مجال التميز | تميز دراسي وبحثي |
البحوث المنشورة |
|
البحث (1): | |
عنوان البحث: |
Effectiveness of technology-enhanced simulation in teaching digital rectal examination: a systematic review narrative synthesis |
رابط إلى البحث: | |
تاريخ النشر: |
01/09/2020 |
موجز عن البحث: |
Background: Digital rectal examination (DRE) is a challenging examination to learn. Objective: To synthesise evidence regarding the effectiveness of technology-enhanced simulation (TES) for acquiring DRE skills. Study selection: EMBASE, Medline, CINAHL, Cochrane, Web of Knowledge (Science and Social Science), Scopus and IEEE Xplore were searched; the last search was performed on 3 April 2019. Included were original research studies evaluating TES to teach DRE. Data were abstracted on methodological quality, participants, instructional design and outcomes; a descriptive synthesis was performed. Quality was assessed using a modified Medical Education Research Study Quality Instrument. The study design domain was modified by scoring the papers based on (1) evaluation of risk of bias for randomised controlled trials, (2) description of participants and (3) assessment of robustness and degree of simulation fidelity of the assessments used to evaluate learning. Findings: 863 articles were screened; 12 were eligible, enrolling 1507 prequalified medical/clinical students and 20 qualified doctors. For skill acquisition, role player was statistically significantly superior to a static manikin (2 studies). For knowledge acquisition, manikin use was significantly superior to role player (1 study); 2 studies showed no difference. For confidence, manikin use was significantly superior to no manikin (4 studies). For comfort, manikin use was significantly superior to no manikin (2 studies). For anxiety, role player was significantly superior to manikin (1 study). Median overall quality score (QS) was 48% (27–62). Highest median QS was 73% (33–80) for data analysis; lowest median QS was 20% (7–40) for the validity of instrument. Six papers scored over 50% of the maximum score for overall quality. Conclusions TES training is associated with improved DRE skills and should be used more widely. |
المؤتمرات العلمية |
|
المؤتمر (1): | |
عنوان المؤتمر: |
The Association for the Study of Medical Education: Annual General Meeting 2020 |
تاريخ الإنعقاد: |
02/07/2020 |
مكان الإنعقاد: |
Edinburgh. UK |
طبيعة المشاركة: |
Oral Presentation |
عنوان المشاركة: |
The effectiveness of technology-enhanced simulation in teaching digital rectal examination: a systematic review narrative synthesis |
ملخص المشاركة: |
Background: Digital rectal examination (DRE) is a challenging intimate examination to learn. The objective of this study is to synthesise evidence regarding the effectiveness of technology‐enhanced simulation training for acquiring DRE skills. Methodology: EMBASE, Medline, CINAHL, Cochrane, Web of Knowledge (Science & Social Science), Scopus and IEEE Xplore were searched; the last search was performed on April 3, 2019. Included studies were original research studies evaluating technology‐enhanced simulation to teach DRE. Reviewers evaluated study eligibility and then abstracted data on: methodological quality, participants, instructional design and outcomes, and used a descriptive synthesis to summarise methodology, participants, instructional design and outcomes. Results: 863 articles were screened; 12 were eligible, enrolling 1,507 prequalified medical/clinical students and 20 qualified doctors. Of these, four were randomised controlled trials (RCT), two were non‐RCT with two or more groups, one was crossover with randomisation, four were single‐group pretest‐posttest studies and one used a single‐group post‐test design. The outcomes of interest divided into five categories: acquisition of clinical skills (measured in five papers), acquisition of knowledge (three papers), learner satisfaction (four papers) and confidence (five papers), and learner anxiety and comfort levels (four papers). Quality was assessed using a version of the Medical Education Research Study Quality Instrument (1) modified as follows: (i) an evaluation of risk of bias for randomised controlled trials, (ii) level of detail of description of participants, (iii) assessment of robustness and degree of simulation fidelity of the assessments used to collect objective data and to evaluate learning when measuring outcomes. The median overall quality score (QS) was 48% (range 27‐62). The highest median QS was 73% (33‐80) for data analysis; lowest median QS was 20% (7‐40) for the validity of the instrument. Six papers scored more than 50% of the maximum score on overall quality. Discussion: Technology‐enhanced simulation training is associated with improved DRE skills and may facilitate the transfer of skills that are challenging to learn. Enhanced feedback at the end of training appears to improve learning. Most studies assessed learning but none assessed impact on behaviours in clinical setting or patient care. |
الرابط: | |
المؤتمر (2): | |
عنوان المؤتمر: |
National Physician Associate Educators Virtual Conference |
تاريخ الإنعقاد: |
26/03/2021 |
مكان الإنعقاد: |
Keele University, UK |
طبيعة المشاركة: |
Poster presentation |
عنوان المشاركة: |
An educational audit of the experience, comfort and self-perceived competence in performing digital rectal examination (DRE) among Physician Associate (PA) students in the UK |
ملخص المشاركة: |
Introduction: Digital rectal examination (DRE) is an important physical examination tool to identify abnormalities of the anus, rectum, and (in the male) prostate including life-threatening diseases such as prostate cancer1. The General Medical Council2,3 has indicated the need for doctors to conduct intimate examinations and will soon regulate PAs. The available evidence shows few newly qualified doctors have performed sufficient DREs to be confident4; however, there is no evidence concerning PAs’ DRE experience. Aim: To investigate and describe the number of DREs performed by PA students during their clinical placement as well as their confidence and comfort in performing this procedure. Method: A self-administered, online, anonymous questionnaire was distributed through Jisc online survey software platform to second-year UK physician associate students via their faculty. The questionnaire collected the following information: 1. gender and ethnicity (UK census categories), 2. previous work experience, 3. type of lab training, 4. number of DREs they had performed, 5. self-reported competence and confidence. Results: 145 students responded from 18 HEIs, (111 female, 34 male). 121 (83%) of students have done < 5 DREs; 44 (30%) zero; 83 (82%) have never examined a malignant prostate. 76 (75%) reported their DRE findings were NOT confirmed by a doctor. 92 (63%) not very confident to perform DRE and locate the prostate. 122 (84%) not very confident to differentiate between normal and abnormal prostate presentation. 102 (70%) not very comfortable with performing DRE. There was a strong, positive correlation between number DREs and confidence (d = 0.252, p < .0005). Conclusion: The number of DREs performed by PA students is low and many are not verified by a doctor. We recommend that students must demonstrate a minimal level of competence and comfort before performing this invasive examination on a ‘real’ patient. More training and supervision of students are required both before and during clinical placement for them to acquire even basic competence and confidence. |
منصور عائض علي الأسمري
دكتوراه
الطب والخدمات الصحية
University of Birmingham