Bieri Julie, Tuor Carlotta, Nendaz Mathieu, L Savoldelli Georges, Blondon Katherine, Schiffer Eduardo, Zamberg Ido
Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
JMIR Med Educ. 2023 Mar 2;9:e38870. doi: 10.2196/38870.
The COVID-19 pandemic caused a major disruption in the health care sector with increased workload and the need for new staff to assist with screening and vaccination tasks. Within this context, teaching medical students to perform intramuscular injections and nasal swabs could help address workforce needs. Although several recent studies discuss medical students' role and integration in clinical activities during the pandemic, knowledge gaps exist concerning their role and potential benefit in designing and leading teaching activities during this period.
The aim of our study was to prospectively assess the impact in terms of confidence, cognitive knowledge, and perceived satisfaction of a student-teacher-designed educational activity consisting of nasopharyngeal swabs and intramuscular injections for the training of second-year medical students in the Faculty of Medicine, University of Geneva, Switzerland.
This was a mixed methods pre-post surveys and satisfaction survey study. Activities were designed using evidence-based teaching methodologies based on the SMART (specific, measurable, achievable, realistic, and timely) criteria. All second-year medical students who did not participate in the activity's old format were recruited unless they explicitly stated that they wanted to opt out. Pre-post activity surveys were designed to assess perception of confidence and cognitive knowledge. An additional survey was designed to assess satisfaction in the mentioned activities. Instructional design was blended with a presession e-learning activity and a 2-hour practice session with simulators.
Between December 13, 2021, and January 25, 2022, a total of 108 second-year medical students were recruited; 82 (75.9%) students participated in the preactivity survey and 73 (67.6%) in the postactivity survey. Students' confidence in performing intramuscular injections and nasal swabs significantly increased on a 5-point Likert scale for both procedures-from 3.31 (SD 1.23) and 3.59 (SD 1.13) before the activity to 4.45 (SD 0.62) and 4.32 (SD 0.76) after the activity (P<.001), respectively. Perceptions of cognitive knowledge acquisition also significantly increased for both activities. For the nasopharyngeal swab, knowledge acquisition concerning indications increased from 2.7 (SD 1.24) to 4.15 (SD 0.83), and for the intramuscular injection, knowledge acquisition concerning indications increased from 2.64 (SD 1.1) to 4.34 (SD 0.65) (P<.001). Knowledge of contraindications for both activities increased from 2.43 (SD 1.1) to 3.71 (SD 1.12) and from 2.49 (SD 1.13) to 4.19 (SD 0.63), respectively (P<.001). High satisfaction rates were reported for both activities.
Student-teacher-based blended activities for training novice medical students in commonly performed procedural skills seem effective for increasing their confidence and cognitive knowledge and should be further integrated within a medical school curriculum. Blended learning instructional design increases students' satisfaction about clinical competency activities. Future research should elucidate the impact of student-teacher-designed and student-teacher-led educational activities.
新冠疫情给医疗保健部门带来了重大干扰,工作量增加,需要新员工协助筛查和疫苗接种任务。在此背景下,教医学生进行肌肉注射和鼻拭子采样有助于满足劳动力需求。尽管最近有几项研究讨论了医学生在疫情期间在临床活动中的作用和融入情况,但关于他们在此期间设计和主导教学活动的作用和潜在益处仍存在知识空白。
我们研究的目的是前瞻性评估一项由学生-教师设计的教育活动对瑞士日内瓦大学医学院二年级医学生进行鼻咽拭子采样和肌肉注射培训在信心、认知知识和感知满意度方面的影响。
这是一项混合方法的前后测调查和满意度调查研究。活动采用基于SMART(具体、可衡量、可实现、现实和及时)标准的循证教学方法进行设计。所有未参加该活动旧形式的二年级医学生均被招募,除非他们明确表示想退出。活动前后的调查旨在评估信心和认知知识的感知。另一项调查旨在评估对上述活动的满意度。教学设计与课前电子学习活动和为期2小时的模拟器实践课程相结合。
在2021年12月13日至2022年1月25日期间,共招募了108名二年级医学生;82名(75.9%)学生参加了活动前调查,73名(67.6%)学生参加了活动后调查。学生进行肌肉注射和鼻拭子采样的信心在5分量表上均显著提高,两种操作分别从活动前的3.31(标准差1.23)和3.59(标准差1.13)提高到活动后的4.45(标准差0.62)和4.32(标准差0.76)(P<0.001)。两项活动中对认知知识获取的感知也显著增加。对于鼻咽拭子采样,关于适应症的知识获取从2.7(标准差1.24)增加到4.15(标准差0.83),对于肌肉注射,关于适应症的知识获取从2.64(标准差1.1)增加到4.34(标准差0.65)(P<0.001)。两项活动的禁忌症知识分别从2.43(标准差1.1)增加到3.71(标准差1.12)和从2.49(标准差1.13)增加到4.19(标准差0.63)(P<0.001)。两项活动的满意度都很高。
基于学生-教师的混合活动对培训新手医学生常见操作技能似乎有效,可提高他们的信心和认知知识,应进一步纳入医学院课程。混合学习教学设计提高了学生对临床能力活动的满意度。未来的研究应阐明学生-教师设计和学生-教师主导的教育活动的影响。