Cryder Sydney, Jensen Stephen, McCarthy Joseph, Whitworth Kristen, Kennelley Gabrielle E, Nowak Andrew S, Hysell Matthew K
Graduate Medical Education Department, Emergency Medicine Residency Corewell Health South St. Joseph Michigan USA.
Department of Medical Education Central Michigan University College of Medicine Mt. Pleasant Michigan USA.
AEM Educ Train. 2023 Apr 11;7(2):e10867. doi: 10.1002/aet2.10867. eCollection 2023 Apr.
Mental, motor, and guided imagery techniques are commonly used in sports psychology, but less often in medical education. Utilization of imagery-based techniques (IBTs) in combination with traditional teaching methods may provide a low-cost, innovative approach to improving outcomes in graduate medical education.
The objective was to assess whether medical students demonstrate greater proficiency in the ability to obtain central venous access in simulation trainers following exposure to guided, mental, and motor imagery teaching methods in comparison to traditional methods.
Volunteer fourth-year medical students during their emergency medicine rotation were randomly assigned to two groups, traditional plus imagery teaching or traditional teaching alone. The control group watched a video tutorial on central line placement methods. The study group watched the same video with the addition of imagery components. Participants filled out survey questions before and after the video and again after line placement. Proctors blinded to student group assignments then observed student placement of an internal jugular triple-lumen catheter on a simulation trainer and completed a standardized performance rubric.
Sixty medical students participated. Two were excluded for having performed five or more lines either clinically or in a previous simulation. There was no difference in self-perceived competence in line placement prior to watching the video or in the number of lines previously performed between groups. The imagery group ( = 25) averaged 1.3 errors/need for intervention compared to 2.2 errors/need for intervention in the control group ( = 33; = 0.045, 95% confidence interval [CI] 0.02 to 1.61). Time to place the line was similar-8.9 min for the control group versus 8.6 min for the imagery group ( = 0.74, 95% CI -1.39 to 1.95).
The use of IBTs may be a promising adjunct to traditional medical teaching of procedures in emergency medicine.
心理、运动和引导式意象技术在运动心理学中常用，但在医学教育中较少使用。将基于意象的技术（IBTs）与传统教学方法相结合，可能为改善研究生医学教育的效果提供一种低成本、创新的方法。
目的是评估与传统方法相比，医学生在接触引导式、心理和运动意象教学方法后，在模拟训练器中获取中心静脉通路的能力是否表现出更高的熟练度。
在急诊医学轮转期间的四年级志愿医学生被随机分为两组，传统加意象教学组或仅传统教学组。对照组观看了关于中心静脉置管方法的视频教程。研究组观看了添加了意象成分的相同视频。参与者在视频前后以及置管后再次填写调查问卷。对学生分组不知情的监考人员随后观察学生在模拟训练器上放置颈内静脉三腔导管的操作，并完成标准化的操作评分标准。
60名医学生参与。两名学生因在临床或之前的模拟中已进行过五次或更多次置管而被排除。在观看视频之前，两组在自我感知的置管能力或之前进行的置管次数方面没有差异。意象组（n = 25）平均每次干预需求的错误数为1.3个，而对照组（n = 33）为2.2个（P = 0.045，95%置信区间[CI] 0.02至1.61）。置管时间相似——对照组为8.9分钟，意象组为8.6分钟（P = 0.74，95% CI -1.39至1.95）。
在急诊医学中，使用IBTs可能是传统医学操作教学的一种有前景的辅助方法。
