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学习如何安排影像学检查并做出后续临床决策:一项关于虚拟学习环境对医学生有效性的随机研究。

Learning How to Order Imaging Tests and Make Subsequent Clinical Decisions: a Randomized Study of the Effectiveness of a Virtual Learning Environment for Medical Students.

作者信息

Viteri Jusué Ainhoa, Tamargo Alonso Andrea, Bilbao González Amaia, Palomares Teodoro

机构信息

Department of Surgery, Radiology and Physical Medicine, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Leioa, Spain.

Radiology Department, Araba University Hospital, Osakidetza-SVS, Vitoria-Gasteiz, Spain.

出版信息

Med Sci Educ. 2021 Jan 11;31(2):469-477. doi: 10.1007/s40670-020-01188-5. eCollection 2021 Apr.

Abstract

RATIONALE AND OBJECTIVES

Two critical skills that medical students must acquire during undergraduate education are the ability to order imaging tests and make clinical decisions based on their results. We implemented an e-learning course in Moodle specifically designed to teach these skills to medical students. The aim of this study was to assess the effectiveness of our course.

MATERIAL AND METHODS

We randomized 26 undergraduate medical students to an experimental group that had access to the virtual learning environment and a control group that did not. Three weeks after the course, we evaluated its effectiveness through a blinded objective structured clinical examination. To avoid any bias in favor of the experimental group, the assessment considered scores on two pre-specified subscales: one related to the contents of the course and the other to new clinical scenarios.

RESULTS

Students that completed the e-course performed better overall than controls (mean score ± standard deviation 59.3 ± 6.2 vs 41.8 ± 10.2,  = 0.0020). This better performance was observed in both types of skills assessed (ordering imaging tests, and making diagnostic and therapeutic decisions based on test results). More importantly, this better performance of the experimental group was observed consistently both with items related to the course content (1.7 times higher,  = 0.0034) and new scenarios (1.3 times higher,  = 0.0098).

CONCLUSIONS

Through an e-course, undergraduate medical students learned effectively how to order imaging tests and make optimal subsequent decisions. Moreover, they were able to apply these skills to new clinical scenarios.

摘要

原理与目的

医学生在本科教育期间必须掌握的两项关键技能是开具影像学检查单的能力以及根据检查结果做出临床决策的能力。我们在Moodle平台上实施了一门专门设计用于向医学生传授这些技能的电子学习课程。本研究的目的是评估我们课程的有效性。

材料与方法

我们将26名本科医学生随机分为实验组和对照组,实验组可以使用虚拟学习环境,对照组则不能。课程结束三周后,我们通过盲法客观结构化临床考试评估其有效性。为避免对实验组产生任何偏袒性偏差,评估考虑了两个预先指定子量表的得分:一个与课程内容相关,另一个与新的临床场景相关。

结果

完成电子课程的学生总体表现优于对照组(平均得分±标准差59.3±6.2 vs 41.8±10.2,P = 0.0020)。在评估的两种技能类型(开具影像学检查单以及根据检查结果做出诊断和治疗决策)中均观察到了这种更好的表现。更重要的是,实验组在与课程内容相关的项目(高1.7倍,P = 0.0034)和新场景(高1.3倍,P = 0.0098)中均始终表现更好。

结论

通过一门电子课程,本科医学生有效地学会了如何开具影像学检查单并做出最佳的后续决策。此外,他们能够将这些技能应用于新的临床场景。

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