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游戏化学习在哥伦比亚医学教育中文化安全的影响:一项随机对照试验。

Impact of game jam learning about cultural safety in Colombian medical education: a randomised controlled trial.

机构信息

CIET-PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges 3rd Floor, Suite 300, Montreal, Quebec, H3S 1Z1, Canada.

Facultad de Medicina, Universidad de La Sabana, Campus Universitario puente del común, Chía, Colombia, CP, 250001.

出版信息

BMC Med Educ. 2021 Feb 25;21(1):132. doi: 10.1186/s12909-021-02545-7.

Abstract

BACKGROUND

Cultural safety, whereby health professionals respect and promote the cultural identity of patients, could reduce intercultural tensions that hinder patient access to effective health services in Colombia. Game jams are participatory events to create educational games, a potentially engaging learning environment for Millennial medical students. We set out to determine whether medical student participation in a game jam on cultural safety is more effective than more conventional education in changing self-reported intended patient-oriented behavior and confidence in transcultural skills.

METHODS

We conducted a parallel-group, two-arm randomized controlled trial with 1:1 allocation. Colombian medical students and medical interns at University of La Sabana participated in the trial. The intervention was a game jam to create an educational game on cultural safety, and the reference was a standard lesson plus an interactive workshop on cultural safety. Both sessions lasted eight hours. Stratified randomization allocated the participants to the intervention and control groups, with masked allocation until commencement.

RESULTS

531 students completed the baseline survey, 347 completed the survey immediately after the intervention, and 336 completed the survey after 6 months. After the intervention, game jam participants did not have better intentions of culturally safe behaviour than did participants in the reference group (difference in means: 0.08 95% CI - 0.05 to 0.23); both groups had an improvement in this outcome. Multivariate analysis adjusted by clusters confirmed that game jam learning was associated with higher transcultural self-efficacy immediately after the intervention (wt OR 2.03 cl adj 95% CI 1.25-3.30).

CONCLUSIONS

Game jam learning improved cultural safety intentions of Colombian medical students to a similar degree as did a carefully designed lecture and interactive workshop. The game jam was also associated with positive change in participant transcultural self-efficacy. We encourage further research to explore the impact of cultural safety training on patient-related outcomes. Our experience could inform initiatives to introduce cultural safety training in other multicultural settings.

TRIAL REGISTRATION

Registered on ISRCTN registry on July 18th 2019. Registration number: ISRCTN14261595 .

摘要

背景

文化安全是指卫生专业人员尊重和促进患者的文化认同,这可能会减少阻碍患者获得有效卫生服务的跨文化紧张关系。游戏竞赛是一种参与式的活动,旨在制作教育游戏,这是一种潜在的吸引千禧一代医学生的学习环境。我们旨在确定医学生参与文化安全游戏竞赛是否比更传统的教育更能有效地改变自我报告的以患者为中心的行为意向和跨文化技能的信心。

方法

我们进行了一项平行组、双臂随机对照试验,分配比例为 1:1。参与试验的是哥伦比亚萨巴纳大学的医学生和实习医生。干预措施是制作文化安全教育游戏的游戏竞赛,参考组是文化安全标准课程加互动工作坊。两个课程都持续 8 小时。分层随机化将参与者分配到干预组和对照组,直到开始时才进行盲法分配。

结果

531 名学生完成了基线调查,347 名学生在干预后立即完成了调查,336 名学生在 6 个月后完成了调查。干预后,游戏竞赛组的学生在文化安全行为意向方面并不比参考组的学生更好(差异平均值:0.08,95%置信区间-0.05 至 0.23);两组在这一结果上都有所改善。通过聚类进行的多变量分析证实,游戏竞赛学习与干预后立即的跨文化自我效能感较高相关(加权 OR 2.03,cl adj 95%置信区间 1.25-3.30)。

结论

游戏竞赛学习提高了哥伦比亚医学生的文化安全意向,程度与精心设计的讲座和互动工作坊相似。游戏竞赛还与参与者跨文化自我效能感的积极变化相关。我们鼓励进一步研究探索文化安全培训对与患者相关结果的影响。我们的经验可以为在其他多元文化环境中引入文化安全培训提供信息。

试验注册

于 2019 年 7 月 18 日在 ISRCTN 注册。注册号:ISRCTN85344077。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddef/7905593/95fbd53379be/12909_2021_2545_Fig1_HTML.jpg

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