背景:近年来,医学教育见证了将超声整合到医学院临床前几年的转变。鉴于超声技术的可及性呈指数级增长,学生现在有机会创建同伴学习小组,其中可以从同伴到同伴教授超声概念,使学生能够共同努力,在临床前教育早期整合超声概念。该项目调查了同伴授课的学生导师(PTSTs)在识别和标记上肢肌肉骨骼(MSK)解剖结构方面向一年级医学生传授基本超声技术基础知识的功效。方法:指导一年级医学生使用超声探头识别前臂掌侧结构。学生和教师被允许使用超声波探头,超声凝胶,iPad,一个标准化的病人。学生由超声教练(UI)或PTST教授。在UI或PTST的动手演示之后,参与的学生被告知要尽可能准确地截图并标记他们的图像,在没有任何反馈的情况下识别标准化患者的前述掌侧结构。基于清晰地可视化预期结构的能力来对掌状结构的标记的屏幕截图图像进行分级。结果:这项研究的结果比较了PTSTs作为基础超声识别技术教育者的功效与UI教职员工的功效。在UI和PTST学生获得的图像之间进行卡方分析,组间识别准确性无统计学差异(p=0.7538、0.1977、0.1812、0.301)。当使用Mann-WhitneyU秩检验时,与由UI教授的学生相比,由STs教授的学生的准确性之间没有统计学上的显着差异(p=0.7744,0.09538,0.07547,0.1846)。另一个发现表明,当给出有关上肢超声的病理学鉴定问题时,属于两个教学组的学生通常无法推断掌侧腕部结构的病理学。使用卡方和耶茨校正,没有足够的证据证明回答基于病理学的超声问题的能力与指导者类型之间存在关联(p=p=0.6299,0.8725).
结论:这项研究支持以下解释:一年级医学生学习新手MSK超声检查的能力与教育者是PTST还是UI无关。这种解释揭示了在医学教育早期整合超声识别基础的有希望的途径,而几乎不必担心机构资源的枯竭。除了医学院使用STs的其他有据可查的好处之外,以本研究描述的方式设计的以超声技能为中心的同伴辅导系统可能是一种有效的,资源节约系统,提高医学生的超声能力,在他们的临床前几年早期。
BACKGROUND: In recent years, medical education has witnessed a shift in the integration of ultrasound into the preclinical years of medical school. Given the exponential increase in accessibility to ultrasound technology, students now have the opportunity to create peer learning groups in which ultrasound concepts can be taught from peer to peer, empowering students to work together to integrate ultrasound concepts early in their preclinical education. This project investigates the efficacy of peer-taught student tutors (PTSTs) in imparting the fundamentals of basic ultrasound techniques to first-year medical students in the setting of identifying and labeling upper extremity musculoskeletal (MSK) anatomy. Methods: First-year medical students were instructed to identify volar forearm structures with an ultrasound probe. Students and instructors were given access to an ultrasound probe, ultrasound gel, an iPad, and a standardized patient. Students were taught either by an ultrasound instructor (UI) or PTST. After a hands-on demonstration by a UI or PTST, participating students were told to take screenshots and label their images as accurately as possible, identifying the aforementioned volar structures on a standardized patient without any feedback. The labeled screenshot images of volar structures were graded based on the ability to clearly visualize the intended structures. Results: The results of this study compare the efficacy of PTSTs as educators of basic sonographic identification techniques with that of UI faculty members. A chi-square analysis was performed between the images obtained by the UI and PTST students, and there was no statistically significant difference in identification accuracy between the groups (p = 0.7538, 0.1977, 0.1812, 0.301). When using the Mann-Whitney U rank test, there remained no statistically significant difference between the accuracy of the students taught by STs compared to students taught by UIs (p = 0.7744, 0.09538, 0.07547, 0.1846). Another finding showed that students belonging to both teaching groups were generally not able to infer the pathology of volar wrist structures when given pathology identification questions regarding upper extremity ultrasound. Using chi-square with Yates correction, there is no sufficient evidence to justify an association between the ability to answer pathology-based ultrasound questions and instructor type (p = p = 0.6299, 0.8725).
CONCLUSIONS: This study supports the interpretation that the capability of first-year medical students to learn novice MSK sonographic identification is independent of whether the educator is a PTST or UI. This interpretation reveals a promising avenue toward the integration of the fundamentals of ultrasound identification early in medical education with little to no concern for the exhaustion of institutional resources. Along with the other well-documented benefits of the utilization of STs in medical school, a peer tutoring system centered on ultrasound skills designed in the way this study describes can be an effective, resource-sparing system that enhances medical students\' sonographic capabilities early in their preclinical years.