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对持续进行基于模拟的教育和实践后二年级医学生的血压测量技能进行评估。

Assessment of blood pressure measurement skills in second-year medical students after ongoing simulation-based education and practice.

机构信息

Department of Medical Education, Tokyo Medical University , Shinjuku-ku, Tokyo, Japan.

Simulation Center, Tokyo Medical University Hospital , Shinjuku-ku, Tokyo, Japan.

出版信息

Med Educ Online. 2021 Dec;26(1):1841982. doi: 10.1080/10872981.2020.1841982.

Abstract

BACKGROUND

Simulation-Based Education (SBE) simulates specific physiological characteristics of a patient, allowing student practice in developing clinical skills and assessment of skill competency. Literature is limited regarding SBE's effectiveness in curriculum enrichment. This study investigated Blood Pressure (BP) measuring proficiency of second-year medical students with first-year SBE training and a second-year review, by comparing data from Simulation-Based assessments in 2017 and 2019.

METHODS

Second-year medical students measured BP on three manikin arms, associated with distinct clinical contexts (healthy young male, young female experiencing hypotension, and older male suffering hypertension and diabetes). All manikins' BP settings were independent of clinical context. In January 2019, 108 second-year medical students who received traditional training, as well as SBE in 2017 and Simulation-Based practice in 2018, were divided into four groups (n = 32, 24, 24, and 28), with two groups each assessed on consecutive days. The proportions of correct BP values in each of three contexts were compared between experiments in 2017 and 2019. Additionally, systolic (SBP) and diastolic (DBP) blood pressure results were stratified into three groups: lower than setting value, correct, and higher than setting vgalue, with proportions for each group compared for the 2017 and 2019 studies using Fisher's Exact Tests.

RESULTS

In Case Two and Three, the proportion of correct BP values significantly increased from 2017 (Case Two: 51%; Case Three: 55%) to 2019 (Case Two: 73%; Case Three: 75%). Additionally, proportions of students who reported lower SBP values than setting values were significantly decreased in Case One and Two, with five failing all contexts.

CONCLUSIONS

Second-year student BP measurement skills were improved, not only due to repeated Simulation-Based practice but advancing basic science knowledge and mastery experience in ongoing curriculum. Simulation-Based assessment provided an effective tool for evaluating skill retention and proficiency in medical training.

摘要

背景

基于模拟的教育(SBE)模拟了患者的特定生理特征,使学生能够在发展临床技能和评估技能能力方面进行练习。关于 SBE 在丰富课程方面的有效性,文献有限。本研究通过比较 2017 年和 2019 年基于模拟的评估数据,调查了具有第一年 SBE 培训和第二年复习的二年级医学生的血压(BP)测量能力。

方法

二年级医学生在三个假人手臂上测量血压,这些手臂与不同的临床情况相关(健康的年轻男性、年轻女性低血压、老年男性高血压和糖尿病)。所有假人的 BP 设置均与临床情况无关。2019 年 1 月,108 名接受传统培训的二年级医学生,以及 2017 年 SBE 和 2018 年基于模拟的实践,被分为四组(n=32、24、24 和 28),每组在连续两天进行评估。比较 2017 年和 2019 年实验中三种情况下正确 BP 值的比例。此外,收缩压(SBP)和舒张压(DBP)的血压结果分为三组:低于设定值、正确和高于设定值,使用 Fisher 精确检验比较每组 2017 年和 2019 年的研究结果。

结果

在病例二和三,从 2017 年(病例二:51%;病例三:55%)到 2019 年(病例二:73%;病例三:75%),正确 BP 值的比例显著增加。此外,在病例一和二中,报告 SBP 值低于设定值的学生比例显著下降,有五人在所有情况下都失败了。

结论

二年级学生的 BP 测量技能有所提高,这不仅是由于反复进行基于模拟的实践,而且还因为基础科学知识的进步和正在进行的课程中的掌握经验。基于模拟的评估为评估医学培训中的技能保留和熟练程度提供了有效的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5709/7605316/d0b4780a8c03/ZMEO_A_1841982_F0001_B.jpg

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