Scottish Centre for Simulation and Clinical Human Factors, Forth Valley Royal Hospital, Larbert, FK5 4WR, UK.
Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK.
BMC Med Educ. 2022 Aug 16;22(1):621. doi: 10.1186/s12909-022-03654-7.
Intercostal chest drain (ICD) insertion is a skill that medical trainees lack confidence in performing. This study explores the impact of a national programme of Simulation-Based Mastery Learning (SBML) on procedural confidence, including the impact of time intervals between booster sessions and interim clinical experience.
Internal Medicine Trainees in Scotland were surveyed about confidence and clinical experience with ICD insertion before and immediately after SBML and booster session. Data were matched and analysed using paired sample t-tests. Short interval and long interval groups were compared using Student's unpaired t-test. The impact of interim clinical experience was assessed using Analysis of Variance.
Mean confidence in ICD insertion rose following SBML, fell between initial and booster session, and increased again following booster session (P = < 0.001). 33 of 74 trainees had successfully inserted an ICD between sessions. Fall in confidence was unaffected by the time interval between training sessions, but was mitigated by interim clinical experience.
SBML boosts trainee confidence in ICD insertion. However, there is evidence of confidence decay, possibly due to a lack of clinical experience between sessions. More research is needed to explore barriers to transfer of skills from simulated to real-world environments.
肋间胸部引流 (ICD) 插入是医学实习生缺乏信心的技能。本研究探讨了基于模拟的掌握学习 (SBML) 国家计划对程序信心的影响，包括在助推课程和中期临床经验之间的时间间隔的影响。
苏格兰的内科受训者在接受 SBML 和助推课程之前和之后就 ICD 插入的信心和临床经验进行了调查。使用配对样本 t 检验对数据进行匹配和分析。使用学生的独立 t 检验比较短期间隔和长期间隔组。使用方差分析评估中期临床经验的影响。
在 SBML 之后，ICD 插入的信心均值升高，在初始和助推课程之间下降，在助推课程之后再次升高（P<0.001）。在课程之间，有 33 名受训者成功插入了 ICD。信心下降不受培训课程之间时间间隔的影响，但受中期临床经验的影响。
SBML 提高了实习生对 ICD 插入的信心。然而，有证据表明信心下降，可能是由于课程之间缺乏临床经验。需要进一步研究以探讨从模拟到现实环境中转移技能的障碍。
