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通过 SIMBA 为全球医疗保健专业人员提供公平的学习环境:一项混合方法研究。

Levelling the learning ground for healthcare professionals across the world through SIMBA: a mixed-methods study.

机构信息

Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, India.

Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

出版信息

BMJ Open. 2023 Jul 10;13(7):e069109. doi: 10.1136/bmjopen-2022-069109.

Abstract

OBJECTIVES

To compare the acceptance, strengths and limitations of Simulation via Instant Messaging-Birmingham Advance (SIMBA) in low/middle-income countries (LMICs) and high-income countries (HICs), on healthcare professionals' professional development and learning.

DESIGN

Cross-sectional study.

SETTING

Online (either mobile or computer/ laptop or both).

PARTICIPANTS

462 participants (LMICs: 29.7%, n=137 and HICs: 71.3%, n=325) were included.

INTERVENTIONS

Sixteen SIMBA sessions were conducted between May 2020 and October 2021. Doctors-in-training solved anonymised real-life clinical scenarios over WhatsApp. Participants completed pre-SIMBA and post-SIMBA surveys.

PRIMARY AND SECONDARY OUTCOME MEASURES

Outcomes were identified using Kirkpatrick's training evaluation model. LMIC and HIC participants' reactions (level 1) and self-reported performance, perceptions and improvements in core competencies (level 2a) were compared using the χ test. Content analysis of open-ended questions was performed.

RESULTS

Postsession, there were no significant differences in application to practice (p=0.266), engagement (p=0.197) and overall session quality (p=0.101) between LMIC and HIC participants (level 1). Participants from HICs showed better knowledge of patient management (LMICs: 77.4% vs HICs: 86.5%; p=0.01), whereas participants from LMICs self-reported higher improvement in professionalism (LMICs: 41.6% vs HICs: 31.1%; p=0.02). There were no significant differences in improved clinical competency scores in patient care (p=0.28), systems-based practice (p=0.05), practice-based learning (p=0.15) and communication skills (p=0.22), between LMIC and HIC participants (level 2a). In content analysis, the major strengths of SIMBA over traditional methods were providing individualised, structured and engaging sessions.

CONCLUSIONS

Healthcare professionals from both LMICs and HICs self-reported improvement in their clinical competencies, illustrating that SIMBA can produce equivalent teaching experiences. Furthermore, SIMBA's virtual nature enables international accessibility and presents potential for global scalability. This model could steer future standardised global health education policy development in LMICs.

摘要

目的

比较即时通讯模拟(SIMBA)在中低收入国家(LMICs)和高收入国家(HICs)中对医疗保健专业人员专业发展和学习的接受程度、优势和局限性。

设计

横断面研究。

地点

在线(移动或计算机/笔记本电脑或两者兼有)。

参与者

纳入了 462 名参与者(LMICs:29.7%,n=137;HICs:71.3%,n=325)。

干预措施

2020 年 5 月至 2021 年 10 月期间进行了 16 次 SIMBA 会议。接受培训的医生通过 WhatsApp 解决匿名的真实临床病例。参与者在 SIMBA 之前和之后完成了调查。

主要和次要结果

使用柯克帕特里克的培训评估模型确定结果。使用 χ 检验比较了 LMIC 和 HIC 参与者的反应(第 1 级)和自我报告的绩效、对核心能力的看法和改进(第 2a 级)。对开放式问题的内容分析。

结果

课后,LMIC 和 HIC 参与者在实践应用(p=0.266)、参与度(p=0.197)和整体课程质量(p=0.101)方面没有显著差异(第 1 级)。来自 HIC 的参与者在患者管理方面表现出更好的知识(LMICs:77.4% vs HICs:86.5%;p=0.01),而来自 LMIC 的参与者自我报告的专业精神提高幅度更高(LMICs:41.6% vs HICs:31.1%;p=0.02)。在患者护理(p=0.28)、基于系统的实践(p=0.05)、基于实践的学习(p=0.15)和沟通技巧(p=0.22)方面,LMIC 和 HIC 参与者的临床能力评分均无显著改善(第 2a 级)。在内容分析中,SIMBA 相对于传统方法的主要优势在于提供个性化、结构化和引人入胜的课程。

结论

来自 LMIC 和 HIC 的医疗保健专业人员自我报告其临床能力有所提高,这表明 SIMBA 可以产生同等的教学效果。此外,SIMBA 的虚拟性质使其具有国际可访问性,并具有全球可扩展性的潜力。该模型可以指导未来中低收入国家标准化全球卫生教育政策的制定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b50/10335543/8e1fcc289b68/bmjopen-2022-069109f01.jpg

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