Mutter M Kathryn, Pedersen Kathryn, Cunningham Tim, Martindale James R
Department of Emergency Medicine, University of Virginia, 1215 Lee St, PO Box 800699, Charlottesville, VA 22908 USA.
Virginia Commonwealth University, Richmond, VA USA.
Med Sci Educ. 2021 Oct 26;31(6):2001-2005. doi: 10.1007/s40670-021-01445-1. eCollection 2021 Dec.
Many medical schools offer a culminating internship readiness experience. Curricula focus on particular knowledge and skills critical to internship, such as answering urgent nursing pages. Studies have shown student performance improvement with mock paging education programs, but the role of feedback versus self-regulated practice has not been studied.
The interprofessional mock paging program included 156 medical students enrolled in a 4-year internship readiness course and 44 master's level direct entry nursing students. Medical students were randomized to receive verbal feedback immediately after each of the three phone calls (intervention group) or delayed written feedback (control group) after the third phone call only. Specialty-specific case scenarios were developed and a single checklist for all scenarios was developed using the communication tool ISBAR. Medical students and nursing students had separate training sessions before the pages commenced. The nursing students administered the phone calls and evaluated the medical students by ISBAR checklist. An interrater reliability measure was obtained with physician observation of a selection of phone calls.
After adjusting for the case effects (different case scenarios for different specialties), students showed no statistically significant differences on checklist scores for case 1 (first case, = 1.491, = 1, = .224), but did show statistically significant differences on checklist scores for case 3 (final case, = 12.238, = 1, = .001). Strong interrater reliability was found between the faculty physician and observed nursing students (ICC = .89).
Immediate feedback significantly improves student checklist scores with a mock paging program. This finding suggests that coaching with feedback may have advantages above self-regulated learning.
许多医学院校提供实习前的综合准备体验。课程聚焦于对实习至关重要的特定知识和技能,比如接听紧急护理呼叫。研究表明模拟呼叫教育项目能提高学生表现,但反馈与自我调节练习的作用尚未得到研究。
跨专业模拟呼叫项目包括156名参加为期4年实习准备课程的医学生和44名直接入学的护理学硕士研究生。医学生被随机分为两组,一组在三次电话呼叫每次结束后立即接受口头反馈(干预组),另一组仅在第三次电话呼叫后接受延迟的书面反馈(对照组)。开发了特定专业的病例场景,并使用沟通工具ISBAR为所有场景制定了一份单一检查表。在呼叫开始前,医学生和护理学学生分别进行了培训。护理学学生拨打这些电话,并根据ISBAR检查表对医学生进行评估。通过医生对部分电话呼叫的观察获得了评分者间信度测量值。
在调整病例效应(不同专业的不同病例场景)后,学生在病例1(第一个病例,=1.491,=1,=0.224)的检查表得分上没有统计学显著差异,但在病例3(最后一个病例,=12.238,=1,=0.001)的检查表得分上有统计学显著差异。在教师医生和观察到的护理学学生之间发现了很强的评分者间信度(ICC = 0.89)。
即时反馈通过模拟呼叫项目显著提高了学生的检查表得分。这一发现表明,有反馈的指导可能比自我调节学习更具优势。