Cavuoto Petrizzo Marie, Olvet Doreen M, Samuels Roya, Paul Aleena, John Janice T, Pawelczak Melissa, Steiner Shara D
Departments of Science Education and Pediatrics, Zucker School of Medicine, Hempstead, NY, USA.
Department of Science Education, Zucker School of Medicine, Hempstead, NY, USA.
Adv Med Educ Pract. 2023 Apr 12;14:363-369. doi: 10.2147/AMEP.S396046. eCollection 2023.
Effective teaching and assessment of otologic examinations are challenging. Current methods of teaching otoscopy using traditional otoscopes have significant limitations. We hypothesized that use of all-in-one video otoscopes provides students with an opportunity for real-time faculty feedback and re-practicing of skills, increasing self-reported confidence.
An otoscopy microskills competency checklist was provided to third-year medical students during their pediatric clerkship to self-assess otoscopy technique during patient examinations, and to clinical preceptors to assess and provide feedback during exams. Over the course of two years, we collected data from students randomly assigned to train on a video otoscope or a traditional otoscope during the clerkship. Pre- and post-clerkship surveys measured confidence in performing otoscopy microskills, making a diagnosis and documentation of findings. For those students who trained on the video otoscope, we solicited post-clerkship feedback on the experience of using a video otoscope.
Pre-clerkship confidence did not differ between the groups, but the video otoscope trained group had significantly higher scores than the traditional otoscope trained group on all self-reported technical and diagnostic microskills confidence questions items post-clerkship. Students trained on video otoscopes had a significant increase in confidence with all microskills items (-values<0.001), however confidence in the traditional otoscope trained group did not change over time (-values>0.10). Qualitative feedback from the video otoscope trained group reflected positive experiences regarding "technique/positioning" and "feedback from preceptors.".
Teaching otoscopy skills to pediatric clerkship medical students using a video otoscope significantly enhanced confidence compared to those training on a traditional otoscope by 1. enabling preceptors and students to simultaneously visualize otoscopy findings 2. allowing preceptors to provide real-time feedback and 3. providing opportunity for deliberate practice of microskills. We encourage the use of video otoscopes to augment student confidence and self-efficacy when training in otoscopy.
耳科检查的有效教学与评估具有挑战性。目前使用传统耳镜进行耳镜检查教学的方法存在显著局限性。我们推测,使用一体化视频耳镜能为学生提供获得教师实时反馈和技能再练习的机会,从而提高自我报告的信心。
在儿科实习期间,向三年级医学生提供一份耳镜检查微技能能力清单,以便他们在患者检查期间自我评估耳镜检查技术,并供临床带教教师在考试期间进行评估和提供反馈。在两年的时间里,我们收集了在实习期间被随机分配使用视频耳镜或传统耳镜进行培训的学生的数据。实习前后的调查测量了学生在进行耳镜检查微技能、做出诊断和记录检查结果方面的信心。对于那些使用视频耳镜进行培训的学生,我们征求了他们在实习后对使用视频耳镜体验的反馈。
实习前两组学生的信心没有差异,但在实习后所有自我报告的技术和诊断微技能信心问题项目上,使用视频耳镜培训的组得分显著高于使用传统耳镜培训的组。使用视频耳镜培训的学生在所有微技能项目上的信心都有显著提高(P值<0.001),然而,使用传统耳镜培训的组的信心并没有随时间变化(P值>0.10)。使用视频耳镜培训的组的定性反馈反映了在“技术/定位”和“带教教师的反馈”方面的积极体验。
与使用传统耳镜培训的学生相比,使用视频耳镜向儿科实习医学生教授耳镜检查技能显著增强了他们的信心,原因如下:1. 使带教教师和学生能够同时可视化耳镜检查结果;2. 允许带教教师提供实时反馈;3. 提供微技能刻意练习的机会。我们鼓励在耳镜检查培训中使用视频耳镜来增强学生的信心和自我效能感。