模拟患者会诊期间的学生表现对汇报者遵循PEARLS汇报模型没有影响。

Student Performance During a Simulated Patient Encounter Has No Impact on Debriefer Adherence to PEARLS Debriefing Model.

作者信息

McNutt Richard, Tews Matthew, Kleinheksel A J

机构信息

Department of Emergency Medicine, Medical College of Georgia at Augusta University, 1120 15th Street, AF 1018, 30912 Augusta, Georgia.

Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia.

出版信息

Med Sci Educ. 2021 Apr 23;31(3):1141-1148. doi: 10.1007/s40670-021-01290-2. eCollection 2021 Jun.

Abstract

PURPOSE

Debriefing is necessary for effective simulation education. The PEARLS (Promoting Excellence and Reflective Learning in Simulations) is a scripted debriefing model that incorporates debriefing best practices. It was hypothesized that student simulation performance might impact facilitator adherence to the PEARLS debriefing model. There are no published findings on the effect of student performance on debriefer behavior.

METHODS

Third-year medical students participated in a video-recorded, formative simulation to treat a high-fidelity mannequin for an asthma exacerbation. A faculty debriefer trained in the PEARLS model evaluated student performance with a standardized rubric and conducted a recorded debriefing. Debriefing recordings were analyzed for debriefer adherence to the PEARLS model. Debriefers were assigned a debriefing score (DS) from 0 to 13; 13 was perfect adherence to the model. Definitive intervention (DI) for asthma exacerbation was defined as bronchodilator therapy. Critical actions were as follows: a focused history, heart/lung exam, giving oxygen, and giving a bronchodilator.

RESULTS

Mean DS for the debriefers of students who provided DI was 8.57; 9.14 for those students who did not ( = 0.25). Mean DS for debriefers of students who completed all critical actions was 8.68; 8.52 for those students who did not ( = 0.62). Analysis of elapsed time to DI showed no relationship between the time DI was provided and DS.

CONCLUSIONS

Student performance had no impact on debriefer performance, suggesting the PEARLS model is an effective aid for debriefers, regardless of learner performance. These findings suggest student performance may not bias facilitators' ability to conduct quality debriefings.

摘要

目的

总结汇报对于有效的模拟教育至关重要。PEARLS(促进模拟中的卓越与反思性学习)是一种融入了总结汇报最佳实践的脚本式总结汇报模型。据推测,学生的模拟表现可能会影响引导者对PEARLS总结汇报模型的遵循情况。目前尚无关于学生表现对总结汇报者行为影响的已发表研究结果。

方法

三年级医学生参与了一场视频录制的形成性模拟,以治疗一个用于模拟哮喘急性加重的高仿真人体模型。一名接受过PEARLS模型培训的教员总结汇报者使用标准化评分标准评估学生表现,并进行了一次录制的总结汇报。对总结汇报的录像进行分析,以评估总结汇报者对PEARLS模型的遵循情况。为总结汇报者分配一个从0到13的总结汇报分数(DS);13分表示完全遵循该模型。哮喘急性加重的确定性干预(DI)定义为支气管扩张剂治疗。关键操作如下:重点病史采集、心肺检查、给氧以及给予支气管扩张剂。

结果

对提供DI的学生的总结汇报者而言,平均DS为8.57;对未提供DI的学生的总结汇报者而言,平均DS为9.14(P = 0.25)。对完成所有关键操作的学生的总结汇报者而言,平均DS为8.68;对未完成所有关键操作的学生的总结汇报者而言,平均DS为8.52(P = 0.62)。对至DI的 elapsed 时间的分析表明,提供DI的时间与DS之间无关联。

结论

学生表现对总结汇报者的表现没有影响,这表明无论学习者的表现如何,PEARLS模型都是总结汇报者的有效辅助工具。这些发现表明学生表现可能不会使引导者进行高质量总结汇报的能力产生偏差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca47/8368893/7cfa64e6213a/40670_2021_1290_Fig1_HTML.jpg

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