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急诊医学口头病例报告:对一种新型课程的评估

Emergency Medicine Oral Case Presentations: Evaluation of a Novel Curriculum.

作者信息

Wawrykow Teresa M J, McColl Tamara, Velji Alkarim, Chan Ming-Ka

机构信息

Department of Emergency Medicine Max Rady College of Medicine Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba.

Department of Pediatrics and Child Health Max Rady College of Medicine Rady Faculty of Health Sciences University of Manitoba Winnipeg Manitoba Canada.

出版信息

AEM Educ Train. 2019 Dec 10;4(4):379-386. doi: 10.1002/aet2.10408. eCollection 2020 Oct.

Abstract

OBJECTIVES

Oral case presentation (OCP) is recognized as a central educational and patient care activity, yet has not been well studied in the emergency medicine (EM) setting. The purpose of this study was to evaluate the effect of a novel curriculum on medical students' EM-OCP skills.

METHODS

An EM-OCP assessment tool and novel blended curriculum were developed based on results from a Canadian survey of emergency physicians and focus groups with key stakeholders. We conducted a randomized controlled trial of 96 clerkship students between 2017 and 2018. Students were randomly assigned into an intervention group where they completed a novel EM-OCP curriculum or a control group without the curriculum. A pretest baseline assessment of students' OCP skills was performed using a standardized patient case at the beginning of their EM rotation. Similarly, all students completed a posttest assessment with a different standardized patient case at the end of their 6-week EM rotation. Audio recordings of pre- and posttests were assessed using the EM-OCP assessment tool by two blinded assessors.

RESULTS

Using the Kruskal-Wallis test, all students demonstrated improvement in EM-OCP skills between their pretest and posttest; however, those who received the curriculum (intervention group) showed significantly greater improvement in "synthesis of information," "management," and "overall entrustment decision" scores.

CONCLUSIONS

Implementation of a novel EM-OCP curriculum resulted in improved clinical reasoning and higher entrustment scores. This curriculum could improve OCP performance not only in EM settings but also across specialties where medical students and residents manage critically ill patients.

摘要

目的

口头病例汇报(OCP)被认为是一项核心的教育和患者护理活动,但在急诊医学(EM)环境中尚未得到充分研究。本研究的目的是评估一种新型课程对医学生急诊医学口头病例汇报技能的影响。

方法

基于对加拿大急诊医生的调查结果以及与关键利益相关者的焦点小组讨论,开发了一种急诊医学口头病例汇报评估工具和新型混合课程。我们在2017年至2018年期间对96名临床实习学生进行了一项随机对照试验。学生被随机分配到干预组,在该组中他们完成了新型急诊医学口头病例汇报课程,或分配到未接受该课程的对照组。在急诊轮转开始时,使用标准化患者病例对学生的口头病例汇报技能进行预测试基线评估。同样,所有学生在为期6周的急诊轮转结束时,使用不同的标准化患者病例完成后测试评估。两名盲法评估者使用急诊医学口头病例汇报评估工具对预测试和后测试的音频记录进行评估。

结果

使用Kruskal-Wallis检验,所有学生在预测试和后测试之间的急诊医学口头病例汇报技能均有提高;然而,接受课程培训的学生(干预组)在“信息综合”、“管理”和“总体委托决策”得分方面的提高显著更大。

结论

实施新型急诊医学口头病例汇报课程可提高临床推理能力和委托评分。该课程不仅可以提高急诊环境中的口头病例汇报表现,还可以提高医学生和住院医师管理重症患者的各个专业的口头病例汇报表现。

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