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一种观察者工具,用于增强医学生在心肺复苏模拟训练中的学习效果:一项随机对照试验。

An observer tool to enhance learning of medical students during simulation training of cardiopulmonary resuscitation: a randomised controlled trial.

机构信息

Centre de simulation LabForSIMS, Département de Recherche et Innovation Pédagogique en Santé, Faculté de médecine, Université Paris Saclay, Le Kremlin-Bicêtre, 94275, France.

Département d'Anesthésie-Réanimation Médecine Péri Opératoire, APHP, CHU Bicêtre, Le Kremlin Bicêtre, 94275, France.

出版信息

BMC Med Educ. 2024 Jul 3;24(1):719. doi: 10.1186/s12909-024-05658-x.

Abstract

BACKGROUND

Simulation training in cardiopulmonary resuscitation (CPR) is effective but active practice time is limited given the large number of students and the learning effect size remains small. To improve learning during observation, the use of an observer tool (OT) has been advocated. The aim was to assess the value of OT to improve medical students' learning outcomes during CPR simulation training.

METHODS

This prospective, randomized study took place during CPR training of medical students. The workshop targeted recognition of unconsciousness, absence of breathing, call for help, cardiac massage and defibrillation. Students practicing in dyads were randomized to use an OT (i.e., a checklist summarizing CPR skills and step-by-step actions) (OT +) or not (OT-) when observing others. At the end of the training, the global performance of the dyad was assessed by an evaluator using the OT checklist (primary outcome). The non-technical skills (NTS), chest compression quality, perceived improvement in knowledge and skills and knowledge score (MCQ) were also recorded.

RESULTS

The student dyads were included (OT + : n = 40 and OT-: n = 41). Immediately after training, the global performance was similar between the two groups: OT + : 24 [23-25] and OT-: 23 [21-24] (out of 25), p = 0.052. However, better learning of breathing assessment and cardiac massage performance, as well as a better knowledge score, were found in the OT + group. No significant difference was observed for NTS or perceived improvement in knowledge and skills. Satisfaction was higher in the OT- group.

CONCLUSIONS

The use of an OT during CPR simulation did not show any pedagogical benefit on the global performance of medical students. However, a potential benefit was found for several important secondary outcomes. Further studies are needed to confirm these positive results.

摘要

背景

心肺复苏(CPR)模拟培训是有效的,但由于学生人数众多,且学习效果的规模仍然较小,因此实际操作时间有限。为了提高观察过程中的学习效果,提倡使用观察者工具(OT)。其目的是评估 OT 是否有助于提高医学生在 CPR 模拟培训中的学习效果。

方法

这是一项前瞻性、随机研究,在医学生的 CPR 培训期间进行。该研讨会的目标是识别意识丧失、无呼吸、呼救、心脏按压和除颤。练习双人 CPR 的学生被随机分为观察组(使用 OT,即总结 CPR 技能和逐步操作的检查表)(OT+)或不使用观察组(OT-)。培训结束时,评估者使用 OT 检查表(主要结局)评估双人组的整体表现。还记录了非技术技能(NTS)、胸外按压质量、知识和技能的感知改善以及知识得分(MCQ)。

结果

纳入学生双人组(OT+:n=40,OT-:n=41)。培训后立即,两组的整体表现相似:OT+:24 [23-25],OT-:23 [21-24](满分 25 分),p=0.052。然而,在 OT+组中,呼吸评估和心脏按压表现的学习以及知识得分的提高更好。在 NTS 或知识和技能的感知改善方面未观察到显著差异。OT-组的满意度更高。

结论

在 CPR 模拟培训中使用 OT 并没有显示出对医学生整体表现的任何教学益处。然而,在一些重要的次要结局方面发现了潜在的益处。需要进一步的研究来证实这些积极的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cee9/11223434/910e484621fb/12909_2024_5658_Fig1_HTML.jpg

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