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遇见 EBE:一个基于证据的内镜模拟训练器的研发。

Meet EBE: The Development of an Evidence-Based Endoscopy Simulator.

机构信息

Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Digestive Health Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.

出版信息

Clin Gastroenterol Hepatol. 2022 May;20(5):e1180-e1187. doi: 10.1016/j.cgh.2021.11.041. Epub 2021 Dec 10.

Abstract

BACKGROUND AND AIMS

In the digital era of evidence-based medicine, there is a paucity of video endoscopy teaching platforms that use evidence-based medicine principles, or that allow for cognitive simulation of endoscopic management strategies. We created a guideline-based teaching platform for fellows that incorporates these features, and tested it.

METHODS

A pilot video module with embedded questions was drafted, and after incorporation of feedback from several attending gastroenterologists, an additional 2 modules were created. The embedded questions were designed to simulate cognitive management decisions as if the viewer were doing the endoscopy procedure in the video. A narrator explained the evidence behind the task being performed, and its certainty based on endoscopic guidelines. Quizzes and surveys were developed and administered to a sample of attendings and fellows who completed the video modules to test efficacy, usability, and likeability.

RESULTS

Three video modules, named evidence-based endoscopy (EBE), incorporating low fidelity simulation, and utilizing evidence-based medicine principles, were created. Eight fellows and 10 attendings completed the video modules and all quizzes and surveys. Mean test scores improved from before to after completing the video modules (56% to 92%; mean difference = -35%; 95% confidence interval, 27%-47%). Surveys indicated that the product was viewed favorably by participants, and that there is a strong desire for this type of educational product.

CONCLUSIONS

The EBE simulator is a unique, desirable, and effective educational platform based on evidence-based medicine principles that fills a gap in available tools for endoscopy education. Further studies are needed to assess whether EBE can aid in long-term knowledge retention and increase adherence to guideline recommendations.

摘要

背景与目的

在循证医学的数字时代,缺乏使用循证医学原则的视频内镜教学平台,或者允许对内镜管理策略进行认知模拟的平台。我们创建了一个基于指南的住院医师教学平台,包含这些功能,并对其进行了测试。

方法

起草了一个带有嵌入式问题的试点视频模块,在纳入几位主治胃肠病学家的反馈后,又创建了另外 2 个模块。嵌入式问题旨在模拟认知管理决策,就好像观看者正在视频中进行内镜检查程序一样。旁白者解释了执行任务背后的证据,以及根据内镜指南确定的确定性。开发并向完成视频模块的一组主治医生和住院医师进行了测验和调查,以测试其功效、可用性和吸引力。

结果

创建了三个视频模块,命名为基于证据的内镜(EBE),结合低保真度模拟,并利用循证医学原则。八名住院医师和十名主治医生完成了视频模块和所有测验和调查。完成视频模块后,平均测试分数从 56%提高到 92%(平均差异为-35%;95%置信区间为 27%-47%)。调查表明,参与者对该产品评价良好,并且强烈希望拥有这种类型的教育产品。

结论

EBE 模拟器是一种基于循证医学原则的独特、可取且有效的教育平台,填补了内镜教育现有工具的空白。需要进一步的研究来评估 EBE 是否有助于长期知识保留和增加对指南建议的依从性。

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