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基于模拟的临床实习前程序技能课程:减轻焦虑并提高程序技能操作的信心。

A pre-clerkship simulation-based procedural skills curriculum: decreasing anxiety and improving confidence of procedural skill performance.

作者信息

Battaglia Frank, Ivankovic Victoria, Merlano Maria, Patel Vishesh, Sayed Céline, Wang Hao, McConnell Meghan, Rastogi Nikhil

机构信息

Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Faculty of Medicine, University of Ottawa, Ontario, Canada.

出版信息

Can Med Educ J. 2021 Nov 1;12(5):34-39. doi: 10.36834/cmej.71483. eCollection 2021 Nov.

Abstract

INTRODUCTION

Pre-clerkship procedural skills training is not yet a standard across Canadian medical school curricula, resulting in limited exposure to procedures upon entering clerkship. While simulated skills training has been documented in the literature to improve performance in technical ability, anxiety and confidence have yet to be investigated despite their documented impact on performance and learning. This study therefore aims to evaluate the effect of pre-clerkship procedural skills training on medical student anxiety and confidence.

METHODS

A procedural skills training program was designed based on an evidence-based near-peer, flipped classroom model of education. Ninety-two second-year medical students volunteered for the study. Fifty-six were randomized to the training group, and 36 were randomized to the control group. Students in the training group attended seven procedural skills tutorials over seven months. The control group represented the average medical school student without standardized procedural training. Student anxiety and confidence were assessed at the beginning and end of the program using the State Trait Anxiety Inventory and Confidence Questionnaires.

RESULTS

Students who participated in the procedural skills program demonstrated greater reductions in their state anxiety and greater improvements in confidence compared to the control group.

CONCLUSION

Longitudinal procedural skills training in the simulation setting has demonstrated improvements in anxiety and confidence among pre-clerkship medical students. These added benefits to training have the potential to ease medical students' transition into clerkship, while also contributing to a safer and more effective clinical experience. Therefore, future integration of standardized pre-clerkship procedural skills training within medical school curricula should be considered.

摘要

引言

临床实习前的操作技能培训在加拿大医学院课程中尚未成为标准,导致学生在进入临床实习时接触操作的机会有限。虽然文献记载模拟技能培训可提高技术能力表现,但焦虑和信心对表现及学习有影响,却尚未得到研究。因此,本研究旨在评估临床实习前操作技能培训对医学生焦虑和信心的影响。

方法

基于循证的近龄同伴翻转课堂教育模式设计了一项操作技能培训项目。92名二年级医学生自愿参与该研究。56名被随机分配到培训组,36名被随机分配到对照组。培训组的学生在七个月内参加了七次操作技能辅导课。对照组代表未接受标准化操作培训的普通医学院学生。在项目开始和结束时,使用状态特质焦虑量表和信心问卷对学生的焦虑和信心进行评估。

结果

与对照组相比,参加操作技能项目的学生在状态焦虑方面有更大程度的降低,在信心方面有更大的提高。

结论

模拟环境下的纵向操作技能培训已证明可改善临床实习前医学生的焦虑和信心。这些培训带来的额外益处有可能缓解医学生向临床实习的过渡,同时也有助于提供更安全、更有效的临床体验。因此,应考虑未来在医学院课程中纳入标准化的临床实习前操作技能培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29c6/8603885/0cd0cb04a333/CMEJ-12-034-g001.jpg

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