Board 428 - Research Abstract Development of an Integrated Surgical Skills Course
Notice bibliographique
Résumé
Introduction/Background Hybrid simulation, combining simulated/standardized patients (SPs) and technical skill training kits (e.g. suture pads attached to the arm) can lead to immediate improvements in surgical residents communication skills while preserving technical proficiency.1 Our goals were: 1) to assess whether learning on hybrid simulations is sustained on a delayed-post intervention retention test; 2) to evaluate the added role of feedback vs simple exposure in leading to improvements and 3) to assess the level of acceptance for SP-based hybrid simulations in a highly technical domain. Methods The study design was a prospective randomized control study, with a delayed post-test to assess retention. Twenty four residents were randomly divided into the Feedback or Exposure groups. All residents were exposed to four, 15-minute SP-based hybrid simulations over five weeks during their regularly scheduled weekly procedural skill laboratory (one hybrid simulation per week), combining a procedural and communication challenge (e.g. wound closure on intoxicated patient). Residents in the Feedback group remained for a further 15- minute, video-prompted feedback session with the SP, focused on their communication and interpersonal skills. Similar feedback was given to each participant in the Exposure group but not until after the post-test assessment was completed. All residents were assessed on a pre-test using two hybrid scenarios and on a delayed post-test using two (new) hybrid scenarios. The post-test occurred two weeks after the last teaching simulation. The residents also completed an exit survey about their experience of the hybrid simulations.` Results Performance was assessed by two independent raters using a communication global rating scale (GRS), a technical skills global rating scale and a combined assessment of technical and communication skills. Raters were blinded to the study hypotheses and group allocation. There were no differences between the two groups at baseline. At post-test, residents in the Feedback group outperformed the Exposure group on the communication GRS (p<.05) and the combined assessment (p<.05). There was a trend toward higher scores on the technical skills GRS, but this difference did not reach significance (p=.16). Analysis of the exit survey revealed that while a subset of the residents reported feeling ill-prepared (37.5%), confused (8%) and frustrated (12.5%) by the simulations, a large subset reported the exposure as enjoyable (70.8%) and valuable (87.5%). Ninety six percent of the residents had previously experienced similar communication challenges in their residency training. Conclusion Improvements in communication skills following SP-based hybrid simulations are maintained at delayed post-test for retention and appear to depend on feedback received from SPs. References 1. Moulton CA, Tabak D, Kneebone R, Nestel D, MacRae H, LeBlanc VR. (2009). Teaching. Communication Skills Using the Integrated Procedural Performance Instrument (IPPI): A Randomized Controlled Trial. American Journal of Surgery, 197, 113-118. D Tabak3, C Moulton1, A Robb3, H MacRae1, D Nestel5, R Kneebone4, V LeBlanc1 1Wilson Centre, Faculty of Medicine, University of Toronto, Ontario, Canada. 2Department of Surgery, University of Toronto, Ontario, Canada. 3Standardized Patient Program, University of Toronto, Ontario, Canada. 4Department of Biosurgery & Surgical Technology, Imperial College London, London UK. 5School of Rural Health, HealthPEER, Monash University, Churchill, Australia. Disclosures None.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,093 | 0,017 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».