A randomised controlled trial of extended immersion in multi-method continuing simulation to prepare senior medical students for practice as junior doctors.
A randomised controlled trial of extended immersion in multi-method continuing simulation to prepare senior medical students for practice as junior doctors.
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DOI：
10.1186/1472-6920-14-90
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发表时间：
2014-05-02
影响因子：
3.6
通讯作者：
Lombard M
中科院分区：
文献类型：
--
作者：
Rogers GD;McConnell HW;de Rooy NJ;Ellem F;Lombard M
世界各地许多刚开始工作的初级医生都觉得自己没有做好准备来应对新的职责，尤其是开处方。模拟已广泛应用于医学教育，但使用扩展多方法模拟来模拟初级医生经验的报道很少。一项随机对照试验比较了经历两次为期一周的延长模拟的学生，间隔几个月（干预），与单独参加相关研讨会和研讨会的学生（对照），进行了一系列结果测量。研究生入学医学课程的84名三年级学生被随机分配，82名完成了研究。在第一周结束时，干预组学生在处方测试中的平均得分为75%，而对照组学生为70%（P = 0.02），干预组在复苏测试中平均开始心脏按压29.1秒，而对照组为70.1秒（P < 0.01）。在第二周开始时，平均9个月后，与仅处方试验相关的显著差异保持（78% vs 70%，P < 0.01）。在第二周结束时，在知识和推理测试、进一步处方测试（71% vs 63% [P < 0.01]）和儿科复苏情景测试（252秒开始液体复苏vs 339秒[P = 0.05]）中观察到干预组与对照组的显著差异。该研究表明，通过扩展的多方法模拟，从情境化学习活动中长期保留了改进的处方技能，并对知识获取，推理和复苏技能产生了直接影响。
Many commencing junior doctors worldwide feel ill-prepared to deal with their new responsibilities, particularly prescribing. Simulation has been widely utilised in medical education, but the use of extended multi-method simulation to emulate the junior doctor experience has rarely been reported. A randomised controlled trial compared students who underwent two, week-long, extended simulations, several months apart (Intervention), with students who attended related workshops and seminars alone (Control), for a range of outcome measures. Eighty-four third year students in a graduate-entry medical program were randomised, and 82 completed the study. At the end of the first week, Intervention students scored a mean of 75% on a prescribing test, compared with 70% for Control students (P = 0.02) and Intervention teams initiated cardiac compressions a mean of 29.1 seconds into a resuscitation test scenario, compared with 70.1 seconds for Control teams (P < 0.01). At the beginning of the second week, an average of nine months later, a significant difference was maintained in relation to the prescribing test only (78% vs 70%, P < 0.01). At the end of the second week, significant Intervention vs Control differences were seen on knowledge and reasoning tests, a further prescribing test (71% vs 63% [P < 0.01]) and a paediatric resuscitation scenario test (252 seconds to initiation of fluid resuscitation vs 339 seconds [P = 0.05]). The study demonstrated long-term retention of improved prescribing skills, and an immediate effect on knowledge acquisition, reasoning and resuscitation skills, from contextualising learning activities through extended multi-method simulation.
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DOI：
10.4103/0974-2700.70758
发表时间：
2010-10-01
期刊：
Journal of emergencies, trauma, and shock
影响因子：
--
作者：
Sahu, Sandeep;Lata, Indu
通讯作者：
Lata, Indu
影响因子：
6
作者：
Blum, RH;Raemer, DB;Cooper, JB
通讯作者：
Cooper, JB
DOI：
10.1097/sih.0b013e3181cd0679
发表时间：
2010-06-01
期刊：
SIMULATION IN HEALTHCARE
影响因子：
--
作者：
Laack, Torrey A.;Newman, James S.;Torsher, Laurence C.
通讯作者：
Torsher, Laurence C.
影响因子：
3.2
作者：
Levett-Jones, Tracy;Lapkin, Samuel;Roche, Jan
通讯作者：
Roche, Jan
影响因子：
3.6
作者：
Ochsmann, Elke B.;Zier, Ulrike;Schmid, Klaus
通讯作者：
Schmid, Klaus