McGee Richard G, Wark Stuart, Mwangi Felista, Drovandi Aaron, Alele Faith, Malau-Aduli Bunmi S
School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, 2308, Australia.
Campbelltown Hospital, South Western Sydney Local Health District, Campbelltown, NSW, Australia.
BMC Med Educ. 2024 Dec 18;24(1):1477. doi: 10.1186/s12909-024-06471-2.
The constraints imposed by the COVID-19 pandemic has led to the rapid development and implementation of digital methods for teaching clinical skills in medical education. This systematic review presents both the benefits, challenges, and effectiveness of this transition.
A systematic search of six electronic databases (SCOPUS, Medline, CINAHL, PsycINFO, ERIC & Informit) was conducted on 1st October 2023 and updated on 1st April 2024 to identify peer- reviewed articles, from 2019 onwards, which used any type of digital tool (online or otherwise) to teach clinical skills to medical trainees (undergraduate or postgraduate) and were published in English language. The primary outcome synthesised was the reported effectiveness of these digital tools in the development of clinical skills. Risk of bias of included studies was assessed using the Quality Assessment With Diverse Studies (QuADS) tool.
Twenty-seven studies involving 3,895 participants were eligible for inclusion in this review. The QuADS quality assessment scores ranged from 22 to 35, indicating medium quality and thirteen of the studies were randomized trials. Overall, digital teaching of clinical skills demonstrated improved or comparable outcomes to in-person teaching. There was a beneficial effect of digital learning tools on assessment outcomes, with meta-analysis showing a mean difference increase of 1.93 (95% CI 1.22 to 2.64), albeit with a high amount of statistical heterogeneity I2 97%, P < 0.001. Digital clinical skills teaching also resulted in improved student satisfaction scores in many situations and was also shown in one study to be cost effective.
Teaching of clinical skills using digital tools is an important alternative to the traditional format of face-to-face delivery, which is resource intensive and difficult to implement during a pandemic. This review demonstrates their potential efficacy in improving education outcomes, student satisfaction and potentially reducing costs. However, the integration of traditional and innovative digital teaching methods appeared to provide the most comprehensive learning experience. Future research could focus on longitudinal studies to assess the long-term impact and efficacy of different digital and blended learning modalities on the acquisition of clinical skills and professional competencies.
2019年冠状病毒病（COVID-19）大流行带来的限制促使医学教育中临床技能教学的数字方法迅速发展和应用。本系统评价阐述了这一转变的益处、挑战和有效性。
于2023年10月1日对六个电子数据库（SCOPUS、Medline、CINAHL、PsycINFO、ERIC和Informit）进行系统检索，并于2024年4月1日更新，以识别2019年起发表的、使用任何类型数字工具（在线或其他）向医学学员（本科或研究生）教授临床技能且以英文发表的同行评审文章。综合的主要结果是这些数字工具在临床技能培养方面报告的有效性。使用多样研究质量评估（QuADS）工具评估纳入研究的偏倚风险。
27项涉及3895名参与者的研究符合纳入本评价的条件。QuADS质量评估分数在22至35之间，表明质量中等，其中13项研究为随机试验。总体而言，临床技能的数字教学显示出与面对面教学相比有所改善或相当的结果。数字学习工具对评估结果有有益影响，荟萃分析显示平均差异增加1.93（95%可信区间1.22至2.64），尽管存在高度的统计异质性I2 97%，P < 0.001。数字临床技能教学在许多情况下也提高了学生满意度分数，并且在一项研究中还显示具有成本效益。
使用数字工具进行临床技能教学是传统面对面教学形式的重要替代方案，传统教学形式资源密集且在大流行期间难以实施。本评价证明了它们在改善教育成果、学生满意度以及可能降低成本方面的潜在功效。然而，传统和创新数字教学方法的整合似乎能提供最全面的学习体验。未来的研究可侧重于纵向研究，以评估不同数字和混合学习模式对临床技能和专业能力获取的长期影响和功效。
