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针对临床前医学生的急诊医学模拟学习课程的知识保留情况

Knowledge Retention From Emergency Medicine Simulation-Based Learning Curriculum for Pre-clinical Medical Students.

作者信息

McMains Jennifer C, Larkins Michael C, Doherty Alexandra M, Horiates Julia, Alachraf Kamel, Gordon Julian A, Fletcher James, Brewer Kori L

机构信息

Emergency Medicine, East Carolina University Brody School of Medicine, Greenville, USA.

出版信息

Cureus. 2023 Jun 30;15(6):e41216. doi: 10.7759/cureus.41216. eCollection 2023 Jun.

Abstract

Introduction Traditional medical school curricula rely on textbook-based learning during the first two years, often limiting students' clinical exposure. Simulation-based learning (SBL) provides an opportunity for students to gain clinical exposure and competency with common procedures as well as to gain knowledge related to common clinical topics. Retention of factual knowledge is a current topic of discussion as medical learners often have difficulty with long-term retention. The aim of this study was to assess if students would learn, retain, and enjoy emergency medicine (EM)-focused SBL. Materials and methods We developed an EM-focused SBL curriculum consisting of four main educational events: suturing, medical stabilization, mass casualty triage, and point-of-care ultrasound (POCUS). Participants were first- and second-year healthcare students enrolled in a traditional, preclinical curriculum, who completed pre- and post-event quizzes consisting of multiple-choice questions on topics covered during the SBL scenario. We compared pre- and post-event quiz scores using a one-way paired t-test. Quizzes were readministered up to 100 days after each SBL event to test knowledge retention, and scores were compared across time by repeated-measures analysis of variance (RMANOVA). Results For suture (n=22), mass casualty (n=20), and ultrasound simulations (n=17), post-event mean quiz scores increased significantly in comparison to mean quiz scores from before the event (p≤0.05). Medical stabilization simulation post-event scores were increased but did not reach statistical significance. Data collected at 45, 74, and 94 days following the suture lab as well as 29 and 49 days after the medical evacuation event, and 20 days after the mass casualty event showed no statistical decrease in quiz means suggesting retention of knowledge among learners. Subjective assessments of participant satisfaction demonstrated an enjoyment of the events. Discussion EM-focused SBL events offered enjoyable learning opportunities for students to effectively obtain and possibly retain clinical knowledge. Conclusion SBL has the potential to improve student retention of clinical knowledge during the preclinical years and, therefore, should be further explored and implemented as a core pillar of medical education as opposed to its current state as a learning adjunct.

摘要

引言 传统医学院课程在前两年依赖基于教科书的学习,这常常限制了学生的临床接触机会。基于模拟的学习(SBL)为学生提供了一个获得临床接触机会和常见操作技能的途径,同时也能让他们获取与常见临床主题相关的知识。由于医学学习者在长期记忆方面常常存在困难,事实性知识的记忆是当前讨论的一个话题。本研究的目的是评估学生是否会学习、记住并喜欢以急诊医学(EM)为重点的SBL。

材料与方法 我们开发了一个以EM为重点的SBL课程,包括四个主要教育活动:缝合、医疗稳定、大规模伤亡分诊和即时超声检查(POCUS)。参与者是参加传统临床前课程的一年级和二年级医学生,他们完成了事件前后的测验,测验由关于SBL场景中涵盖主题的多项选择题组成。我们使用单因素配对t检验比较事件前后的测验分数。在每个SBL事件后长达100天重新进行测验以测试知识记忆,并通过重复测量方差分析(RMANOVA)比较不同时间的分数。

结果 对于缝合(n = 22)、大规模伤亡(n = 20)和超声模拟(n = 17),事件后的平均测验分数与事件前的平均测验分数相比显著提高(p≤0.05)。医疗稳定模拟事件后的分数有所提高,但未达到统计学显著性。在缝合实验室后的第45、74和94天以及医疗疏散事件后的第29和49天以及大规模伤亡事件后的第20天收集的数据显示,测验平均分没有统计学上的下降,这表明学习者能够记住知识。对参与者满意度的主观评估表明他们喜欢这些活动。

讨论 以EM为重点的SBL活动为学生提供了愉快的学习机会,使他们能够有效地获取并可能记住临床知识。

结论 SBL有潜力在临床前阶段提高学生对临床知识的记忆,因此,应作为医学教育的核心支柱进行进一步探索和实施,而不是像目前这样作为学习辅助手段。

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