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混合模拟教学结合标准化病人在医学生临床哺乳技能教学中的效果:一项初步研究。

The Efficacy of Hybrid Telesimulation with Standardized Patients in Teaching Medical Students Clinical Lactation Skills: A Pilot Study.

机构信息

Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.

Department of Family Medicine, Michigan State University, East Lansing, Michigan, USA.

出版信息

Breastfeed Med. 2021 Apr;16(4):332-337. doi: 10.1089/bfm.2020.0253. Epub 2021 Jan 25.

Abstract

Medical students lack competencies in clinical lactation. We determined the effect of hybrid telesimulation with a standardized patient (SP) on medical students' clinical performance in lactation support. We assessed students' engagement and satisfaction with the experience. Undergraduate medical students ( = 13) completed (1) preparatory case scenarios with multiple-choice questions and (2) three telesimulations with SPs wearing a high-fidelity breast model. Students had the option to complete the Encounter Documentation. SPs used the Formative Assessment Rubric (FAR) to evaluate students' interpersonal skills and clinical lactation experts used the Summative Assessment Rubric to evaluate documentation skills. Investigators collected satisfaction data from a focus group and written evaluation. Dunn's multiple comparison and Freidman tests were used to measure differences in FAR scores between cases and telesimulations. Qualitative data were analyzed using thematic analysis. Most students (70%) attempted case questions multiple times and scores improved ( < 0.0001) between attempts. FAR scores suggest students were prepared for telesimulations (5.5/6-pt Likert) and interpersonal skills were appropriate (5.4/6), with no differences by case ( = 0.11). FAR scores increased between telesimulation 1-2 (+24.5/114,  = 0.002) and 2-3 (+17.5/114,  = 0.014). Students were satisfied with the experience and would recommend it to classmates (both 4.6/6). Thematic analysis revealed feedback regarding interpersonal skills was helpful. Medical students must develop skills to support breastfeeding in virtual settings. Telesimulation can be incorporated into existing curricula to support clinical lactation competencies.

摘要

医学生缺乏临床哺乳能力。我们确定了混合远程模拟与标准化患者(SP)对医学生在哺乳支持中的临床表现的影响。我们评估了学生对该体验的参与度和满意度。13 名本科医学生完成了以下步骤:(1)带有多项选择题的预备案例情景;(2)与佩戴高保真乳房模型的 SP 进行三次远程模拟。学生可以选择完成“接触记录”。SP 使用形成性评估量表(FAR)评估学生的人际交往能力,临床哺乳专家使用总结性评估量表评估记录技能。调查人员从焦点小组和书面评估中收集满意度数据。Dunn 多重比较和 Friedman 检验用于测量 FAR 分数在案例和远程模拟之间的差异。使用主题分析对定性数据进行分析。大多数学生(70%)多次尝试案例问题,并且尝试之间的分数有所提高( < 0.0001)。FAR 分数表明学生为远程模拟做好了准备(5.5/6 分制),人际交往能力合适(5.4/6 分制),案例之间没有差异( = 0.11)。从第一次远程模拟到第二次模拟(+24.5/114, = 0.002)和从第二次模拟到第三次模拟(+17.5/114, = 0.014),FAR 分数有所提高。学生对该体验感到满意,并会向同学推荐(均为 4.6/6)。主题分析显示,关于人际交往能力的反馈很有帮助。医学生必须在虚拟环境中发展支持母乳喂养的技能。远程模拟可以纳入现有课程,以支持临床哺乳能力。

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