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首页> 外文期刊>Journal of athletic training >A Learner-Centered Technique and Clinical Reasoning, Reflection, and Case Presentation Attributes in Athletic Training Students
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A Learner-Centered Technique and Clinical Reasoning, Reflection, and Case Presentation Attributes in Athletic Training Students

机译：以运动者为中心的以学习者为中心的技术以及临床推理，反思和案例演示属性

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Context: Providing opportunities to develop clinical decision-making skills, including clinical reasoning, is an important aspect of clinical education. The learner-centered technique of summarizing the history and findings, narrowing the differential, analyzing the differential, probing the instructor about uncertainties, plan management, and selecting an issue for self-directed study (SNAPPS) is used in medicine to express clinical reasoning. Objective: To investigate the effects of SNAPPS on the clinical reasoning, reflection, and 4 case presentation attributes (length, conciseness, case summary, and expression of clinical reasoning) in athletic training students. Design: Randomized controlled clinical trial. Setting: Three undergraduate programs accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants: We randomly assigned 38 athletic training students (17 men, 21 women; age = 21.53 ± 1.18 years, grade point average = 3.25 ± 0.31) who had completed at least 1 year of clinical education and all orthopaedic evaluation coursework to the SNAPPS group or the usual and customary group using a stratification scheme. Intervention(s): The SNAPPS group completed four 45-minute clinical reasoning and case presentation learning modules led by an investigator to learn the SNAPPS technique, whereas the usual and customary group received no formal instruction. Both groups audio recorded all injury evaluations performed over a 2-week period. Main Outcome Measures: Participants completed the Diagnostic Thinking Inventory and Reflection in Learning Scale twice. Case presentations were analyzed for 4 attributes: length, conciseness, case summary, and expression of clinical reasoning. Results: Case presentations were longer (t18.806 = ?5.862, P < .001) but were more concise (t32 = 11.297, P < .001) for the SNAPPS group than for the usual and customary group. The SNAPPS group performed better on both the case summary subscale (t32 = 2.857, P = .007) and the clinical reasoning subscale (t25.773 = ?14.162, P < .001) than the other group. We found a time effect for Diagnostic Thinking Inventory scores (F1,34 = 6.230, P = .02) but observed no group effects (F1,34 = 0.698, P = .41) or time-by-group interaction (F1,34 = 1.050, P = .31). The Reflection in Learning Scale scores analysis revealed no group-by-time interaction (F1,34 = 1.470, P = .23) and no group (F1,34 = 3.751, P = .06) or time (F1,34 = 0.835, P = .37) effects. Conclusions: The SNAPPS is an effective and feasible clinical education technique for case presentations. This learner-centered technique provides the opportunity for the expression of clinical reasoning skills.
机译：背景：提供发展临床决策技能（包括临床推理）的机会是临床教育的重要方面。在医学中使用以学习者为中心的技术来总结历史和发现，缩小差异，分析差异，探究指导老师的不确定性，计划管理以及选择自我指导的问题（SNAPPS）来表达临床推理。目的：研究SNAPPS对运动训练学生的临床推理，反思和4种病例表现属性（长度，简洁性，病例摘要和临床推理表达）的影响。设计：随机对照临床试验。地点：经运动训练教育认证委员会认可的三个本科课程。患者或其他参与者：我们随机分配了38名运动训练学生（17名男性，21名女性;年龄= 21.53±1.18岁，平均成绩= 3.25±0.31），他们完成了至少一年的临床教育并完成了所有骨科评估课程SNAPPS小组或通常的习惯小组使用分层方案。干预措施：SNAPPS组完成了四个由研究人员主持的45分钟临床推理和案例演示学习模块，以学习SNAPPS技术，而通常和惯常组未接受正式指导。两组音频都记录了为期2周的所有伤害评估。主要指标：参与者完成了《诊断思维量表和学习量表的反思》。案例分析分析了4个属性：篇幅，简洁，案例摘要和临床推理表达。结果：与常规组相比，SNAPPS组的病例报道时间更长（t18.806 =？5.862，P <.001），但更简洁（t32 = 11.297，P <.001）。 SNAPPS组在病例总结子量表（t32 = 2.857，P = .007）和临床推理子量表（t25.773 =？14.162，P <.001）上均优于另一组。我们发现诊断思维量表得分具有时间效应（F1,34 = 6.230，P = .02），但没有观察到群体效应（F1,34 = 0.698，P = .41）或组间互动（F1,34 = 1.050，P = 0.31）。学习量表反射评分分析显示没有按时间分组的互动（F1,34 = 1.470，P = .23），也没有分组（F1,34 = 3.751，P = .06）或时间（F1,34 = 0.835） ，P = .37）效果。结论：SNAPPS是一种有效且可行的病例介绍临床教育技术。这种以学习者为中心的技术为表达临床推理技能提供了机会。

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