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首页> 外文期刊>BMC Medical Education >Intraosseous access can be taught to medical students using the four-step approach
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Intraosseous access can be taught to medical students using the four-step approach

机译：可以使用四步法向骨科学生讲授骨内入路

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Background The intraosseous (IO) access is an alternative route for vascular access when peripheral intravascular catheterization cannot be obtained. In Denmark the IO access is reported as infrequently trained and used. The aim of this pilot study was to investigate if medical students can obtain competencies in IO access when taught by a modified Walker and Peyton’s four-step approach. Methods Nineteen students attended a human cadaver course in emergency procedures. A lecture was followed by a workshop. Fifteen students were presented with a case where IO access was indicated and their performance was evaluated by an objective structured clinical examination (OSCE) and rated using a weighted checklist. To evaluate the validity of the checklist, three raters rated performance and Cohen’s kappa was performed to assess inter-rater reliability (IRR). To examine the strength of the overall IRR, Randolph’s free-marginal multi rater kappa was used. Results A maximum score of 15 points was obtained by nine (60%) of the participants and two participants (13%) scored 13 points with all three raters. Only one participant failed more than one item on the checklist. The expert rater rated lower with a mean score of 14.2 versus the non-expert raters with mean 14.6 and 14.3. The overall IRR calculated with Randolph’s free-marginal multi rater kappa was 0.71. Conclusion The essentials of the IO access procedure can be taught to medical students using a modified version of the Walker and Peyton’s four-step approach and the checklist used was found reliable.
机译：背景技术当无法获得周围血管内导管插入术时，骨内（IO）通路是用于血管通路的另一种途径。在丹麦，IO访问被报告为不经常接受培训和使用。这项初步研究的目的是研究医学学生在采用改进的Walker和Peyton的四步法教学后是否可以获得IO访问方面的能力。方法19名学生参加了紧急程序中的人类尸体课程。讲座之后举行了研讨会。向15名学生介绍了表示有IO接入的情况，并通过客观结构化临床检查（OSCE）评估了他们的表现，并使用加权清单对他们进行了评估。为了评估清单的有效性，三名评分员对绩效进行了评分，并通过Cohen的kappa评估了评分员之间的可靠性（IRR）。为了检查总体IRR的强度，使用了Randolph的自由边际多评分者kappa。结果九名参与者（60％）获得最高分15分，而三名评分者中两名参与者（13％）得分为13分。只有一名参与者未通过检查表中的一项以上。专家评级者的平均得分为14.2，而非专家评级者的平均得分为14.6和14.3。根据兰道夫的免费边际多评分者kappa计算得出的总IRR为0.71。结论可以使用Walker和Peyton的四步法的改进版本向医学生教授IO访问程序的基本知识，并且所使用的清单可靠。

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