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[心律失常教育——当前的考量,重点关注心电图教学]

[Arrhythmias education-current considerations with a focus on ECG teaching].

作者信息

Raupach Tobias

机构信息

Institut für Medizindidaktik, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

Medizinische Klinik und Poliklinik II - Herzzentrum, Universitätsklinikum Bonn, Bonn, Deutschland.

出版信息

Herzschrittmacherther Elektrophysiol. 2025 Mar;36(1):91-95. doi: 10.1007/s00399-024-01057-3. Epub 2024 Dec 2.

DOI:10.1007/s00399-024-01057-3
PMID:39621055
Abstract

In order to achieve favorable learning outcomes in medical students and residents, the development of educational interventions should be guided by specific principles. This article presents readers with a short summary of Kern's six-step approach to curriculum development before discussing results of medical education research with a focus on ECG teaching. A number of consecutive studies concluded that the choice of instructional format is less important for student learning outcome than examination consequences. Thus, if the final examination is summative (i.e., graded), students achieve higher scores regardless of the instructional method employed-even in the absence of formal teaching. Formative examinations are associated with considerably worse learning outcomes; however, they facilitate the detection of differences in effectiveness between various instructional formats. Follow-up data indicate that the loss of ECG interpretation skills is greater following a summative exam compared with a formative exam. In summary, while summative exams result in a short-term performance increase as they create a strong incentive to learn, they do not guarantee superior long-term retention. This begs the question which learning objectives can and should actually be covered in undergraduate and continuing medical education. The article concludes with a set of recommendations for the development of teaching interventions on heart rhythm disorders.

摘要

为了让医学生和住院医师取得良好的学习成果,教育干预措施的制定应遵循特定原则。本文在讨论以心电图教学为重点的医学教育研究结果之前,向读者简要介绍了克恩课程开发六步法。一系列连贯的研究得出结论,教学形式的选择对学生学习成果的重要性低于考试结果。因此,如果期末考试是总结性的(即评分的),无论采用何种教学方法,学生都会取得更高的分数——即使没有正式教学。形成性考试与明显更差的学习成果相关;然而,它们有助于发现各种教学形式在有效性方面的差异。后续数据表明,与形成性考试相比,总结性考试后心电图解读技能的丧失更为严重。总之,虽然总结性考试会因创造强大的学习动力而导致短期成绩提高,但它们并不能保证长期的优异记忆效果。这就引出了一个问题,即本科医学教育和继续医学教育中实际可以且应该涵盖哪些学习目标。文章最后针对心律失常教学干预措施的开发提出了一系列建议。

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本文引用的文献

1
Machine learning in cardiac stress test interpretation: a systematic review.机器学习在心脏负荷试验解读中的应用:一项系统综述。
Eur Heart J Digit Health. 2024 Apr 17;5(4):401-408. doi: 10.1093/ehjdh/ztae027. eCollection 2024 Jul.
2
Artificial neural networks for ECG interpretation in acute coronary syndrome: A scoping review.人工神经网络在急性冠状动脉综合征心电图解读中的应用:系统评价。
Am J Emerg Med. 2024 Sep;83:1-8. doi: 10.1016/j.ajem.2024.06.026. Epub 2024 Jun 24.
3
Artificial intelligence-enhanced electrocardiography for accurate diagnosis and management of cardiovascular diseases.
人工智能增强心电图在心血管疾病的准确诊断和管理中的应用。
J Electrocardiol. 2024 Mar-Apr;83:30-40. doi: 10.1016/j.jelectrocard.2024.01.006. Epub 2024 Jan 28.
4
2023 ESC Guidelines for the management of acute coronary syndromes.2023年欧洲心脏病学会急性冠状动脉综合征管理指南。
Eur Heart J. 2023 Oct 12;44(38):3720-3826. doi: 10.1093/eurheartj/ehad191.
5
Predictors of ECG Interpretation Proficiency in Healthcare Professionals.医疗保健专业人员心电图解读能力的预测因素。
Curr Probl Cardiol. 2023 Dec;48(12):102011. doi: 10.1016/j.cpcardiol.2023.102011. Epub 2023 Aug 4.
6
How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial.我们如何提高心电图解读技能的教学?一项前瞻性随机试验的结果。
J Electrocardiol. 2016 Jan-Feb;49(1):7-12. doi: 10.1016/j.jelectrocard.2015.10.004. Epub 2015 Oct 13.
7
Moving Knowledge Acquisition From the Lecture Hall to the Student Home: A Prospective Intervention Study.将知识获取从讲堂转移到学生家中:一项前瞻性干预研究。
J Med Internet Res. 2015 Sep 28;17(9):e223. doi: 10.2196/jmir.3814.
8
Summative assessments are more powerful drivers of student learning than resource intensive teaching formats.总结性评估比资源密集型教学模式更能有效促进学生学习。
BMC Med. 2013 Mar 5;11:61. doi: 10.1186/1741-7015-11-61.
9
Use of unannounced spaced telephone testing to improve retention of knowledge after life-support courses.使用未事先通知的间隔电话测试来提高生命支持课程后知识的保留率。
Med Teach. 2011;33(9):731-7. doi: 10.3109/0142159X.2010.542521. Epub 2011 Feb 28.
10
Impact of teaching and assessment format on electrocardiogram interpretation skills.教学和评估形式对心电图解读技能的影响。
Med Educ. 2010 Jul;44(7):731-40. doi: 10.1111/j.1365-2923.2010.03687.x. Epub 2010 May 28.