Qi Xin, He Rui, Wen Bing, Li Qiang, Wu Hongbin
Plastic Surgery and Burn, Peking University First Hospital, Beijing, China.
Institute of Medical Education/National Centre for Health Professions Education Development, Peking University, Beijing, China.
PeerJ. 2021 Apr 14;9:e11104. doi: 10.7717/peerj.11104. eCollection 2021.
It is vital to cover wound management knowledge and operations in the early stages of resident training. With this in mind, a simulated wound management course for postgraduate year one surgery residents (PGY1s) was designed and its effectiveness was evaluated.
A retrospective quasi-experimental method was used. PGY1s in 2014 constituted the control group, and PGY1s in 2015 and 2016 constituted the intervention group. The course given to the control group comprised didactic teaching followed by deliberate practice plus immediate personalized feedback. The newly designed course given to the intervention group was reconstructed and disassembled into four components according to the simulation-based mastery learning model, which were baseline test, interactive learning, basic skills practice, and reflective learning. The same performance assessments were used in the control and intervention group, including process measurement and outcome measurement.
The process measurement showed that the intervention group's scores were significantly higher in the "dissociation of subcutaneous tissue" and "quality of suturing and knots". The outcome measurement showed that the accuracy of debridement was greatly improved and both key and total suture numbers were significantly higher in the intervention group.
Simulation-based mastery learning was incorporated into our proposed course framework, promoting the learning outcome of PGY1s. It has the potential to be adapted for other surgical training sites for residents in China.
在住院医师培训的早期阶段传授伤口管理知识与操作至关重要。鉴于此,为一年级外科住院医师(PGY1)设计了一门模拟伤口管理课程,并对其效果进行了评估。
采用回顾性准实验方法。2014年的PGY1组成对照组,2015年和2016年的PGY1组成干预组。对照组的课程包括理论教学,随后是刻意练习并给予即时个性化反馈。给予干预组的新设计课程根据基于模拟的掌握学习模型进行重构并拆解为四个部分,即基线测试、互动学习、基本技能练习和反思学习。对照组和干预组采用相同的绩效评估,包括过程测量和结果测量。
过程测量显示,干预组在“皮下组织分离”和“缝合与打结质量”方面的得分显著更高。结果测量显示,干预组清创的准确性有了很大提高,关键缝线数和总缝线数均显著更高。
基于模拟的掌握学习被纳入我们提出的课程框架,促进了PGY1的学习成果。它有可能适用于中国其他住院医师外科培训场所。