How does video case-based learning influence clinical decision-making by midwifery students? An exploratory study
How does video case-based learning influence clinical decision-making by midwifery students? An exploratory study
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DOI：
10.1186/s12909-020-1969-0
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发表时间：
2020-03-06
影响因子：
3.6
通讯作者：
Suzuki, Yasuyuki
中科院分区：
文献类型：
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作者：
Nunohara, Kana;Imafuku, Rintaro;Suzuki, Yasuyuki
临床决策技能对于提供高质量的患者护理至关重要。为了提高这些技能，世界上许多机构使用基于案例的学习（CBL）作为临床前培训的教育策略。然而，迄今为止，不同的学习方式对学生临床决策过程的影响尚未得到充分的探讨。本研究旨在探讨视频和纸质案例模式对助产学学生临床决策过程的影响。方法对45名助产学学生进行正常孕妇的CBL调查。他们被分成12组；6组采用视频方式，6组采用纸质方式。小组讨论录像，并在CBL后进行焦点小组讨论。根据小组讨论的互动模式分析小组讨论记录，并根据临床决策的三阶段模型（提示获取、解释和评估/决策）对焦点小组进行主题分析。结果视频组的学生更重视心理社会方面而不是生物医学方面，并讨论了为妇女及其家庭成员量身定制的护理。她们没有做阴道检查和胎儿心脏电监护。相反，论文组的学生更关注生物医学而不是社会心理方面，并讨论何时进行阴道检查和胎儿心脏电监护。结论本研究明确了视频和纸质案例模式对学习者临床决策过程的不同影响。视频案例学习鼓励助产士学生对分娩和分娩护理有一个以妇女和家庭为中心的整体观点，这导致了对社会心理方面的仔细考虑。纸质案例学习鼓励助产学学生从以医疗保健提供者为中心的生物医学角度看待分娩和分娩护理，从而进行彻底的生物医学评估。
Background Clinical decision-making skills are essential for providing high-quality patient care. To enhance these skills, many institutions worldwide use case-based learning (CBL) as an educational strategy of pre-clinical training. However, to date, the influence of different learning modalities on students' clinical decision-making processes has not been fully explored. This study aims to explore the influence of video and paper case modalities on the clinical decision-making process of midwifery students during CBL. Methods CBL involving a normal pregnant woman was provided for 45 midwifery students. They were divided into 12 groups; six groups received the video modality, and six groups received the paper modality. Group discussions were video-recorded, and focus groups were conducted after the CBL. Transcripts of the group discussions were analysed in terms of their interaction patterns, and focus groups were thematically analysed based on the three-stage model of clinical decision-making, which includes cue acquisition, interpretation, and evaluation/decision-making. Results The students in the video groups paid more attention to psychosocial than biomedical aspects and discussed tailored care for the woman and her family members. They refrained from vaginal examinations and electric fetal heart monitoring. Conversely, the students in the paper groups paid more attention to biomedical than psychosocial aspects and discussed when to perform vaginal examinations and electric fetal heart monitoring. Conclusion This study clarified that video and paper case modalities have different influences on learners' clinical decision-making processes. Video case learning encourages midwifery students to have a woman- and family-centred holistic perspective of labour and birth care, which leads to careful consideration of the psychosocial aspects. Paper case learning encourages midwifery students to have a healthcare provider-centred biomedical perspective of labour and childbirth care, which leads to thorough biomedical assessment.