McMahon Colin J, Gallagher Sarah, James Adam, Deery Aoife, Rhodes Mark, van Merriënboer Jeroen J G
Department of Paediatric Cardiology, Children's Health Ireland, Crumlin, Dublin 12, Ireland.
Department of Economics, Leeds Beckett University, Leeds, England.
Cardiol Young. 2021 Apr;31(4):602-608. doi: 10.1017/S1047951120004412. Epub 2020 Dec 10.
Factors that facilitate transfer of training in paediatric echocardiography remain poorly understood. This study assessed whether high-variation training facilitated successful transfer in paediatric echocardiography.
A mixed-methods study of transfer of technical and interpretive skill application amongst postgraduate trainees. Trainees were randomised to a low or high-variation training group. After a period of 8 weeks intensive echocardiography training, we video-recorded how trainees completed an echocardiogram in a complex cardiac lesion not previously encountered. Blinded quantitative analysis and scoring of trainee performance (echocardiogram performance, report, and technical proficiency) were performed using a validated assessment tool by a blinded cardiologist and senior cardiac physiologist. Qualitative interviews of the trainees were recorded to ascertain trainee experiences during the training and transfer process.
Sixteen trainees were enrolled in the study. For the cumulative score for all three components tested (echocardiogram performance, report, and technical proficiency), χ2 = 8.223, p = .016, which showed the high-variation group outperformed the low-variation group. Two common themes which assisted in the transfer emerged from interviews are as follows: (1) use of strategies described in variation theory to describe abnormal hearts, (2) the use of formative live feedback from trainers during hands-on training.
Training strategies exposing trainees to high-variation training may aid transfer of paediatric echocardiography skills.
促进儿科超声心动图培训迁移的因素仍未得到充分理解。本研究评估了高变异度培训是否有助于儿科超声心动图培训的成功迁移。
一项关于研究生学员技术和解释技能应用迁移的混合方法研究。学员被随机分为低变异度或高变异度培训组。经过8周的强化超声心动图培训后，我们对学员如何完成一个此前未遇到过的复杂心脏病变的超声心动图检查进行了录像。由一位不知情的心脏病专家和资深心脏生理学家使用经过验证的评估工具对学员表现（超声心动图检查表现、报告和技术熟练程度）进行不知情的定量分析和评分。对学员进行定性访谈，以确定他们在培训和迁移过程中的经历。
16名学员参与了该研究。对于所测试的所有三个组成部分（超声心动图检查表现、报告和技术熟练程度）的累积分数，χ2 = 8.223，p = 0.016，这表明高变异度组的表现优于低变异度组。访谈中出现的有助于迁移的两个共同主题如下：（1）使用变异理论中描述的策略来描述异常心脏，（2）在实践培训中使用培训师提供的形成性实时反馈。
让学员接受高变异度培训的培训策略可能有助于儿科超声心动图技能的迁移。
