| Summary: | 碩士 === 國立臺灣大學 === 醫學教育暨生醫倫理研究所 === 104 === Background and Aim
Simulation is popular in advanced clinical training and considered to reduce errors made during learning. Medical beginners feel more unfamiliar in assessing and managing the pediatric patients. This study aims to explore the feasibility of using high-fidelity patient simulator in the teaching of medical clerks , and whether this new course helps them to learn the initial assessment and management for the sick children.
Material and Method
A total of 141 fifth-year medical students rotated pediatric clerkship in National Taiwan University Hospital from Sep.2014 to Aug.2015 were enrolled. Students were separated into two groups. Students in the conventional group S(-) received video and teaching aid-assisted teaching of pediatric initial assessment, initial management and basic life support(BLS). Students in the simulation group S(+) had an additional 30-minutes of practice and debriefing with high-fidelity infant simulator after the conventional course. There were 3 teachers involved in this course. The self-evaluated ability and confidence for pediatric patient assessment and management, the attitude for learning, and the evaluation and satisfaction for this course were evaluated by pre and post-course questionnaires which were not included into the semester score. The answer of each questions were scored with Likert scale 1 to 5. The questionnaire with all the questions have same answers of Likert scale was defined as invalid questionnaire. Data of the questionnaires were analyzed by Chi-square test, Student t test, Analysis of variance(ANOVA) and Linear regression. A p value<0.05 was considered statistically significant.
Result
One hundred and forty-one students were enrolled with 108 (76.6%) questionnaires were valid. Forty-four students were in the S(-) group and 37 valid questionnaires were obtained. Ninety-seven students were in the S(+) group and 71 valid questionnaires were obtained. For all students , the pre-course scale of “simulation increases learning motivation” had positive association with the scale of “this course is helpful for learning” (p value <0.01) after the course. Students who have scale of pre-course “simulation increases motivation” >3 stated significantly higher score for ‘this course is helpful for learning’ (4.55 v.s. 4.31, p value=0.04). In addition, for students with “overall clinical capacity” scale improvement≧2, the pre-course scale of“overall clinical capacity”had borderline association with the agreement of “this course is helpful for learning” (p value=0.06) but had significant association specifically for students in the S(+) group (p value=0.03). Students who stated higher scale of pre course “overall clinical capacity’, scored higher scale of “this course is helpful for learning”(p value=0.03) after the course.
Discussion
High-fidelity simulation is a popular and interesting learning / teaching method which reduces error made in training. In this study, the student satisfaction was high in both group. The rating of “this course is helpful for learning” was higher in the S(+) group but had not reached statistically significance. Supported by further analysis, the learning / teaching method meets the learner’s preference and leads to learning motivation is crucial for the course satisfaction and good learning outcome. Moreover, the learner’s prior knowledge and ability are important for gaining learning effectiveness.
Conclusion
High-fidelity patient simulator-assisted teaching is a feasible teaching method in the training of medical clerks and the student’s satisfaction is high. Besides, simulation is more beneficial in the teaching of students with active motivation or having prior knowledge and ability.
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