Collinson Joseph W, Brown Thomas, Chalmers Louis A, Gales Alistair, Shepherd Laura
Emergency Department, Tauranga Hospital, Tauranga, New Zealand.
Anaesthetics Department, University College London Hospitals NHS Foundation Trust, London, UK.
BMJ Simul Technol Enhanc Learn. 2018 Mar 23;4(2):71-76. doi: 10.1136/bmjstel-2016-000172. eCollection 2018.
Near-peer teaching is recognised for its benefit to both students and facilitators when used as an adjunct to traditional teaching. Simulation is an effective tool for teaching acute management. There are currently no published long-term objective data of the efficacy of near-peer simulation teaching.
We designed the 'Immediate Management: Peer Led Simulated Emergencies' course, a near-peer simulation course for medical students run by junior doctors covering common medical and surgical emergencies. Participants and teachers were objectively tested before and after sessions, and participant confidence in various areas was self-assessed. Participants were followed up at 18 months with both repeat testing and analysis of finals examination results.
Participants' mean test scores improved significantly postcourse and remained significantly higher than baseline at 18-month follow-up. There was no difference between participants' and non-participants' final examination performance. Participant confidence increased in all areas immediately and at 18-month follow-up. Junior doctor facilitator test scores significantly improved after teaching on the course.
Near-peer simulation courses can be effectively designed and run by junior doctors and our results suggest that they result in long-term improvement in test scores. Larger studies with randomised control groups are required to confirm the efficacy of such teaching.
近伴教学作为传统教学的辅助手段,对学生和教师均有益处,这一点已得到认可。模拟是一种有效的急性处理教学工具。目前尚无已发表的关于近伴模拟教学效果的长期客观数据。
我们设计了“即时处理:同伴主导的模拟急诊”课程,这是一门由初级医生为医学生开设的近伴模拟课程,涵盖常见的内科和外科急诊。在课程前后对参与者和教师进行客观测试,并让参与者对各个领域的信心进行自我评估。在18个月时对参与者进行随访,包括重复测试和分析期末考试成绩。
参与者的平均测试成绩在课程结束后显著提高,在18个月随访时仍显著高于基线水平。参与者和非参与者的期末考试成绩没有差异。参与者在所有领域的信心在课程结束时和18个月随访时均有所增加。初级医生教师在参与该课程教学后的测试成绩显著提高。
初级医生可以有效地设计和开展近伴模拟课程,我们的结果表明这些课程能带来测试成绩的长期提高。需要开展有随机对照组的更大规模研究来证实此类教学的效果。