Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial
Evaluation of App-Based Serious Gaming as a Training Method in Teaching Chest Tube Insertion to Medical Students: Randomized Controlled Trial
复制标题
DOI：
10.2196/jmir.9956
复制
发表时间：
2018-05-01
影响因子：
7.4
通讯作者：
Tanner, Michael C.
中科院分区：
文献类型：
--
作者：
Haubruck, Patrick;Nickel, Felix;Tanner, Michael C.
背景：胸管的插入应尽可能快速和准确，以最大限度地提高患者的获益和减少可能的并发症。因此，在紧急情况前进行全面的培训和评估对于熟练掌握胸管插入是至关重要的。严肃游戏在外科训练中变得越来越普遍，因为它们使学生能够独立学习和训练手术，并且错误对患者没有影响。然而，关于严肃游戏对急诊医学过程中表现的影响的最新证据仍然很少。目的：探讨应用Touch Surgery应用程序在医学生急诊手术（胸管插入）教学中的严肃游戏方法和改进的客观结构技术技能评估（OSATS）。方法：采用前瞻性、非盲法、随机对照试验，将医学生随机分为干预组和对照组。Touch Surgery是一款创新且免费的移动设备应用。全自动软件使用户能够训练医疗程序，然后自我评估他们的训练效果。模块胸管插入教导在插入胸管的每个关键步骤，并使用户能够细致的应用胸管。相比之下，“胸刺针”模块讨论了基本的胸刺针。所有学生都参加了关于胸管插入的讲座（常规课程），之后进行了Touch Surgery训练课：干预组采用模块式胸管插入，对照组采用胸穿刺作为对照训练。参与者在猪模型上的胸管插入表现通过盲法面对面评分和使用改进的OSATS工具的视频记录进行现场评分。之后，每位参与者都收到了一份自我评价问卷。在这里，受训者提供了他们的个人培训水平、以前的经历、性别和爱好等信息。主要终点是直接观察胸管插入期间的手术表现。结果：共纳入183名学生，116名学生参与（63.4%），21名学生因既往有胸管插入经验而被排除。将学生随机分为干预组（49/ 95,52 %）和对照组（46/ 95,48 %）。干预组明显优于对照组(干预组：38.0 [I-50=7.0]分；对照组：30.5 [I-50=8.0]分
Background: The insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce.Objective: The aim of this study was to investigate the serious gaming approach in teaching medical students an emergency procedure (chest tube insertion) using the app Touch Surgery and a modified objective structural assessment of technical skills (OSATS).Methods: In a prospective, rater-blinded, randomized controlled trial, medical students were randomized into two groups: intervention group or control group. Touch Surgery has been established as an innovative and cost-free app for mobile devices. The fully automatic software enables users to train medical procedures and afterwards self-assess their training effort. The module chest tube insertion teaches each key step in the insertion of a chest tube and enables users the meticulous application of a chest tube. In contrast, the module "Thoracocentesis" discusses a basic thoracocentesis. All students attended a lecture regarding chest tube insertion (regular curriculum) and afterwards received a Touch Surgery training lesson: intervention group used the module chest tube insertion and the control group used Thoracocentesis as control training. Participants' performance in chest tube insertion on a porcine model was rated on-site via blinded face-to-face rating and via video recordings using a modified OSATS tool. Afterwards, every participant received an individual questionnaire for self-evaluation. Here, trainees gave information about their individual training level, as well as previous experiences, gender, and hobbies. Primary end point was operative performance during chest tube insertion by direct observance.Results: A total of 183 students enrolled, 116 students participated (63.4%), and 21 were excluded because of previous experiences in chest tube insertion. Students were randomized to the intervention group (49/95, 52%) and control group (46/95, 48%). The intervention group performed significantly better than the control group (Intervention group: 38.0 [I-50=7.0] points; control group: 30.5 [I-50=8.0] points; P