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比较三种机械通气教学方法在急诊环境下对六年级医学生的效果:一项随机试验。

Comparison of three methods for teaching mechanical ventilation in an emergency setting to sixth-year medical students: a randomized trial.

机构信息

Doutor em ciências Médicas - Universidade Federal de São Paulo (UNIFESP), Departamento de Medicina, São Paulo, SP, Brasil.

Especialista em Clínica Médica - Universidade Federal de São Paulo (UNIFESP), Departamento de Medicina, São Paulo, SP, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2020 Oct;66(10):1409-1413. doi: 10.1590/1806-9282.66.10.1409.

Abstract

OBJECTIVE

To determine if there are significant differences between the tutorial, simulation, or clinical-case-based discussion teaching methods regarding the transmission of medical knowledge on mechanical ventilation.

METHODS

A randomized, multicenter, open-label controlled trial was carried out using 3 teaching methods on mechanical ventilation: clinical-case-based discussion, simulation, and online tutorial. Voluntary students of the sixth year of medical school from 11 medical colleges answered a validated questionnaire on knowledge about mechanical ventilation for medical students before, immediately after, and 6 months after in-person training consisting of 20 multiple-choice questions, and 5 questions about the participants' demographic profile.

RESULTS

Immediately after the test there was no difference between the scores in the simulation and clinical case groups,[15,06 vs 14,63] whereas, after some time, there was a significant difference in retention between the case-based and simulation groups, with the score in the simulation group 1.46 [1.31; 1.64] times higher than the score of the case group (p-value < 0.001). In the multivariate analysis, an individual who had received more than 4 hours of information showed an increase of 20.0% [09.0%; 33.0%] in the score (p-value = 0.001).

CONCLUSIONS

Our results indicate that, in comparison with other forms of training, simulation in mechanical ventilation provides long-lasting knowledge in the medium term. Further studies are needed to improve the designing and evaluation of training that provides minimal mechanical ventilation skills.

摘要

目的

确定在机械通气的医学知识传播方面,教程、模拟或临床病例讨论教学方法之间是否存在显著差异。

方法

采用基于临床病例的讨论、模拟和在线教程三种教学方法,对机械通气进行了一项随机、多中心、开放标签的对照试验。来自 11 所医学院的六年级医学生自愿参加,在参加完 20 个多项选择题和 5 个关于参与者人口统计学特征的问题的现场培训后,立即、立即后和 6 个月后回答一份关于机械通气知识的经过验证的问卷。

结果

测试后,模拟组和临床病例组的分数没有差异[15.06 vs 14.63],但一段时间后,病例组和模拟组之间的保留分数存在显著差异,模拟组的分数高 1.46 倍[1.31; 1.64]病例组(p 值<0.001)。在多变量分析中,接受超过 4 小时信息的个体得分增加了 20.0%[09.0%; 33.0%](p 值=0.001)。

结论

我们的结果表明,与其他形式的培训相比,机械通气中的模拟在中期提供了持久的知识。需要进一步研究以改进提供最小机械通气技能的培训的设计和评估。

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