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课程创新:中国一家教学医院神经内科住院医师脑血管病培训中的近伴学习

Curriculum Innovations: Near-Peer Learning in Neurology Residency Training on Cerebrovascular Disease in a Teaching Hospital in China.

作者信息

Hong Yuehui, Su Ning, Fu Hanhui, Cao Yuze, Yao Ming, Zhou Lixin, Ni Jun, Zhu Yicheng

机构信息

From the Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.

出版信息

Neurol Educ. 2023 May 10;2(2):e200072. doi: 10.1212/NE9.0000000000200072. eCollection 2023 Jun.

Abstract

INTRODUCTION AND PROBLEM STATEMENT

Traditional faculty-led training is teacher-centric and requires substantial investments in teaching faculty and resources. Near-peer learning (NPL) is a teaching strategy in which senior residents instruct juniors who are only 1 or 2 years earlier in their training. NPL promotes student engagement and may enhance teaching competency of participants. We implemented an NPL instructional design for a course on cerebrovascular disease for residents in China.

OBJECTIVES

Tutors and tutees will be able to (1) demonstrate knowledge of cerebrovascular anatomy, (2) understand cerebrovascular physiology, and (3) use neuroimaging and physiology to evaluate cerebrovascular pathology.

METHODS AND CURRICULUM DESCRIPTION

From December 2019 to March 2022, NPL was implemented in a neurology residency training program in China. A series of NPL lectures was conducted in addition to traditional faculty-led lectures. The NPL intervention consisted of senior resident tutors who designed and led lectures on foundational topics in cerebrovascular neurology (e.g., anatomy and imaging of cerebral blood vessels, clinical and imaging features of ischemic and hemorrhagic stroke) under the guidance of faculty instructors. Tutees were junior residents in the same program. Precourse/postcourse examinations and feedbacks through online questionnaires were used to evaluate the effectiveness of the NPL intervention on knowledge acquisition and teaching competency.

RESULTS AND ASSESSMENT DATA

Over 3 academic years, 57 total residents participated, including 18, 18, and 21, respectively. All participated in the NPL intervention, with some attending more than once. Participants could be assigned as tutor or tutee in different years. Eighteen lectures were delivered by 15 tutors. The rest were tutees. Postcourse examination scores improved significantly compared with precourse scores (64.22 ± 12.11 vs 59.80 ± 15.88, = 0.003), with the most remarkable improvements seen for the first-year residents and first-time participants. One hundred sixty-two postsession feedbacks from participants (both tutors and tutees) and 15 postprogram feedbacks from tutors were collected. Respondents thought highly of NPL, reporting gain in knowledge and teaching opportunities.

DISCUSSION AND LESSONS LEARNED

NPL enabled residents to acquire foundational knowledge of cerebrovascular diseases and provided senior residents with teaching opportunities.

摘要

引言与问题陈述

传统的由教员主导的培训以教师为中心,需要在教师和资源方面进行大量投入。近伴学习(NPL)是一种教学策略,即高年级住院医师指导培训年限仅早1或2年的低年级住院医师。NPL能促进学生参与,并可能提高参与者的教学能力。我们为中国住院医师的脑血管疾病课程实施了一种NPL教学设计。

目标

导师和学员将能够(1)展示对脑血管解剖学的知识,(2)理解脑血管生理学,以及(3)运用神经影像学和生理学评估脑血管病理学。

方法与课程描述

2019年12月至2022年3月,在中国的一个神经科住院医师培训项目中实施了NPL。除了传统的教员主导讲座外,还开展了一系列NPL讲座。NPL干预由高年级住院医师导师组成,他们在教员的指导下设计并讲授脑血管神经病学的基础主题(如脑血管的解剖学和影像学、缺血性和出血性卒中的临床及影像学特征)。学员为同一项目中的低年级住院医师。通过课前/课后考试以及在线问卷反馈来评估NPL干预对知识获取和教学能力的有效性。

结果与评估数据

在3个学年中,共有57名住院医师参与,分别为18名、18名和21名。所有人都参与了NPL干预,有些人参加了不止一次。参与者在不同年份可被分配为导师或学员。15名导师进行了18次讲座。其余为学员。与课前成绩相比,课后考试成绩显著提高(64.22±12.11对59.80±15.88,P = 0.003),一年级住院医师和首次参与者的成绩提高最为显著。收集了162份参与者(包括导师和学员)的课后反馈以及15份导师的项目后反馈。受访者对NPL评价很高,称获得了知识和教学机会。

讨论与经验教训

NPL使住院医师能够获得脑血管疾病的基础知识,并为高年级住院医师提供了教学机会。

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