Acute Medical Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
BMJ Open Qual. 2022 Apr;11(2). doi: 10.1136/bmjoq-2021-001565.
Simulation-based learning (SBL) is well-established in medical education and has gained popularity, particularly during the COVID-19 pandemic when in-person teaching is infeasible. SBL replicates real-life scenarios and provides a fully immersive yet safe learning environment to develop clinical competency. Simulation via Instant Messaging - Birmingham Advance (SIMBA) is an exemplar of SBL, which we previously showed to be effective in endocrinology and diabetes. Previous studies reported the efficacy of SBL in acute medicine. We studied SIMBA as a learning intervention for healthcare professionals interested in acute medicine and defined our aims using the Kirkpatrick model: (i) develop an SBL tool to improve case management; (ii) evaluate experiences and confidence before and after; and (iii) compare efficacy across training levels.Three sessions were conducted, each representing a PDSA cycle (Plan-Do-Study-Act), consisting of four cases and advertised to healthcare professionals at our hospital and social media. Moderators facilitated progression through 25 min simulations and adopted patient and clinical roles as appropriate. Consultants chaired discussion sessions using relevant guidelines. Presimulation and postsimulation questionnaires evaluated self-reported confidence, feedback and intended changes to clinical practice.Improvements were observed in self-reported confidence managing simulated cases across all sessions. Of participants, 93.3% found SIMBA applicable to clinical practice, while 89.3% and 88.0% felt SIMBA aided personal and professional development, respectively. Interestingly, 68.0% preferred SIMBA to traditional teaching methods. Following participant feedback, more challenging cases were included, and we extended the time for simulation and discussion. The transcripts were amended to facilitate more participant-moderator interaction representing clinical practice. In addition, we refined participant recruitment over the three sessions. In cycle 1, we advertised incentives: participation counted towards teaching requirements, certificates and feedback. To rectify the reduction in participants in cycle 2, we implemented new advertisement methods in cycle 3, including on-site posters, reminder emails and recruitment of the defence deanery cohort.
基于模拟的学习(SBL)在医学教育中已经得到广泛应用,尤其是在 COVID-19 大流行期间,面对面教学变得不可行时。SBL 模拟真实场景,提供完全沉浸式但安全的学习环境,以发展临床能力。通过即时通讯的模拟 - 伯明翰高级版(SIMBA)是 SBL 的一个范例,我们之前已经证明它在内分泌学和糖尿病方面是有效的。先前的研究报告了 SBL 在急性医学中的效果。我们将 SIMBA 作为对急性医学感兴趣的医疗保健专业人员的学习干预措施,并使用 Kirkpatrick 模型来定义我们的目标:(i)开发一种 SBL 工具来改善病例管理;(ii)在前后评估经验和信心;(iii)比较不同培训水平的效果。
进行了三次会议,每次会议代表一个 PDSA 周期(计划-执行-研究-行动),包括四个病例,并向我们医院和社交媒体上的医疗保健专业人员宣传。主持人通过适当的患者和临床角色来促进 25 分钟模拟的进展。顾问使用相关指南主持讨论会议。预模拟和后模拟问卷评估自我报告的信心、反馈和对临床实践的预期改变。
在所有会议中,自我报告的信心都有所提高,以管理模拟病例。参与者中,93.3%认为 SIMBA 适用于临床实践,89.3%和 88.0%分别认为 SIMBA 有助于个人和职业发展。有趣的是,68.0%的人更喜欢 SIMBA 而不是传统的教学方法。根据参与者的反馈,增加了更具挑战性的病例,并延长了模拟和讨论的时间。对记录进行了修订,以促进更多的参与者与主持人之间的互动,代表临床实践。此外,我们在三个周期中完善了参与者的招募工作。在第 1 周期中,我们宣传了激励措施:参与计入教学要求、证书和反馈。为了纠正第 2 周期参与者减少的问题,我们在第 3 周期中实施了新的广告方法,包括现场海报、提醒电子邮件和招聘防御教务长群体。