教育研究：住院医师培训项目中模拟教学的应用：对成人神经病学住院医师培训项目主任的一项调查。
Education Research: Utilization of Simulation in Residency Programs: A Survey of Adult Neurology Residency Program Directors.
作者信息
Ghoshal Shivani, Albin Catherine S W, Malhotra Nisha A, Asonye Ifeyinwa, Budrow John, Stainman Rebecca, Kurzweil Arielle, Bell Michelle, Ford Jenna, Kleyman Inna, Massad Nina, Mikhaeil-Demo Yara, Wasserstrom Briana, Tchopev Zahari, Morris Nicholas A
机构信息
From the Department of Neurology (S.G., I.A., J.B., M.B., I.K.), Columbia University Vagelos College of Physicians and Surgeons, New York, NY; Department of Neurology (C.S.W.A.), Emory University School of Medicine, Atlanta, GA; Department of Neurology (N.A. Malhotra, A.K.), NYU Grossman School of Medicine, New York; Department of Neurology (R.S.), Johns Hopkins School of Medicine, Baltimore, MD; Department of Neurology (J.F., Y.M.-D.), Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Neurology (N.M.), University of Miami Leonard M. Miller School of Medicine, FL; Department of Neurology (B.W.), University of Florida College of Medicine, Gainesville; Department of Neurology (Z.T.), F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD; and Department of Neurology (N.A. Morris), University of Maryland School of Medicine, Baltimore.
出版信息
Neurol Educ. 2024 Nov 14;3(4):e200156. doi: 10.1212/NE9.0000000000200156. eCollection 2024 Dec.
BACKGROUND AND OBJECTIVES
Previous research has demonstrated that simulation-based medical education (SBME) can improve neurology trainees' confidence, knowledge, and competence. However, a general needs assessment and review of current SBME used within neurology are needed to guide SBME curriculum development. The objective of this study was to describe the current use of SBME in resident education and to assess perceived barriers to expanding SBME interventions.
METHODS
We surveyed adult neurology residency program directors (PDs) listed in the Accreditation Council for Graduate Medical Education directory using a Qualtrics-based survey platform. Survey questions addressed current utilization of SBME and barriers to SBME growth.
RESULTS
Seventy-five PDs of 171 contactable PDs responded to our survey (response rate 44%). Of the respondents, 84% (64/75) report using SBME in their adult neurology residencies. Of those using SBME, 87% (55/64) programs create their own cases. Most programs use simulation to teach neurocritical care topics (63%) and vascular neurology (78%); few use simulation to teach outpatient topics and teleneurology. Among programs that use SBME, there was variability in the frequency of the SBME interventions and in the target trainee cohort. Among responding programs, most expressed interest in expanding SBME in their curriculum (69%, 52/64), but frequently cited lack of faculty protected time (55%), funding (35%), and resident availability (32%) as barriers to doing so.
DISCUSSION
Most responding programs use SBME. However, the frequency and target learner for SBME interventions varied between programs. Many programs wish to expand SBME at their institutions but are constrained by limited protected time and institutional financial support. We discuss potential solutions to the perceived barriers to SBME, including intra-institutional collaboration to advance SBME use and case diversity for learners and help innovate neurology medical education.
背景与目的
先前的研究表明，基于模拟的医学教育（SBME）可提高神经科住院医师培训学员的信心、知识水平和能力。然而，需要对神经科目前使用的SBME进行全面的需求评估和审查，以指导SBME课程的开发。本研究的目的是描述SBME在住院医师培训中的当前使用情况，并评估扩大SBME干预措施所感知到的障碍。
方法
我们使用基于Qualtrics的调查平台，对医学研究生教育认证委员会名录中列出的成人神经科住院医师培训项目主任（PD）进行了调查。调查问题涉及SBME的当前使用情况以及SBME发展的障碍。
结果
171名可联系的PD中有75名回复了我们的调查（回复率44%）。在受访者中，84%（64/75）报告在其成人神经科住院医师培训项目中使用SBME。在使用SBME的项目中，87%（55/64）的项目创建自己的病例。大多数项目使用模拟教学神经重症监护主题（63%）和血管神经病学（78%）；很少有项目使用模拟教学门诊主题和远程神经病学。在使用SBME的项目中，SBME干预的频率和目标学员群体存在差异。在回复的项目中，大多数表示有兴趣在其课程中扩大SBME（69%，52/64），但经常提到缺乏教师保护时间（55%）、资金（35%）和住院医师可参与时间（32%）是这样做的障碍。
讨论
大多数回复的项目使用SBME。然而，SBME干预的频率和目标学习者在不同项目之间存在差异。许多项目希望在其机构中扩大SBME，但受到保护时间有限和机构财政支持的限制。我们讨论了针对SBME所感知到的障碍的潜在解决方案，包括机构内部合作以推进SBME的使用以及为学习者提供多样化的病例，并帮助创新神经科医学教育。
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