Student-centred Learning With Near-peer Tutoring Compared With a Standard Faculty-led Course for Undergraduate Training in Abdominal Ultrasound. A Multicentre Open-label Randomized Controlled Trial.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 152
- 试验地点
- 6
- 主要终点
- Mean participants' "Swiss Students' Ultrasound Skills Assessment" scores six months after the end of their courses (OSCE 2).
研究概览
简要总结
Background:
Ultrasound has become clinical skill widely used in most medical disciplines. Institutions are changing their curricula to implementing basic ultrasound knowledge, often supplementing traditional teaching with 'near-peer' tutoring through classes held by advanced peers. Near-peer tutoring has been found to be both effective and cost-effective.
In Switzerland the most popular course in postgraduate training is a resource-intensive 21-hour basic course for abdominal ultrasound. However, this is expensive, and may not be the best way to impart these skills to undergraduates, who need training more adapted to their needs.
Therefore a 21-hour blended-learning ultrasound course, comprising 5 hours of e-learning and 16 hours of near-peer tutoring has been developped. Students and their near-peer tutors autonomously organize individual practical teaching sessions within a 16 weeks time period.
Methods:
Medical students from second to fourth year at the Universities of Bern, Fribourg and Zurich will be included. Stratified by study site, students will be randomized to one of the two interventions. The blended-learning group will receive e-learning and near-peer tutoring over 16 weeks; the other group will receive 21 hours of teaching, from ultrasound experts, in a 2.5-day course. All participants will undergo a six-station OSCE directly after the course and 6 months later. Students will fill out online questionnaires at baseline, directly after the course and 6 months later. The mean scores of both groups will be compared at six months after the end of both courses. Secondary outcome measures will be students' ultrasound skills immediately after the courses, student satisfaction, multivariate regression exploring factors that affect outcome at 6 months and exploratory subgroup analysis.
Discussion:
This study is designed to compare the current way of ultrasound education in Switzerland with a new blended learning course. It aims to determine whether the blended learning course is as good as, or better than the existing 21-hour standard course. If this is found to be the case, blended learning could help to expand capacity to offer such courses to undergraduate medical students. It would eventually allow undergraduate Swiss medical students to acquire ultrasound skills before starting their residencies. This study also aims at improving the understanding of how to achieve effective student-centred learning supported by near-peer tutoring.
详细描述
Background:
Over the last decades, ultrasound (US) examination has become commonly used in many medical specialties, including internal medicine and primary care. Young doctors often perform simple ultrasound investigations as residents in internal medicine or primary care especially in emergency care. Currently, 30% of Swiss primary care practices are equipped with an ultrasound machine.
The Swiss Society for Ultrasound in Medicine (SGUM/SSUM) is the accreditation body for ultrasound education in Switzerland. Doctors must obtain a certificate from the SGUM before they can bill ultrasound examinations for insurance payments. However, ultrasound courses are time-intensive (63 hours total, plus a final examination), and are offered in the postgraduate phase, when doctors often have few resources and little time. This may explain why only about half of General Practitioners who use ultrasound have the SGUM certificate. For the half without the certificate, not only can they not bill their ultrasound examination to an insurance company, but also the quality of the examination is less assured, as they have not demonstrated their competence in US skills in the SGUM examination. This may lead to insecurity for the patient and for the performing doctor. There is also a risk that this results in unnecessary examinations.
The SGUM certificate is achieved by passing three courses (basic/advanced/final; 21 hours each) as well as a summative final examination. Between courses, trainees must perform a certain number of US examinations on real patients, under direct and distant supervision. These courses are now being opened to undergraduates, and the 2017 revision of the Swiss learning objectives for medical studies (PROFILES) added basic US skills as mandatory learning goal.
In the past years US training courses at Swiss medical universities were mostly optional, and were quickly overbooked. This shortage of courses could be addressed by using near-peer tutors, which are increasingly used in faculty-organized US classes. Near-peer tutors are "trainees one or more years senior to trainees on the same level of medical education spectrum". Five randomized-controlled trials of ultrasound training have compared near-peer tutoring with faculty-led teaching and assessed students' practical ultrasound skills as a primary outcome measure. Four of these found peer-tutoring to be non-inferior and one found that students in the near-peer-tutoring group slightly underperformed.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 35 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Medical students at three Swiss universities (Bern, Freiburg, Zurich) in the 3rd to 8th semester, who:
- •are willing to participate in the study;
- •are willing to pay the 200.- CHF course fees (partial reimbursement of tutors and administrative fee for the SGUM course certificate)
- •fill out a baseline questionnaire
- •signed informed consent sheet
排除标准
- •Did not sign study agreement or pay the course fee
- •More than 5 hours of previous formal ultrasound training
- •Failure to fill out baseline questionnaire
结局指标
主要结局
Mean participants' "Swiss Students' Ultrasound Skills Assessment" scores six months after the end of their courses (OSCE 2).
时间窗: 10 months from enrollment at each site
The investigators will assess the participants' ultrasound skills using the "Swiss Students' Ultrasound Skills Assessment". This uses a validated OSCE form (Hofer et al. 2011), which has been adapted to specific Swiss needs and revalidated. The total score can range from 0-300 points, a higher total representing a better performance. The OSCE assesses handling of the probe, explanation of the ultrasound image, examination skills and theoretical knowledge. Each station will assess a key topic that arises in both courses.
次要结局
- Change in mean participants' "Swiss Students' Ultrasound Skills Assessment" scores (knowledge retention).(10 months from enrollment at each site)
- Participants' satisfaction with allocated courses(16 weeks from enrollment at each site)
- Mean participants' "Swiss Students' Ultrasound Skills Assessment" scores immediately after the end of their courses (OSCE 1).(16 weeks from enrollment at each site)
- Multivariate regression exploring factors that affect outcome at six months after the end of their courses(10 months after enrollment at each site)