Ginsburg Joshua, Sande Margaret, Ahmed Azhar, Moak James, Sudhir Amita, Mutter Mary K
Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, USA.
Emergency Medicine, University of Virginia School of Medicine, Charlottesville, USA.
Cureus. 2024 Sep 24;16(9):e70117. doi: 10.7759/cureus.70117. eCollection 2024 Sep.
Objectives Previous studies have shown that residents play an important role in the education of medical students in the clinical setting, but the busy environment of the emergency department (ED) poses a challenge to the effective teaching of medical students by emergency medicine (EM) residents. To combat this, this study relies on just-in-time teaching, which refers to the application of teaching efforts specific to a particular moment, in this case, a clinical case or procedure. Building on studies showing that just-in-time teaching can improve education despite time constraints, as well as data showing that practitioners and trainees increasingly use apps for diagnosis and education, the objective of this project was to determine whether a free open-access medical education (FOAM) smartphone application (app) is feasible and improves the quality and frequency of resident teaching of medical students in the emergency department. Methods We created a smartphone app-based teaching resource that was available to residents and students on shift. We taught residents and medical students how to integrate the app into their workflow. We performed an observational pre/post-study design by surveying residents' and students' pre- and post-teaching app introduction to determine self- and student-reported teaching frequency and quality. Outcome measures were self-reported teaching frequency and quality of teaching. Results Ten of 17 residents (59%) reported using the app at least once per shift. Among them, six of 10 (60%) reported that it increased their teaching frequency, and eight of 10 (80%) reported that it increased the quality of their teaching. There was an increase in the number of residents with positive perceptions of the availability of evidence-based teaching resources on the shift from pre-intervention (five residents) to post-intervention (14 residents, p = 0.01); however, we were otherwise unable to identify any significant differences in residents' or students' perceptions of teaching after implementation of our intervention. Conclusion Just-in-time teaching of medical students by residents using a smartphone app is feasible, as evidenced by the majority of resident respondents reporting that they used the teaching app at least once per shift. Residents reported an improvement in teaching frequency and quality. The study is limited by a small sample size and a single-site design with a pre/post design. Further studies with a focus on qualitative feedback and objective measures of learning are needed to assess whether there is an impact on medical student instruction by residents when using this app-based teaching resource.
目的 以往研究表明，住院医师在临床环境中对医学生的教育起着重要作用，但急诊科（ED）忙碌的环境对急诊医学（EM）住院医师有效教授医学生构成了挑战。为应对这一问题，本研究采用即时教学法，即时教学法是指在特定时刻（在本案例中为临床病例或操作）进行针对性教学。基于表明即时教学法尽管存在时间限制仍可改善教育的研究，以及表明从业者和实习生越来越多地使用应用程序进行诊断和教育的数据，本项目的目的是确定一款免费的开放获取医学教育（FOAM）智能手机应用程序（应用）在急诊科对住院医师教授医学生是否可行，以及是否能提高教学质量和频率。 方法 我们创建了一个基于智能手机应用程序的教学资源，供轮班的住院医师和学生使用。我们教授住院医师和医学生如何将该应用程序融入他们的工作流程。我们通过在引入教学应用程序前后对住院医师和学生进行调查，采用观察性前后研究设计，以确定自我报告和学生报告的教学频率和质量。结果指标是自我报告的教学频率和教学质量。结果 17 名住院医师中有 10 名（59%）报告每班至少使用一次该应用程序。其中，10 名中有 6 名（60%）报告这增加了他们的教学频率，10 名中有 8 名（80%）报告这提高了他们的教学质量。从干预前（5 名住院医师）到干预后（14 名住院医师，p = 0.01），对循证教学资源可用性持积极看法的住院医师人数有所增加；然而，在实施我们的干预后，我们无法在住院医师或学生对教学的看法中发现任何其他显著差异。结论 住院医师使用智能手机应用程序对医学生进行即时教学是可行的，大多数住院医师受访者报告他们每班至少使用一次教学应用程序即可证明。住院医师报告教学频率和质量有所提高。本研究受样本量小和单中心前后设计的限制。需要进一步开展侧重于定性反馈和学习客观指标的研究，以评估使用这种基于应用程序的教学资源时对住院医师教授医学生是否有影响。
