University of Colorado School of Medicine, Department of Emergency Medicine, Denver, Colorado.
Stanford University School of Medicine, Department of Emergency Medicine, Palo Alto, California.
West J Emerg Med. 2022 May 2;23(3):318-323. doi: 10.5811/westjem.2022.2.54748.
Medical students lack adequate training on how to correctly don and doff personal protective equipment (PPE). Simulation-based mastery learning (SBML) is an effective technique for procedural education. The aim of this study was to determine whether SBML improves proper PPE donning and doffing by medical students.
This was a prospective, pre-test/post-test study of 155 medical students on demonstration of correct PPE use before and after a SBML intervention. Subjects completed standard hospital training by viewing a US Centers for Disease Control and Prevention training video on proper PPE use prior to the intervention. They then participated in a SBML training session that included baseline testing, deliberate practice with expert feedback, and post-testing until mastery was achieved. Students were assessed using a previously developed 21-item checklist on donning and doffing PPE with a minimum passing standard (MPS) of 21/21 items. We analyzed differences between pre-test and post-test scores using paired t-tests. Students at preclinical and clinical levels of training were compared with an independent t-test.
Two participants (1.3%) met the MPS on pre-test. Of the remaining 153 subjects who participated in the intervention, 151 (98.7%) reached mastery. Comparison of mean scores from pre-test to final post-test significantly improved from an average raw score of 12.55/21 (standard deviation [SD] = 2.86), to 21/21(SD = 0), t(150) = 36.3, P <0.001. There was no difference between pre-test scores of pre-clinical and clinical students.
Simulation-based mastery learning improves medical student performance in PPE donning and doffing in a simulated environment. This approach standardizes PPE training for students in advance of clinical experiences.
医学生在正确穿戴个人防护装备（PPE）方面缺乏足够的培训。基于模拟的掌握学习（SBML）是一种有效的程序性教育技术。本研究旨在确定 SBML 是否能提高医学生正确佩戴和脱下 PPE 的能力。
这是一项针对 155 名医学生的前瞻性、预测试/后测试研究，在 SBML 干预前后对他们进行正确使用 PPE 的演示。在干预前，所有受试者都观看了美国疾病控制与预防中心关于正确使用 PPE 的培训视频，接受了标准的医院培训。然后，他们参加了一个 SBML 培训课程，包括基线测试、有专家反馈的刻意练习，以及直到掌握为止的后续测试。学生使用之前开发的 21 项 PPE 穿戴检查表进行评估，通过标准为 21/21 项。我们使用配对 t 检验分析了预测试和后测试得分之间的差异。使用独立 t 检验比较了基础临床和临床阶段学生的差异。
有 2 名（1.3%）学生在预测试中达到了通过标准。在其余 153 名参加干预的受试者中，有 151 名（98.7%）达到了掌握水平。从预测试的平均原始分数 12.55/21（标准差[SD] = 2.86）到最终后测试的 21/21（SD = 0），平均分数的比较显著提高，t（150）= 36.3，P <0.001。基础临床和临床学生的预测试分数没有差异。
基于模拟的掌握学习提高了医学生在模拟环境中 PPE 穿戴和脱下的表现。这种方法在临床经验之前为学生提供了标准化的 PPE 培训。
