University of Ottawa Skills and Simulation Center and Academy for Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada.
Simulation Center, University of Western Brittany and University Hospital of Brest, Brest, France.
Korean J Anesthesiol. 2024 Apr;77(2):265-272. doi: 10.4097/kja.23317. Epub 2024 Mar 29.
Although peer-assisted learning is known to be effective for reciprocal learning in medical education, it has been understudied in simulation. We aimed to assess the effectiveness of peer-led compared to instructor-led debriefing for non-technical skill development in simulated crisis scenarios.
Sixty-one undergraduate medical students were randomized into the control group (instructor-led debriefing) or an intervention group (peer debriefer or peer debriefee group). After the pre-test simulation, the participants underwent two more simulation scenarios, each followed by a debriefing session. After the second debriefing session, the participants underwent an immediate post-test simulation on the same day and a retention post-test simulation two months later. Non-technical skills for the pre-test, immediate post-test, and retention tests were assessed by two blinded raters using the Ottawa Global Rating Scale (OGRS).
The participants' non-technical skill performance significantly improved in all groups from the pre-test to the immediate post-test, with changes in the OGRS scores of 15.0 (95% CI [11.4, 18.7]) in the instructor-led group, 15.3 (11.5, 19.0) in the peer-debriefer group, and 17.6 (13.9, 21.4) in the peer-debriefee group. No significant differences in performance were found, after adjusting for the year of medical school training, among debriefing modalities (P = 0.147) or between the immediate post-test and retention test (P = 0.358).
Peer-led debriefing was as effective as instructor-led debriefing at improving undergraduate medical students' non-technical skill performance in simulated crisis situations. Peer debriefers also improved their simulated clinical skills. The peer debriefing model is a feasible alternative to the traditional, costlier instructor model.
虽然同伴辅助学习被认为对医学教育中的互惠学习有效，但在模拟教学中对其研究较少。我们旨在评估在模拟危机情景中，同伴主导与教师主导的讨论对非技术技能发展的效果。
61 名本科医学生被随机分为对照组（教师主导的讨论）或干预组（同伴讨论者或同伴讨论接受者组）。在预测试模拟后，参与者进行了另外两个模拟场景，每个场景后都进行了讨论。在第二次讨论后，参与者在当天进行即时后测试模拟，并在两个月后进行保留后测试模拟。使用渥太华全球评估量表（OGRS），由两位盲审员评估预测试、即时后测试和保留测试的非技术技能。
所有组的参与者的非技术技能表现均从预测试显著提高到即时后测试，OGRS 评分的变化分别为教师主导组 15.0（95%置信区间[11.4，18.7]）、同伴讨论者组 15.3（11.5，19.0）和同伴讨论接受者组 17.6（13.9，21.4）。在调整医学院培训年份后，讨论模式之间的表现没有差异（P = 0.147），即时后测试和保留测试之间也没有差异（P = 0.358）。
同伴主导的讨论与教师主导的讨论一样有效，可提高本科医学生在模拟危机情况下的非技术技能表现。同伴讨论者也提高了他们的模拟临床技能。同伴讨论模式是对传统、成本更高的教师模式的可行替代。
