Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, New South Wales, Australia
The University of Sydney Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, New South Wales, Australia.
BMJ Open. 2021 Oct 11;11(10):e052985. doi: 10.1136/bmjopen-2021-052985.
To test the efficacy and acceptability of video-reflexive methods for training medical interns in the use of personal protective equipment (PPE).
Mixed methods study.
A tertiary-care teaching hospital, Sydney, January 2018-February 2019.
72 of 90 medical interns consented to participate. Of these, 39 completed all three time points.
Participants received a standard infection prevention and control (IPC) education module during their hospital orientation. They were then allocated alternately to a control or video group. At three time points (TPs) over the year, participants were asked to don/doff PPE items based on hospital protocol. At the first two TPs, all participants also participated in a reflexive discussion. At the second and third TPs, all participants were audited on their performance. The only difference between groups was that the video group was videoed while donning/doffing PPE, and they watched this footage as a stimulus for reflexive discussion.
The efficacy and acceptability of the intervention were assessed using: (1) comparisons of audit performance between and within groups over time, (2) comparisons between groups on survey responses for evaluation of training and self-efficacy and (3) thematic analysis of reflexive discussions.
Both groups improved in their PPE competence over time, although there was no consistent pattern of significant differences within and between groups. No significant differences were found between groups on reported acceptability of training, or self-efficacy for PPE use. However, analysis of reflexive discussions shows that the effects of the video-reflexive intervention were tangible and different in important respects from standard training.
Video reflexivity in group-based training can assist new clinicians in engagement with, and better understanding of, IPC in their clinical practice. Our study also highlights the need for ongoing and targeted IPC training during medical undergraduate studies as well as regular workplace refresher training.
测试视频反思方法在培训医学实习生使用个人防护设备（PPE）方面的疗效和可接受性。
混合方法研究。
悉尼一家三级保健教学医院，2018 年 1 月至 2019 年 2 月。
90 名医学实习生中有 72 名同意参与。其中 39 名完成了所有三个时间点的研究。
参与者在医院入职培训期间接受了标准感染预防与控制（IPC）教育模块。然后，他们被交替分配到对照组或视频组。在一年中的三个时间点（TP），参与者根据医院的协议要求穿戴/脱下 PPE 物品。在头两个 TP 中，所有参与者还参加了反思性讨论。在第二和第三个 TP 中，所有参与者都接受了表现审核。两组唯一的区别是，视频组在穿戴/脱下 PPE 时被录像，然后观看这段录像作为反思性讨论的刺激。
通过以下方法评估干预措施的疗效和可接受性：（1）比较两组之间和组内随着时间推移的审核表现，（2）比较两组对培训和自我效能评估的调查回答，（3）对反思性讨论的主题分析。
两组的 PPE 能力都随着时间的推移而提高，尽管两组之间和组内都没有一致的显著差异模式。在培训的可接受性或 PPE 使用的自我效能方面，两组之间没有发现显著差异。然而，对反思性讨论的分析表明，视频反思干预的效果在重要方面是切实存在的，与标准培训不同。
基于小组的培训中的视频反思可以帮助新的临床医生在他们的临床实践中参与和更好地理解 IPC。我们的研究还强调了在医学本科学习期间以及定期的工作场所复习培训中，需要进行持续和有针对性的 IPC 培训。
