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探索针对四年级医学生的急性冠状动脉综合征模拟场景的效果

​​Exploring the Efficacy of an Acute Coronary Syndrome Simulation Scenario for Fourth-Year Medical Students​.

作者信息

Mansuri Heena, Cazzaniga Juliana, Fortun Jenny, Athauda Gagani, Toonkel Rebecca L

机构信息

Medical School, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.

Department of Cellular Biology and Pharmacology, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.

出版信息

Cureus. 2025 Jul 29;17(7):e88968. doi: 10.7759/cureus.88968. eCollection 2025 Jul.

Abstract

Acute coronary syndrome (ACS) is ​a critical medical condition characterized by a sudden reduction in blood flow to cardiac muscle. This condition encompasses unstable angina, non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI), requiring rapid diagnosis and intervention for optimal outcomes. Despite advances in treatment, ACS remains a leading cause of morbidity and mortality worldwide.​ Thus, it is essential to ensure that graduating medical students possess the requisite knowledge and confidence to effectively identify and manage patients with ACS as they transition to residency.​    ​Methods: To ensure the readiness of graduating medical students to recognize and initiate management of ACS, we developed and implemented a 45-minute simulation-based scenario during the CO 2023 transition to residency course at the Florida International University Herbert Wertheim College of Medicine (FIU-HWCOM).​ Knowledge gains were ​assessed​ through performance on voluntary pre- and post-session identical assessments consisting of seven multiple-choice questions. Pre- and post-session confidence and post-session satisfaction were assessed using voluntary 5-point Likert-style questions.    Results: All graduating FIU-HWCOM medical students (n=120) participated in the simulation. Students who completed both the pre- and post-session assessments (n=50, 41.7%) were included in the study. Mean knowledge performance improved from 3.74 (SD: 1.14) to 5.34 (SD: 1.19) (p=0.0001) post-session. Confidence in recognizing acute cardiac ischemia increased from 3.88 (SD: 0.66) to 4.42 (SD: 0.67), while confidence in initiating management of acute cardiac ischemia increased from 3.54 (SD: 0.76) to 4.32 (SD: 0.65) post-session (p=0.0001). Overall satisfaction was high, with 94% of participants finding the session a valuable use of their time and 90% agreeing that participation will positively affect the care of patients presenting with chest pain. ​ ​​Conclusion: ​Our findings suggest improvements in graduating medical students' knowledge and confidence in recognizing and managing ACS. The session was well received by students and is easily adaptable for integration into curricula at other medical schools.

摘要

急性冠状动脉综合征(ACS)是一种危急的病症,其特征是流向心肌的血流量突然减少。这种病症包括不稳定型心绞痛、非ST段抬高型心肌梗死(NSTEMI)和ST段抬高型心肌梗死(STEMI),需要快速诊断和干预以获得最佳治疗效果。尽管治疗方法有所进步,但ACS仍然是全球发病和死亡的主要原因。因此,至关重要的是要确保即将毕业的医学生在过渡到住院医师阶段时,具备有效识别和管理ACS患者所需的知识和信心。

方法

为确保即将毕业的医学生做好识别和启动ACS管理的准备,我们在佛罗里达国际大学赫伯特·韦特海姆医学院(FIU-HWCOM)2023年过渡到住院医师阶段的课程中,开发并实施了一个45分钟的基于模拟的情景。通过由七个多项选择题组成的自愿课前和课后相同评估的表现来评估知识收获。课前和课后的信心以及课后满意度使用自愿的5分李克特式问题进行评估。

结果

FIU-HWCOM所有即将毕业的医学生(n = 120)都参加了模拟。完成课前和课后评估的学生(n = 50,41.7%)被纳入研究。课后平均知识表现从3.74(标准差:1.14)提高到5.34(标准差:1.19)(p = 0.0001)。识别急性心肌缺血的信心从3.88(标准差:0.66)提高到4.42(标准差:0.67),而启动急性心肌缺血管理的信心从3.54(标准差:0.76)提高到4.32(标准差:0.65)(p = 0.0001)。总体满意度很高,94%的参与者认为该课程对他们的时间利用很有价值,90%的参与者同意参与将对胸痛患者的护理产生积极影响。

结论

我们的研究结果表明,即将毕业的医学生在识别和管理ACS方面的知识和信心有所提高。该课程受到学生的好评,并且很容易适用于融入其他医学院的课程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8cb/12392693/e39a9f55ab5a/cureus-0017-00000088968-i01.jpg

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