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临床医学生急救综合模拟教育教学效果评价。

Evaluation of teaching effect of first-aid comprehensive simulation-based education in clinical medical students.

机构信息

Department of Critical Care Medicine, The Third Affiliated Hospital of Shenzhen University, Shenzhen, China.

Department of Pharmacy, The Third Affiliated Hospital of Shenzhen University, Shenzhen, China.

出版信息

Front Public Health. 2022 Aug 10;10:909889. doi: 10.3389/fpubh.2022.909889. eCollection 2022.

Abstract

BACKGROUND

Although students mastered the composition skills, they lack of the ability to effectively integrate these composition skills in real clinical situations. To address the problem, we set up different levels of situational simulation training for medical students in grades 2-4, and evaluate the teaching effect of first-aid situation comprehensive simulation-based education (SBE) on clinical medical students.

METHODS

The medical students in Grade 2, 3, and 4 received different situational SBE, respectively. The 2nd-year medical students received a single skill module which included cardiopulmonary resuscitation, endotracheal intubation, and electric defibrillation training. The 3rd-year medical students received a single subject module which included cardiovascular and respiratory system training. The 4th-year medical students received the integrated multidisciplinary module which combined first-aid skills, clinical thinking, and teamwork training. The primary outcome was the expert evaluation and peer evaluation. The secondary outcome was students' satisfaction questionnaire response. In our training, we arranged an adequate teaching staff for intensive training and timely feedback (the student-teacher ratio of 5:1), adequate time for repetitive practice (Each SBE was carried out within 4 h), curriculum design, and integration from real cases by clinicians, realistic computer-driven mannequins to ensure simulation fidelity, providing a different difficult level of SBE to different grades of students, and pre- and post-tests for outcome measurement.

RESULTS

In all of the single skill module, single subject module or comprehensive disciplines module, the scores in the expert evaluation and peer assessment after the training were significantly higher than before the training, and the differences were statistically significant ( < 0.05). The integrated subject training, although having the lowest pre-and post-test marks, had the largest increase in score.

CONCLUSION

The first aid comprehensive simulation-based education in grade 2-4 clinical medical students, basing on timely feedback, repetitive practice, curriculum integration, simulation fidelity, and outcome measurement are effective in improving the students' proficiency in managing the real emergencies.

摘要

背景

尽管学生已经掌握了写作技巧,但他们缺乏将这些写作技巧有效整合到实际临床情境中的能力。为了解决这个问题,我们为 2-4 年级的医学生设置了不同层次的情境模拟培训,并评估了基于急救情境综合模拟教育(SBE)对临床医学学生的教学效果。

方法

2 年级、3 年级和 4 年级的医学生分别接受不同的情境 SBE。2 年级的医学生接受单一技能模块的培训,包括心肺复苏、气管插管和电除颤训练。3 年级的医学生接受单一学科模块的培训,包括心血管和呼吸系统培训。4 年级的医学生接受综合多学科模块的培训,结合急救技能、临床思维和团队合作培训。主要结果是专家评估和同伴评估。次要结果是学生对满意度问卷的反应。在我们的培训中,我们安排了足够的教学人员进行强化培训和及时反馈(师生比为 5:1),为重复练习提供了充足的时间(每次 SBE 在 4 小时内进行),课程设计和整合来自临床医生的真实案例,使用逼真的计算机驱动模拟人来确保模拟的真实性,为不同年级的学生提供不同难度级别的 SBE,并进行前后测试以衡量结果。

结果

在所有单一技能模块、单一学科模块或综合学科模块中,培训后的专家评估和同伴评估得分均明显高于培训前,差异具有统计学意义(<0.05)。综合学科培训虽然前测和后测得分最低,但得分提高幅度最大。

结论

基于及时反馈、重复练习、课程整合、模拟真实性和结果衡量,2-4 年级临床医学学生的急救综合模拟教育在提高学生处理真实紧急情况的熟练程度方面是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eabf/9399416/7b4518d9f07b/fpubh-10-909889-g0001.jpg

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