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A blended approach to invasive bedside procedural instruction.

机译:侵入性床边程序教学的混合方法。

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OBJECTIVE: This study assessed the impact of a blended, standardized curriculum for invasive bedside procedural training on medical knowledge and technical skills for Internal Medicine residents. METHODS: The investigators developed a curriculum in procedural instruction and performance for Internal Medicine house staff, and implemented the program at a tertiary care academic medical center with a primary affiliation with a US medical school. The investigators chose procedures recommended for technical competence by the American Board of Internal Medicine: lumbar puncture, thoracentesis, paracentesis, central venous catheter insertion, and knee arthrocentesis. The program included: (1) assessment of baseline medical knowledge and technical proficiency on mannequins, (2) video instruction of procedure, (3) faculty-led discussion of critical concepts, (4) faculty demonstration of the procedure on mannequin, (5) individual practice on simulators, (6) post-intervention knowledge evaluation, and (7) post-intervention skills evaluation. The performance achieved during the initial skills evaluation on a mannequin was compared to the performance achieved on the first patient subsequent to the instructional portion. RESULTS: All participants with complete data demonstrated a statistically significant pre-intervention to post-intervention improvement (p < 0.05) in comprehensive medical knowledge and procedural skills. CONCLUSION: A blended, standardized curriculum in invasive bedside procedural instruction can significantly improve performance in participants' medical knowledge and technical skills.
机译:目的:本研究评估了混合,标准化的有创床边程序培训课程对内科住院医师医学知识和技术技能的影响。方法:研究人员为内科医师制定了程序指导和绩效课程,并在与美国医学院有主要隶属关系的三级医疗学术医学中心实施了该程序。研究人员选择了美国内部医学委员会推荐的技术能力程序:腰穿,胸腔穿刺术,穿刺术,中心静脉导管插入术和膝关节穿刺术。该计划包括:(1)评估人体模型的基础医学知识和技术水平;(2)程序的视频指导;(3)由教师主导的关键概念讨论;(4)教师示范人体模型的过程;(5 )在模拟器上的个人练习,(6)干预后知识评估,以及(7)干预后技能评估。将在人体模型的初始技能评估过程中获得的性能与教学部分之后第一位患者获得的性能进行比较。结果:所有具有完整数据的参与者在综合医学知识和程序技能方面均显示出干预前对干预后改善的统计学显着性(p <0.05)。结论:混合式,标准化的有创床旁程序教学课程可以显着提高参与者医疗知识和技术技能的表现。

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