Department of Surgery, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
BMC Med Educ. 2024 May 31;24(1):605. doi: 10.1186/s12909-024-05549-1.
This study investigated the perceptions and performance of medical students regarding their engagement and learning of a knot-tying skill presented in an online demonstration format due to the emergency remote measures that accompanied COVID-19 restrictions.
Final-year undergraduate medical students were invited to view an online demonstration of a one-handed knot-tying skill and practice the skill using common household items. They recorded their attempts and uploaded them onto the Flipgrid application. Completed attempts were scored using an adapted Objective Structured Assessment of Technical Skill (OSATS) validated tool. We used a mixed-methods sequential explanatory design; data regarding students' engagement was gathered via a short questionnaire, and a Focus Group Discussion (FGD) was conducted to understand their learning experiences better. Descriptive statistics such as proportions and percentages were used to summarize categorical variables and median for continuous variables. Each video attempt was scored independently by two surgeons; reliability was determined using intraclass correlation; statistical tests were conducted at a 5% level of significance. Responses to open-ended survey questions and qualitative data from the FGDs were analysed using thematic analysis.
Seventy-one students participated in the exercise. Most students (91.5%) expressed confidence in their ability to perform the skill and were able to follow the steps in the video demonstration (83.1%). Median number of times needed to practice before video submission was 7.0 (Interquartile range [IQR] 5.0-10.0). Using the adapted OSATS tool; median scores on student attempts were 19.0 out of 21 (IQR: 17.0-20.0) for Assessor 1 and 18.0 out of 21 (IQR: 17.0-20.0) for Assessor 2, and overall scores showed good reliability between assessors based on intraclass correlation (0.86, 95% CI 0.79-0.90, p < 0.001). Qualitative insights from the students' experiences in learning the skill were generally positive; it was a practical, experiential learning process and they valued the social aspects of learning via Flipgrid. Challenges expressed related to the need for in-person training and formal feedback on how to improve their technique. Suggestions to improve their learning included a request for an interactive session with immediate feedback on attempts, and being able to practice with a friend who would assist with videoing.
Basic knot-tying can be taught with acceptable efficiency and student satisfaction using online methods with items available at home.
本研究调查了医学生对在线演示格式的结打技能的参与和学习的看法和表现，这是由于 COVID-19 限制所采取的紧急远程措施。
邀请应届本科医学生观看单手结打技能的在线演示，并使用常见的家用物品练习该技能。他们将自己的尝试记录下来并上传到 Flipgrid 应用程序上。使用经过改编的客观结构化评估技术技能（OSATS）验证工具对完成的尝试进行评分。我们使用混合方法序贯解释性设计；通过简短的问卷收集有关学生参与度的数据，并进行焦点小组讨论（FGD）以更好地了解他们的学习体验。使用比例和百分比等描述性统计数据总结分类变量，使用中位数总结连续变量。两位外科医生分别独立对每个视频尝试进行评分；使用组内相关系数确定可靠性；在 5%的水平上进行统计检验。使用主题分析对开放式调查问题的回答和 FGD 的定性数据进行分析。
71 名学生参加了这项练习。大多数学生（91.5%）对自己执行技能的能力表示有信心，并能够按照视频演示中的步骤进行操作（83.1%）。中位数需要练习的次数为 7.0（四分位距[IQR]为 5.0-10.0）。使用改编的 OSATS 工具；学生尝试的中位数评分为 21 分中的 19.0（评估者 1 的 IQR 为 17.0-20.0，评估者 2 的 IQR 为 18.0-20.0），评估者之间的总体评分基于组内相关系数显示出良好的可靠性（0.86，95%CI 0.79-0.90，p<0.001）。学生在学习技能过程中的经验的定性见解总体上是积极的；这是一种实用的、经验性的学习过程，他们重视通过 Flipgrid 进行社交学习。表达的挑战与对面对面培训的需求以及如何改进技术的正式反馈有关。他们希望改进学习的建议包括请求进行互动会议，以便立即反馈尝试结果，并能够与协助录像的朋友一起练习。
使用在线方法和家庭中可用的物品，可以以可接受的效率和学生满意度教授基本的结打技能。
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