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A1151
October 25, 2005 9:00:00 AM - 10:30:00 AM Room C305 |
| Instructionally Revised Simulator-Training Leads to Improved Self-Perceived Anesthesia Competencies and OSCE Results |
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Anja P. Schmitz, M.A., Niclas Schaper, Ph.D., Bernhard Graf, M.D., Christoph Grube, M.D. Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany |
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Background: Full-scale simulator training (FST) can be used to bridge the existing gap in medical education between imparting only theoretical knowledge and building actual clinical skills [1]. From an instructional psychology point of view, the question arises whether such complex FST is the most appropriate method to train basic anesthesia skills. This study evaluated three different forms of an FST curriculum. Materials and Methods: Three groups (G1-G3) participated in the study. All groups received two one-hour FST sessions in which students had to conduct anesthesia. G1 (n=176) served as a control group. In this FST version no specific instructional strategy was pursued. G2 (n=97) participated in instructionally revised FST based on constructivist learning principles [2]. G3 (n=140) participated in the same instructionally revised FST as G2. In addition to the FST, each group participated in four sessions of basic emergency care skills practice using a part-scale simulator (PST). G1 and G2 received PST after the FST. G3 received PST in between the two FST sessions, thus receiving less complex practice before the second FST session. Student learning was assessed by collecting questionnaire data on students' self-perceived anesthesia competencies before and after the FST. As an objective transfer measure, the groups' anesthesia OSCE-results were also compared. All groups participated in OSCE after FST and PST. Results and Discussion: Repeated measurements ANOVA on students' self-perceived competencies yielded significant overall effects for group (F(2, 378) = 40.96, p < .000), time of measurement (F(1, 378) = 746.22, p < .000), and the predicted interaction group * time of measurement (F(2, 378) = 19.54, p < .000). Post-hoc comparisons revealed significant differences (p < .001) between each of the groups. The ANOVA of the transfer data (OSCE) also showed the predicted significant effect for group (p < .000). Calculated contrasts yielded significant differences between G3 and both of the other groups (p < .002), with G3 receiving the highest ratings. The results indicate that the training led to an increase in students' self-perceived and OSCE anesthesia competencies and that this increase varied depending on the training the students received. Conclusions: The instructional changes in the curriculum led to increases in students' self-perceived anesthesia competencies as well as in a transfer measure (OSCE) at the end of the semester. Although the competencies of all groups increased over time, training group 3 showed the highest self-perceived increase in their competencies and also the highest OSCE ratings. Taken together, these findings provide a first indication that students learn more when they receive basic skills training with part-scale simulators before they participate in the more complex full-scale simulator training. References: [1] Flanagan B, Nestel D, Joseph M: Making patient safety the focus: Crisis Resource Management in the undergraduate curriculum. Medical Education 2004; 38: 56-66 [2] Cognition and Technology Group at Vanderbilt: The Jasper Series as an example of anchored instruction: Theory, program, description, assessment data. Educational Psychologist 1992; 27: 291-315 Anesthesiology 2005; 103: A1151 |