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仅基于视频的无同伴或专家反馈的模拟训练是不够的:医学生模拟训练的随机对照试验

Video-Based Guided Simulation without Peer or Expert Feedback is Not Enough: A Randomized Controlled Trial of Simulation-Based Training for Medical Students.

作者信息

Tejos Rodrigo, Crovari Fernando, Achurra Pablo, Avila Ruben, Inzunza Martín, Jarry Cristian, Martinez Jorge, Riquelme Arnoldo, Alseidi Adnan, Varas Julian

机构信息

Experimental Surgery and Simulation Center, Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, 8330024, Santiago, Chile.

Department of Gastroenterology and Centre for Medical Education, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile.

出版信息

World J Surg. 2021 Jan;45(1):57-65. doi: 10.1007/s00268-020-05766-x. Epub 2020 Sep 5.

Abstract

BACKGROUND

Feedback is a pivotal cornerstone and a challenge in psychomotor training. There are different teaching methodologies; however, some may be less effective.

METHODS

A prospective randomized controlled trial was conducted in 130 medical students to compare the effectiveness of the video-guided learning (VLG), peer-feedback (PFG) and the expert feedback (EFG) for teaching suturing skills. The program lasted 4 weeks. Students were recorded making 3-simple stitches (pre-assessment and post-assessment). The primary outcome was a global scale (OSATS). The secondary outcomes were performance time, specific rating scale (SRS) and the impact of the intervention (IOI), defined as the variation between the final and initial OSATS and SRS scores.

RESULTS

No significant differences were found between PFG and EFG in post-assessment results of OSATS, SRS scores or in the IOI for OSATS and SRS scores. Post-assessment results of PFG and EFG were significantly superior to VLG in OSATS and SRS scores [(19.8 (18.5-21); 16.6 (15.5-17.5)) and (20.3 (19.88-21); 16.8 (16-17.5)) vs (15.7 (15-16); 13.3 (12.5-14)) (p < 0.05)], respectively. The results of PFG and EFG were significantly superior to VLG in the IOI for OSATS [7 (4.5-9) and 7.4 (4.88-10) vs 3.5 (1.5-6) (p < 0.05)] and SRS scores [5.4 (3.5-7) and 6.3 (4-8.5) vs 3.1 (1.13-4.88) (p < 0.05)], respectively.

CONCLUSION

The video-guided learning methodology without any kind of feedback is not enough for teaching suturing skills compared to expert or peer feedback. The peer feedback methodology appears to be a viable alternative to handling the emerging demands in medical education.

摘要

背景

反馈是心理运动训练的关键基石和一项挑战。存在不同的教学方法;然而,有些方法可能效果较差。

方法

对130名医学生进行了一项前瞻性随机对照试验,以比较视频引导学习(VLG)、同伴反馈(PFG)和专家反馈(EFG)在教授缝合技能方面的有效性。该项目持续4周。记录学生进行3针简单缝合的情况(预评估和后评估)。主要结果是一个整体量表(OSATS)。次要结果是操作时间、特定评分量表(SRS)以及干预影响(IOI),IOI定义为最终和初始OSATS及SRS分数之间的差异。

结果

在OSATS、SRS分数的后评估结果或OSATS和SRS分数的IOI方面,PFG和EFG之间未发现显著差异。在OSATS和SRS分数方面,PFG和EFG的后评估结果显著优于VLG [分别为(19.8(18.5 - 21); 16.6(15.5 - 17.5))和(20.3(19.88 - 21); 16.8(16 - 17.5)) 对比 (15.7(15 - 16); 13.3(12.5 - 14)) (p < 0.05)]。在OSATS的IOI方面,PFG和EFG的结果显著优于VLG [7(4.5 - 9)和7.4(4.88 - 10) 对比 3.5(1.5 - 6) (p < 0.05)],在SRS分数的IOI方面也是如此 [5.4(3.5 - 7)和6.3(4 - 8.5) 对比 3.1(1.13 - 4.88) (p < 0.05)]。

结论

与专家或同伴反馈相比,没有任何反馈的视频引导学习方法对于教授缝合技能是不够的。同伴反馈方法似乎是应对医学教育中新出现需求的一种可行替代方法。

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