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急诊医学中针对高难度低发生率程序及临床诊疗场景的医生和医学实习生的医学教育中的远程模拟:系统评价方案

Telesimulation in Medical Education for High-Acuity Low-Occurrence Procedures and Clinical Encounters for Physicians and Medical Trainees in Emergency Medicine: Protocol for a Systematic Review.

作者信息

Thornhill Kurtis W, Jewer Jennifer, Jacques Queen, Parsons Michael H

机构信息

Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada.

Faculty of Business, Memorial University of Newfoundland, St. John's, NL, Canada.

出版信息

JMIR Res Protoc. 2025 May 9;14:e53565. doi: 10.2196/53565.

Abstract

BACKGROUND

Proficiency in high-acuity low-occurrence (HALO) procedures and clinical encounters is crucial for physicians and medical trainees in emergency medicine. Simulation-based medical education (SBME) provides valuable learning opportunities for these skills. However, accessing SBME can be challenging. Remotely delivered SBME, known as telesimulation, can enhance access to such training, especially in remote locations.

OBJECTIVE

Based on this review, the research team aims to evaluate the effectiveness of telesimulation in enhancing learning outcomes of HALO procedures and clinical encounters in emergency medicine.

METHODS

A systematic review will be conducted using the electronic databases PubMed, CINAHL, Embase, and Cochrane, focusing on studies published in English from 2011 to the present. The inclusion criteria are emergency physicians and medical trainees as learners; telesimulation sessions where the adequate performance of the procedure or clinical encounter, retention of information, or user feedback after implementing telesimulation were assessed; and original research in the form of a randomized controlled trial or nonrandomized experiments with an intervention and control group and pre- and posttest design. The exclusion criterion is defined as any study that does not fully meet the inclusion criteria. The primary outcome is the effectiveness of telesimulation in enhancing learning outcomes for HALO procedures and clinical encounters for physicians and medical trainees in emergency medicine. The secondary outcomes are the effectiveness of telesimulation for these procedures and clinical encounters delivered asynchronously and synchronously for physicians and medical trainees in emergency medicine. At least two reviewers will conduct data extraction and quality assessment. The primary and secondary outcomes will be analyzed through a systematic narrative synthesis. The methodological quality of comparative studies will be assessed using the Downs and Black checklist. The interrater reliability among the authors will be analyzed with Cohen κ.

RESULTS

This project was funded in the summers of 2022 and 2023 by two Summer Undergraduate Research Awards from the Memorial University of Newfoundland Faculty of Medicine. The literature search and screening will begin in April 2025, and the results of the systematic review will be available in the summer of 2026.

CONCLUSIONS

The results of the systematic review could inform the development of research on telesimulation for HALO procedures in emergency medicine. By investigating this topic, more effective telesimulation sessions can be designed in the future, potentially enhancing the skills of physicians and medical trainees.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/53565.

摘要

背景

对于急诊医学领域的医生和医学实习生而言,熟练掌握高难度低发生率(HALO)操作及临床诊疗至关重要。基于模拟的医学教育(SBME)为这些技能提供了宝贵的学习机会。然而,获取SBME可能具有挑战性。远程提供的SBME,即远程模拟,可以增加获得此类培训的机会,尤其是在偏远地区。

目的

基于本综述,研究团队旨在评估远程模拟在提高急诊医学中HALO操作及临床诊疗学习效果方面的有效性。

方法

将使用电子数据库PubMed、CINAHL、Embase和Cochrane进行系统综述,重点关注2011年至今以英文发表的研究。纳入标准为:学习者为急诊医生和医学实习生;对实施远程模拟后程序或临床诊疗的充分表现、信息保留情况或用户反馈进行评估的远程模拟课程;以及采用随机对照试验或有干预组和对照组且有前后测设计的非随机实验形式的原始研究。排除标准定义为任何不完全符合纳入标准的研究。主要结果是远程模拟在提高急诊医学医生和医学实习生HALO操作及临床诊疗学习效果方面的有效性。次要结果是远程模拟对急诊医学医生和医学实习生异步和同步提供的这些操作及临床诊疗的有效性。至少两名评审员将进行数据提取和质量评估。主要和次要结果将通过系统的叙述性综合分析进行分析。比较研究的方法学质量将使用唐斯和布莱克清单进行评估。作者之间评分者间信度将用科恩κ系数进行分析。

结果

该项目在2022年和2023年夏季获得了纽芬兰纪念大学医学院两项暑期本科研究奖的资助。文献检索和筛选将于2025年4月开始,系统综述结果将于2026年夏季公布。

结论

系统综述的结果可为急诊医学中HALO操作远程模拟研究的开展提供参考。通过对该主题的研究,未来可以设计出更有效的远程模拟课程,有可能提高医生和医学实习生的技能。

国际注册报告识别码(IRRID):PRR1-10.2196/53565

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