Simulation-based education with mastery learning improves paracentesis skills.
Simulation-based education with mastery learning improves paracentesis skills.
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DOI：
10.4300/jgme-d-11-00161.1
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发表时间：
2012-03-01
影响因子：
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通讯作者：
Wayne, Diane B
中科院分区：
文献类型：
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作者：
Barsuk, Jeffrey H;Cohen, Elaine R;Wayne, Diane B
背景：腹腔穿刺术是一种常见的床边手术，可能会导致严重的并发症。因此，基于模拟的穿刺教育对临床医生来说很有价值。 目的：评估内科住院医师在穿刺模拟器上进行基于模拟的掌握学习之前和之后的操作技能。 方法：一个具有模拟和操作技能专业知识的团队开发并创建了一个高保真、超声兼容的穿刺操作模拟器。五十八名一年级内科住院医师使用穿刺模拟器完成了基于学习的干预。居民使用包含 25 项的清单进行基线技能评估（预测试）。住院医师在 3 小时的教育课程后完成了后测试，其中包括程序演示、刻意练习、超声培训和反馈。所有住院医师都应在后测中达到或超过最低及格分数（MPS），这是掌握学习的关键特征。我们比较了前测和后测清单分数，以评估教育干预的效果。住院医师对培训课程进行评分。 结果：住院医师的穿刺技能从测试前平均得分 33.0% (SD = 15.2%) 提高到后测时的 92.7% (SD = 5.4%) (P < .001)。培训干预后，所有居民均达到或超过 MPS。学习者对培训课程和模拟的真实性给予了高度评价。结论：这项研究证明了腹腔穿刺模拟器能够显着提高手术能力。
BACKGROUND: Paracentesis is a commonly performed bedside procedure that has the potential for serious complications. Therefore, simulation-based education for paracentesis is valuable for clinicians.OBJECTIVE: To assess internal medicine residents' procedural skills before and after simulation-based mastery learning on a paracentesis simulator.METHODS: A team with expertise in simulation and procedural skills developed and created a high fidelity, ultrasound-compatible paracentesis simulator. Fifty-eight first-year internal medicine residents completed a mastery learning-based intervention using the paracentesis simulator. Residents underwent baseline skill assessment (pretest) using a 25-item checklist. Residents completed a posttest after a 3-hour education session featuring a demonstration of the procedure, deliberate practice, ultrasound training, and feedback. All residents were expected to meet or exceed a minimum passing score (MPS) at posttest, the key feature of mastery learning. We compared pretest and posttest checklist scores to evaluate the effect of the educational intervention. Residents rated the training sessions.RESULTS: Residents' paracentesis skills improved from an average pretest score of 33.0% (SD = 15.2%) to 92.7% (SD = 5.4%) at posttest (P < .001). After the training intervention, all residents met or exceeded the MPS. The training sessions and realism of the simulation were rated highly by learners.CONCLUSION: This study demonstrates the ability of a paracentesis simulator to significantly improve procedural competence.