教育研究:初级神经内科住院医师在短暂的急性缺血性脑卒中模拟课程后达到了能力而不是精通

Catherine Albin, Melissa B. Pergakis, E. Sigman, N. Bhatt, Spencer K. Hutto, Sitara Koneru, Ehizele M Osehobo, J. A. Vizcarra, Nicholas A. Morris
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引用次数: 1

摘要

模拟训练营是用来训练神经学学员的。目前尚不清楚这些训练营是否会导致急性缺血性中风(AIS)的能力。在这项前瞻性、单中心的教育前后干预研究中,采用Angoff标准设定法确定2个AIS模拟的最低及格分数(MPS)和精通分数。初级神经内科住院医师完成课前知识和信心评估,并接受传统的说教式教学。一周后,每位居民完成了第一次评分的AIS模拟。然后,每位住院医生在不记分的模拟中练习中风护理。2至8周后,每位患者在未通知的AIS模拟(后测)中进行评估。研究生学年(PGY)-3的成年神经病学老年住院医师还完成了知识和信心评估,并仅在AIS后测试案例中得分。我们分别使用独立测试和配对测试,比较初级住院医师的记忆保留测试表现与他们的基线评估和老年住院医师的表现。13名初级住院医师(9名PGY-2成人神经内科住院医师和4名PGY-3儿童神经内科住院医师)参加了该课程。在第一次AIS模拟中,只有3名初级住院医师(23%)最初达到了MPS。模拟课程结束后,9名初级住院医师(69%)达到MPS阈值。虽然没有人达到精通,但初级住院医师在模拟中的平均表现得分有所提高(干预前平均分[SD] = 10.3 [2.8] vs干预后平均分[SD] = 15.7 [2.6],p< 0.001),他们的信心有所增加(干预前平均分[SD] = 3.3 [1.9] vs干预后平均分[SD] = 4.9 [1.2],p< 0.001,d= 1.7)。对8名PGY-3成年神经病住院医师进行AIS后测评分。5人达到MPS(63%), 1人表现出精通。课程结束后,大三学生和大四学生的模拟得分相似(大三学生平均得分[SD] = 15.7[2.6],大四学生平均得分[SD] = 16.0 [2.5],p= 0.793)。一个简短的AIS模拟课程可以将初级住院医师的表现和信心提高到与老年住院医师相当的水平,尽管不能达到精通的程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Education Research: Junior Neurology Residents Achieve Competency but Not Mastery After a Brief Acute Ischemic Stroke Simulation Course
Simulation bootcamps are used to onboard neurology trainees. It is not known whether these bootcamps result in competency for acute ischemic stroke (AIS).For this prospective, single-center pre-post educational intervention study, the Angoff standard setting method was used to determine a Minimum Passing Score (MPS) and Mastery Score for 2 AIS simulations. Junior neurology residents completed precourse knowledge and confidence assessments and had traditional didactic teaching. A week later, each resident completed the first scored AIS simulation. Each resident then practiced stroke care in an unscored simulation. Two to 8 weeks later, each resident was evaluated in an unannounced AIS simulation (the post-test). Postgraduate year (PGY)-3 adult neurology senior residents also completed a knowledge and confidence assessment and were scored on just the AIS post-test case. Using independent and pairedttests, respectively, we compared the junior residents' retention test performance to their baseline assessment and to senior residents' performance.Thirteen junior residents (9 PGY-2 adult neurology residents and 4 PGY-3 child neurology residents) participated in the course. Only 3 junior residents (23%) initially achieved the MPS in the first AIS simulation. After the simulation course, 9 junior residents (69%) achieved the MPS threshold. Although none achieved mastery, junior residents' mean performance score in the simulation improved (mean score preintervention [SD] = 10.3 [2.8] vs mean score postintervention [SD] = 15.7 [2.6],p< 0.001) and their confidence increased (mean score preintervention [SD] = 3.3 [1.9] vs mean score postintervention [SD] = 4.9 [1.2],p< 0.001,d= 1.7). Eight PGY-3 adult neurology residents were scored on the AIS post-test. Five reached MPS (63%), and 1 demonstrated mastery. The simulation scores of the postcourse juniors and seniors were similar (junior resident mean score [SD] = 15.7 [2.6] vs senior resident mean score [SD] = 16.0 [2.5],p= 0.793).A brief AIS simulation course may improve junior residents' performance and confidence to a level comparable with senior residents, although not to mastery.
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