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“一个安全、无评判的空间,让我能够真正挑战自我:”学生虚拟案例诊断推理会议中的学习体验。

"A safe, non-judgmental space where I can really challenge myself:" learner experiences in a virtual, case-based diagnostic reasoning conference for students.

机构信息

Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

Medical Service, San Francisco VA Medical Center, San Francisco, CA, USA.

出版信息

Med Educ Online. 2024 Dec 31;29(1):2414559. doi: 10.1080/10872981.2024.2414559. Epub 2024 Oct 14.

DOI:10.1080/10872981.2024.2414559
PMID:39402734
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11486056/
Abstract

Case-based diagnostic reasoning conferences, like morning reports, allow undergraduate medical trainees to practice diagnostic reasoning alongside senior clinicians. However, trainees have reported discomfort doing so. Peer-assisted learning offers an alternative approach. We describe the design, implementation, and evaluation of a virtual, student-only diagnostic reasoning conference that leverages peer-assisted learning. Student virtual morning report's (VMR) design was informed by social and cognitive congruence and experience-based learning. We evaluated participant experiences using a survey focused on participant perceptions of Student VMR's value, their methods for participation, and their preferences for Student VMR compared with VMR with more senior clinicians. 110 participants (28.9%) completed the survey. 90 participants (81.2%) reported that Student VMR was educational. Compared to VMR, participants reported being more likely to participate in Student VMR by turning on their video (50.0%), presenting a case (43.6%), verbally participating (44.5%), or participating in the chat (70.0%). Strengths included a safe learning environment to practice DR and the opportunity to engage with an international learning community. When asked whether they preferred Student VMR or non-Student VMR, most respondents (64.5%, 71/110) identified that they did not have a preference between the two. A student-focused DR conference may offer a valuable complement to, but not a replacement of, apprenticeship-based DR case conferences.

摘要

基于病例的诊断推理会议(如晨交班)允许本科医学生与资深临床医生一起练习诊断推理。然而,学生报告在这样做时感到不舒服。同伴辅助学习提供了一种替代方法。我们描述了一种虚拟的、仅限学生的诊断推理会议的设计、实施和评估,该会议利用了同伴辅助学习。学生虚拟晨交班(VMR)的设计受到社会和认知一致性以及基于经验的学习的启发。我们通过一项重点关注参与者对学生 VMR 价值、参与方法以及与 VMR 与更资深临床医生相比对学生 VMR 的偏好的调查来评估参与者的体验。110 名参与者(28.9%)完成了调查。90 名参与者(81.2%)报告说学生 VMR 具有教育意义。与 VMR 相比,参与者报告说更有可能通过打开视频(50.0%)、提出病例(43.6%)、口头参与(44.5%)或参与聊天(70.0%)来参与学生 VMR。其优势包括一个安全的学习环境来练习 DR 以及与国际学习社区互动的机会。当被问及他们更喜欢学生 VMR 还是非学生 VMR 时,大多数受访者(64.5%,71/110)表示他们对两者没有偏好。以学生为中心的 DR 会议可能是学徒制 DR 案例会议的有价值的补充,但不能替代它。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8918/11486056/a2bcf689ca9a/ZMEO_A_2414559_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8918/11486056/a2bcf689ca9a/ZMEO_A_2414559_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8918/11486056/a2bcf689ca9a/ZMEO_A_2414559_F0001_OC.jpg

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本文引用的文献

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Around the World in 60 Minutes: How a Virtual Morning Report has Created an International Community for Clinical Reasoning and Medical Education.60 分钟环游世界:虚拟晨交班如何为临床推理和医学教育创建国际社区。
Teach Learn Med. 2024 Jun-Jul;36(3):348-357. doi: 10.1080/10401334.2023.2226661. Epub 2023 Jun 21.
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Clinical Reasoning Curricula in Preclinical Undergraduate Medical Education: A Scoping Review.临床推理课程在本科医学教育中的应用:范围综述。
Acad Med. 2023 Aug 1;98(8):958-965. doi: 10.1097/ACM.0000000000005197. Epub 2023 Mar 1.
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The cognitive apprenticeship: advancing reasoning education by thinking aloud.
认知学徒制:通过出声思维推进推理教育。
Diagnosis (Berl). 2022 Dec 1;10(1):9-12. doi: 10.1515/dx-2022-0043. eCollection 2023 Feb 1.
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Diagnosis (Berl). 2021 Dec 14;9(2):265-273. doi: 10.1515/dx-2021-0112.
5
Morning report goes virtual: learner experiences in a virtual, case-based diagnostic reasoning conference.早间病例汇报转为线上进行:学习者在虚拟的、基于病例的诊断推理会议中的体验
Diagnosis (Berl). 2021 Aug 4;9(1):89-95. doi: 10.1515/dx-2021-0073.
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Internal Medicine Residents' Perceptions of Morning Report: a Multicenter Survey.内科住院医师对晨交班的看法:一项多中心调查。
J Gen Intern Med. 2021 Mar;36(3):647-653. doi: 10.1007/s11606-020-06351-7. Epub 2021 Jan 14.
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Diagnosis (Berl). 2020 Aug 27;7(3):169-176. doi: 10.1515/dx-2019-0100.
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