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一种用于提高高年级医学生门诊电话问诊表现的视频干预措施的开发:德尔菲分析与随机对照试验

The Development of a Video Intervention to Improve Senior Medical Students' Performance on Outpatient Telephone Encounters: a Delphi Analysis and Randomized Controlled Trial.

作者信息

Mack Jacob A, Morgan Helen K, Fitzgerald James T, Walford Eric C, Heidemann Lauren A

机构信息

Division of Hospital Medicine, Department of Internal Medicine, University of Michigan, UH South F4323, 1500 E. Medical Center Drive, 48109 Ann Arbor, MI, USA.

Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI USA.

出版信息

Med Sci Educ. 2021 Jun 21;31(4):1429-1439. doi: 10.1007/s40670-021-01331-w. eCollection 2021 Aug.

Abstract

INTRODUCTION

Postgraduate trainees address outpatient telephone calls (OTCs) with little prior training. This study determines the skills necessary for OTCs and examines whether a video intervention improves medical students' performance on simulated OTCs.

MATERIALS AND METHODS

We utilized a Delphi technique to determine skills needed for OTCs and created a 9-min video teaching these skills. Senior medical students were randomized to Intervention (viewed video) and Control (did not view video) groups. Students were assessed pre-/post-intervention on simulated OTCs. The primary outcome was the between-group difference in improvement.

RESULTS

The Delphi yielded 34 important skills with the highest focus on communication ( = 13) and triage ( = 6). Seventy-two students completed assessments (Control,  = 41; Intervention,  = 31). The score (mean ± SD) improved 4.3% in the Control group (62.3 ± 14.3% to 66.6 ± 25.0%) and 12.2% in the Intervention group (60.7 ± 15.2% to 72.9 ± 20.4%,  = 0.15). The effect size measured by Cohen's was 0.55, considered effective (> 0.33) for an educational intervention.

CONCLUSIONS

This project fills a gap in OTC training. The use of the Delphi technique, intervention development based on the results, and evaluation of efficacy is a process that could be reproduced for other educational gaps.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01331-w.

摘要

引言

研究生培训生在几乎没有预先培训的情况下处理门诊电话(OTC)。本研究确定了OTC所需的技能,并研究视频干预是否能提高医学生在模拟OTC中的表现。

材料与方法

我们采用德尔菲技术确定OTC所需的技能,并制作了一个9分钟的视频来教授这些技能。高年级医学生被随机分为干预组(观看视频)和对照组(未观看视频)。在干预前后对学生进行模拟OTC评估。主要结果是组间改善差异。

结果

德尔菲法得出34项重要技能,其中最关注沟通(13项)和分诊(6项)。72名学生完成了评估(对照组41名;干预组31名)。对照组的分数(平均值±标准差)提高了4.3%(从62.3±14.3%提高到66.6±25.0%),干预组提高了12.2%(从60.7±15.2%提高到72.9±20.4%,P = 0.15)。用科恩d值衡量的效应大小为0.55,对于教育干预来说被认为是有效的(>0.33)。

结论

本项目填补了OTC培训的空白。使用德尔菲技术、基于结果开发干预措施以及评估疗效是一个可用于其他教育空白的过程。

补充信息

在线版本包含可在10.1007/s40670-021-01331-w获取的补充材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c58/8368309/684d3b02e494/40670_2021_1331_Fig1_HTML.jpg

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