外科培训中的全任务模拟:医科本科生混合教学法

Caren D’Souza, Supriya Pinto
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摘要

背景:印度目前实施的能力本位医学教育(CBME)课程强调,医学毕业生必须在社区和二级护理环境中展示安全诊断、调查和管理临床表现的能力。因此,需要更多模拟真实情况的混合教学方法。这种方法将帮助新获得资格的医生增强信心,为未来做好准备。我们采用整体任务模拟法,向他们传授最常见的外科问题之一,即乳腺癌,以及沟通技巧、职业精神、跨专业团队合作、无菌操作和安全手术操作。研究方法研究通过有目的的抽样调查,招收了 20 名医学学士学位毕业班学生。在乳腺病例的课堂教学后,根据 SECO(安全有效的临床结果)的设计,提供了一个模拟场景,并增加了模拟手术室的设置。使用标准化病人和人体模型进行病史采集、检查、开检查单和解释、术前咨询和同意以及手术室情景模拟。进行了模拟前和模拟后调查。通过谷歌表格收集定量数据以评估他们的概念性知识,并通过焦点小组讨论收集定性数据。结果:与传统的课堂教学相比,学生们更喜欢在模拟环境中转变这种混合学习方法。他们都认为,参与到真实环境中有助于更好地理解外科手术管理。他们还理解了团队合作和有效沟通的概念。"我觉得这是学习临床医学的最佳方式。再多的文献资料也无法取代我们从情景中获得的知识",这是学员们的回答之一。结论将外科模拟诊所和手术室(OR)设置纳入本科课程,可促进学生积极主动地学习临床技能。这种混合教学方法是传授沟通技巧、专业精神、跨专业团队合作以及临床技能的有效工具。
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Whole task simulation in surgical training: A hybrid method of teaching undergraduate medical students
Background: The current Competency-Based Medical Education (CBME) curriculum practiced in India accentuates that medical graduates must demonstrate competency in safely diagnosing, investigating, and managing clinical presentations across both community and secondary care settings. Therefore, there is a need for more hybrid teaching methods that simulate real situations. This approach will help newly qualified doctors gain confidence and prepare them for the future. We used the whole task simulation method to teach them one of the most common surgical problems i.e., breast cancer along with communication skills, professionalism, Interprofessional teamwork, asepsis, and safe surgery practices. Methods: The study enrolled 20 final-year MBBS students through purposeful sampling. Following classroom-based teaching on a Breast case, a simulated scenario was given, based on SECO (The Safe and Effective Clinical Outcome) design, and was modified with the addition of a simulated operating room setup. History taking, examination, ordering investigations and interpreting them, pre-operative counseling and consent and operation theatre scenario was done using standardized patient and mannequins. Pre- and post-simulation survey was conducted. Quantitative data were collected through Google Forms to assess their conceptual knowledge and qualitative data by Focused group discussions. Results: Students preferred a shift to this hybrid method of learning in a simulated environment over classical classroom-based teaching. They all felt that getting involved in a real-life situation helps in understanding surgical management better. They also understood the concept of teamwork and effective communication. "I feel it’s the best way to learn clinical medicine. No amount of literature could ever replace the knowledge we get from being in the scenario", was one of the responses given by the participants. Conclusion: Integration of surgical simulated clinics along with the operation room (OR) set up into the undergraduate curriculum could facilitate the acquisition of clinical skills actively and interactively. Such a hybrid method of teaching is an effective tool for teaching communication skills, professionalism, interprofessional teamwork along clinical skills.
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