的保留情况,并与仅参加过讲座和临床实习的参与者进行比较。计算P值、均值的95%置信区间、均值标准误差和差异标准差。

结果

所有参与者的自信心均有所增强,且技能有显著提高。进行关节穿刺操作的平均自信心从工作坊前的1.3分提高到工作坊后的5.9分(10分制李克特量表)。膝关节是学生感觉最有信心操作的关节(从1.3分提高到6.5分)。关于皮质类固醇制剂选择的知识(从1.2分提高到5.8分)以及提供注射后建议的信心(从1.9分提高到6.6分)都有显著提高。在客观结构化临床考试中,参加工作坊的学生总分显著更高(16.2分对14.8分,p < 0.05)。

结论

关节穿刺操作工作坊与其他学习活动相结合,非常适合提高四年级医学生的技能和自信心,并有助于培养重要的基础知识和练习侵入性技术,而不会对患者造成风险。

试验注册

本试验已获得阿德莱德大学人类研究伦理委员会批准(伦理批准号H - 2019 - 134)。

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Progress of Medical School Musculoskeletal Education in the 21st Century.
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