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模拟游戏与多项选择题对医学生临床能力评估的比较:前瞻性序贯试验。

Simulation Game Versus Multiple Choice Questionnaire to Assess the Clinical Competence of Medical Students: Prospective Sequential Trial.

机构信息

Department of Paediatric Pulmonology and Allergology, University Hospital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France.

iLumens Simulation Department, University of Paris, Paris, France.

出版信息

J Med Internet Res. 2020 Dec 16;22(12):e23254. doi: 10.2196/23254.

Abstract

BACKGROUND

The use of simulation games (SG) to assess the clinical competence of medical students has been poorly studied.

OBJECTIVE

The objective of this study was to assess whether an SG better reflects the clinical competence of medical students than a multiple choice questionnaire (MCQ).

METHODS

Fifth-year medical students in Paris (France) were included and individually evaluated on a case of pediatric asthma exacerbation using three successive modalities: high-fidelity simulation (HFS), considered the gold standard for the evaluation of clinical competence, the SG Effic'Asthme, and an MCQ designed for the study. The primary endpoint was the median kappa coefficient evaluating the correlation of the actions performed by the students between the SG and HFS modalities and the MCQ and HFS modalities. Student satisfaction was also evaluated.

RESULTS

Forty-two students were included. The actions performed by the students were more reproducible between the SG and HFS modalities than between the MCQ and HFS modalities (P=.04). Students reported significantly higher satisfaction with the SG (P<.01) than with the MCQ modality.

CONCLUSIONS

The SG Effic'Asthme better reflected the actions performed by medical students during an HFS session than an MCQ on the same asthma exacerbation case. Because SGs allow the assessment of more dimensions of clinical competence than MCQs, they are particularly appropriate for the assessment of medical students on situations involving symptom recognition, prioritization of decisions, and technical skills.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03884114; https://clinicaltrials.gov/ct2/show/NCT03884114.

摘要

背景

模拟游戏(SG)在评估医学生临床能力方面的应用研究甚少。

目的

本研究旨在评估 SG 是否比多项选择题(MCQ)更能反映医学生的临床能力。

方法

纳入巴黎(法国)的五年级医学生,他们通过三种连续模式对儿童哮喘发作病例进行个体评估:高保真模拟(HFS),被认为是评估临床能力的金标准,Effic'Asthme SG 和为研究设计的 MCQ。主要终点是评估学生在 SG 和 HFS 模式之间以及 MCQ 和 HFS 模式之间执行的操作之间相关性的中位数 Kappa 系数。学生满意度也进行了评估。

结果

共纳入 42 名学生。学生执行的操作在 SG 和 HFS 模式之间比在 MCQ 和 HFS 模式之间更具可重复性(P=.04)。学生报告对 SG 的满意度明显高于 MCQ 模式(P<.01)。

结论

Effic'Asthme SG 比 MCQ 更能反映医学生在 HFS 模拟中的操作,而不是在相同的哮喘发作病例上。由于 SG 可以评估比 MCQ 更多的临床能力维度,因此它们特别适合评估涉及症状识别、决策优先级和技术技能的医学生。

试验注册

ClinicalTrials.gov NCT03884114;https://clinicaltrials.gov/ct2/show/NCT03884114。

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