Patient Handover as a Learning Activity for Medical Students

M. L. Hoover, N. Posel, D. Fleiszer
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Abstract

The move of medical education in North America to a model based on teaching competencies rather than knowledge requires new methods of assessment. As part of a longer-term project to create objective and quantifiable measures for the learning of these competencies, we argue that the focus should be on the Entrustable Professional Activities (EPAs) that are associated with each competency. In this paper we present a theoretical constructivist analysis of one such EPA, that of patient handover, which is critical to patient safety. By applying an Activity Theory analysis to this EPA, we were able to identify, and thus quantify, key components of the EPA. Analysis of student performance on an online virtual patient simulation of a trauma case indicated that surgical clerkship students were able to correctly mention the majority of the procedures that expert surgeons indicated were most important, but only used less than a third of the professional terms that experts thought appropriate. This result points to a need to increase direct instruction in professional communication among medical learners, while demonstrating that Activity Theory provides an analysis that not only captures what is happening in the learning, but also can be used to develop objective and quantifiable assessment metrics.
作为医学生学习活动的患者交接
北美医学教育向基于教学能力而非知识的模式转变,需要新的评估方法。作为为学习这些能力制定客观和可量化措施的长期项目的一部分,我们认为重点应该放在与每种能力相关的可委托专业活动上。在本文中,我们对其中一个EPA,即对患者安全至关重要的患者交接,进行了理论建构主义分析。通过将活动理论分析应用于EPA,我们能够识别并量化EPA的关键组成部分。对学生在创伤病例的在线虚拟患者模拟中的表现的分析表明,外科书记员学生能够正确地提到专家外科医生认为最重要的大多数手术,但只使用了专家认为合适的不到三分之一的专业术语。这一结果表明,需要增加医学学习者在专业交流中的直接指导,同时证明活动理论提供了一种分析,不仅可以捕捉学习中发生的事情,还可以用于制定客观和可量化的评估指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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