Lin Erica, You Alan X, Wardi Gabriel
Division of Pulmonary and Critical Care and.
Department of Emergency Medicine, University of California San Diego, La Jolla, California.
ATS Sch. 2021 Oct 29;2(4):581-594. doi: 10.34197/ats-scholar.2021-0053OC. eCollection 2021 Dec.
The coronavirus disease (COVID-19) pandemic has disrupted medical education for trainees of all levels. Although telesimulation was initially used to train in resource-limited environments, it may be a reasonable alternative for replicating authentic patient experiences for medical students during the COVID-19 pandemic. It is unclear whether a more passive approach through telesimulation training is as effective as traditional in-person simulation training.
Our aim was to evaluate the effectiveness of in-person versus remote simulation training on learners' comfort with managing critical care scenarios.
This was a prospective observational cohort study assessing the impact of an in-person versus remote simulation course on volunteer fourth-year medical students from February to April 2021 at the University of California San Diego School of Medicine. Precourse and postcourse surveys were performed anonymously using an online secure resource.
In the in-person learners, there was statistically significant improvement in learner comfort across all technical, behavioral, and cognitive domains. In remote learners, there was a trend toward improvement in self-reported comfort across technical and cognitive domains in the telesimulation course. However, the only statistically significant improvement in postcourse surveys of telesimulation learners, compared with baseline, was in running codes. Regardless of the training modality, the students had a positive experience with the critical care simulation course, ranking it, on average, 9.6 out of 10 (9.9 in in-person simulation vs. 9.3 in telesimulation; = 0.06).
We demonstrated that implementation of a telesimulation-based simulation course focusing on critical care cases is feasible and well received by trainees. Although a telesimulation-based simulation course may not be as effective for remote learners as active in-person participants, our study provided evidence that there was still a trend toward improving provider readiness across technical and cognitive domains when approaching critical care cases.
冠状病毒病(COVID-19)大流行扰乱了各级学员的医学教育。虽然远程模拟最初用于资源有限的环境中进行培训,但在COVID-19大流行期间,它可能是为医学生复制真实患者体验的合理替代方法。目前尚不清楚通过远程模拟训练这种更被动的方法是否与传统的面对面模拟训练一样有效。
我们的目的是评估面对面与远程模拟训练对学习者处理重症监护场景的舒适度的有效性。
这是一项前瞻性观察队列研究,评估2021年2月至4月在加利福尼亚大学圣地亚哥分校医学院针对志愿参加的四年级医学生进行的面对面与远程模拟课程的影响。课前和课后调查通过在线安全资源匿名进行。
在面对面学习的学员中,所有技术、行为和认知领域的学习者舒适度都有统计学上的显著提高。在远程学习的学员中,远程模拟课程中自我报告的技术和认知领域舒适度有提高的趋势。然而,与基线相比,远程模拟学习者课后调查中唯一有统计学显著提高的是在执行代码方面。无论培训方式如何,学生对重症监护模拟课程都有积极的体验,平均评分9.6分(满分10分)(面对面模拟为9.9分,远程模拟为9.3分;P = 0.06)。
我们证明了实施以重症监护病例为重点的基于远程模拟的模拟课程是可行的,并且受到学员的好评。虽然基于远程模拟的模拟课程对远程学习者可能不如积极参与的面对面参与者有效,但我们的研究提供了证据,即在处理重症监护病例时,在技术和认知领域提高提供者准备度仍有趋势。