At-home medical student simulation: achieving knot-tying proficiency using video-based assessment
At-home medical student simulation: achieving knot-tying proficiency using video-based assessment
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DOI：
10.1007/s44186-022-00007-2
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发表时间：
2022-02-21
期刊：
影响因子：
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通讯作者：
Scott DJ
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文献类型：
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作者：
Nagaraj MB;Campbell KK;Rege RV;Mihalic AP;Scott DJ
由于大流行，我们将医学生打结模拟重组为虚拟格式。本研究评估了课程的可行性和有效性。在 4 周多的时间里，二年级医学生 (n = 229) 观看了视频教程（任务演示、错误、评分），并使用家用缝合套件（简单间断缝合、器械扎带、彭罗斯引流模型）进行自我练习以熟练使用（无严重错误， < 2 分钟）。提供可选的虚拟辅导课程。学生提交视频表演以进行熟练程度验证。两名外科医生观看了两组，每组 14 个视频，直到建立评估者间可靠性 (IRR)。得分为“需要补救”的学生参加了虚拟补救课程。使用 RStudio 进行非参数统计。所有 229 名医学生在 1 至 4 小时内完成了课程； 1.3% 参加了可选教程。所有视频均经过评估：4.8%“超出预期”，60.7%“符合预期”，34.5%“需要修复”。所有 79 名因严重错误而需要纠正的人都在 1 小时的小组会议中达到了熟练程度。 IRR Cohen 的 κ 为 0.69（初始）和 1.0（最终）。任务完成时间为 56 (47–68) 秒（中位数 [IQR]）；所有对之间 p < 0.01。学生对整体课程（79.2%）和整体课程和视频教程有效性（92.7%）的评价为“同意”或“强烈同意”。对于虚拟形式还是面对面形式，没有出现明确的偏好；然而，80.2% 的人表示想要其他家庭技能课程。评论支持在家练习，因为压力较小；补救学生重视直接的形成性反馈。为期 1 个月的完全虚拟打结模拟对于大型学生班级使用基于视频的评估和按需补救策略的熟练程度是可行且有效的。
Due to the pandemic, we restructured our medical student knot-tying simulation to a virtual format. This study evaluated curriculum feasibility and effectiveness. Over 4 weeks, second-year medical students (n = 229) viewed a video tutorial (task demonstration, errors, scoring) and self-practiced to proficiency (no critical errors, < 2 min) using at-home suture kits (simple interrupted suture, instrument tie, penrose drain model). Optional virtual tutoring sessions were offered. Students submitted video performance for proficiency verification. Two sets of 14 videos were viewed by two surgeons until inter-rater reliability (IRR) was established. Students scoring “needs remediation” attended virtual remediation sessions. Non-parametric statistics were performed using RStudio. All 229 medical students completed the curriculum within 1–4 h; 1.3% attended an optional tutorial. All videos were assessed: 4.8% “exceeds expectations”, 60.7% “meets expectations”, and 34.5% “needs remediation.” All 79 needing remediation due to critical errors achieved proficiency during 1-h group sessions. IRR Cohen’s κ was 0.69 (initial) and 1.0 (ultimate). Task completion time was 56 (47–68) s (median [IQR]); p < 0.01 between all pairs. Students rated the overall curriculum (79.2%) and overall curriculum and video tutorial effectiveness (92.7%) as “agree” or “strongly agree”. No definitive preference emerged regarding virtual versus in-person formats; however, 80.2% affirmed wanting other at-home skills curricula. Comments supported home practice as lower stress; remediation students valued direct formative feedback. A completely virtual 1-month knot-tying simulation is feasible and effective in achieving proficiency using video-based assessment and as-needed remediation strategies for a large student class.