Shan Tong, Kejun Wang, Ying Feng, Jia Huang, Hongyan Jiang
Center of Geriatrics Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital) Haikou China.
Department of Academic Affairs Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital) Haikou China.
Health Sci Rep. 2022 Sep 8;5(5):e757. doi: 10.1002/hsr2.757. eCollection 2022 Sep.
Clinical skills practice is an essential component in standardized residency training. However, traditionally skill training methods are dogmatic and not all residents are exposed to such prescribed situations during their residency. The aims of this study were to evaluate the effectiveness and influence factors of a four-step approach combining situational simulation teaching methods in clinical practice for residents.
Enrolled all second-year residents from the internal medicine base between May 2017 and May 2018 ( = 94), randomly divided into two groups. Forty-eight residents were selected as experimental group, while the others 46 as the control group. Adopted traditional clinical practice method in the teaching and assessment of the control group, while used four-step approach combining situational simulation teaching method in experimental group. We compared the theoretical and skill assessment scores in preclass and postclass. Conducted a satisfaction survey after class and analyzed the influencing factors of the teaching effect evaluation.
There were no significant differences in the theoretical and skill assessment scores between experimental group and control group at the beginning. After the class, both the average skill assessment and Direct Observation of Procedural Skills scores of the experimental group were higher than those of the control. Satisfaction survey findings identified that the experimental group expressed higher satisfaction. Logistic regression showed that educational background, "situational simulation mode helps to improve clinical skills training," "helps to maintain attention during learning," and "helps improve the ability to exercise analysis and solve problems" were the influencing factors of learners' satisfaction.
The application of four-step approach combining situational simulation teaching methods in the clinical practice of residents can significantly improve skills, thinking ability, decision-making ability, and teaching satisfaction. Therefore, four-step approach combining situational simulation teaching methods is worth promoting in teaching clinical skills for internal medicine residency training.
临床技能实践是标准化住院医师培训的重要组成部分。然而，传统的技能培训方法较为教条，并非所有住院医师在培训期间都能接触到此类规定情境。本研究旨在评估一种将情境模拟教学方法相结合的四步法在住院医师临床实践中的有效性及影响因素。
纳入2017年5月至2018年5月内科基地的所有二年级住院医师（n = 94），随机分为两组。选取48名住院医师作为实验组，其余46名作为对照组。对照组在教学与评估中采用传统临床实践方法，而实验组采用将情境模拟教学方法相结合的四步法。比较两组课前和课后的理论及技能评估成绩。课后进行满意度调查并分析教学效果评价的影响因素。
实验组和对照组在开始时的理论和技能评估成绩无显著差异。课后，实验组的平均技能评估和操作技能直接观察得分均高于对照组。满意度调查结果显示实验组表示更高的满意度。逻辑回归显示，教育背景、“情境模拟模式有助于提高临床技能培训”、“有助于在学习过程中保持注意力”以及“有助于提高分析和解决问题的能力”是学习者满意度的影响因素。
将情境模拟教学方法相结合的四步法应用于住院医师临床实践中，可显著提高技能、思维能力、决策能力和教学满意度。因此，将情境模拟教学方法相结合的四步法在内科住院医师培训临床技能教学中值得推广。
