Description
Introduction and objectivesThe COVID-19 pandemic has affected the field of education globally. The process of learning both theoretical and practical skills has changed and distance learning became the primary method of education. Therefore, even after the end of the formal pandemic, distance learning has become the most frequently used method in the field of education, and medical studies are no exception.
Since the beginning of the pandemic and with the ban on conducting face-to-face classes Riga Stradiņš University Medical Education Technology Center team has been actively working on the development and improvement of various educational methodologies, so that university lecturers can effectively continue to teach students remotely. Teaching practical skills remotely is a main challenge, and the RSU METC team has offered several methods, the most effective of which seemed to be packing medical equipment together with small task trainers and sending them to student’s homes so that students can follow the instructor during a remote session and repeat demonstrated skills. The time for the development and application of the methods was very short, which did not allow fully test the effectiveness of the method before starting the lessons.
The aim of the study is to compare distance learning practical training using a communications platform with person-to-person training in intravenous catheterization as one of the basic clinical skill. Assess the results by administering an examination to both groups using the intravenous catheterization combined assessment scale. Test and optimize distance learning methodology with equipment sets; promoting the development of this method outside the time of the pandemic, by reason of the method can theoretically be effectively used in cases when, due to various circumstances, onsite person-to-person teaching cannot take place.
Materials and methods
Cross tabulated randomized controlled trial; united examination via reliable communications platform with individual times, using the same equipment sets and task trainer in both groups during training phase and examination faze. Individual identification numbers for personal data protection and objective assessment of performed manipulation were used. Post-exam anonymous participants survey was filled by research participants.
Research instruments: peripheral venous catheterisation kit, containing of: self-made I/V task trainer, 6 peripheral I/V catheters, 36 alcohol pads, venous tourniquet, 6 injection bandages, 6 peripheral I/V catheter fixation bandages, sharps container, examination gloves, sterile drape, packaging, instructions, 6 10mL syringes, simulated NaCl0,9% (sterile water), I/V catheter sterile cap; self-made combined assessment scale based on international criteria.
Participants: 1-3-year medical students who have not yet studied peripheral i/v catheter placement and have not attempted to do so in clinical practice or the workplace.
A face-to-face lesson was organized for one group, a remote lesson was organized for the other group using previously received sets with equipment and I/V task trainer. Both groups had the same medical equipment, I/V task trainer, instructor, theoretical presentation and length of the master class. The examination was conducted remotely for everyone, ensuring good visibility of the work table by camera, so the instructor could evaluate the student's actions.
Examination was organised for 38 participants (19 from reliable video platform group, 19 onsite group). The condition for passing the exam positively was at least 55% of the maximum mark and the fulfilment of 4 mandatory points of the catheterization process, the failure of which directly threatens the patient's life: Fill the syringe with saline, connect it to the extender an refill it, leave the syringe connected to the extender; disinfects the skin circularly from the centre to the outside; remove the catheter needle cover. Insert the cannula into the skin at an angle of 15-45 degrees until you see blood in the catheter. Stop, slightly retract the stylus (2-3 mm) and insert the catheter all the way into the vein. Remove the catheter needle fully from the vein; connect the extender to the catheter and perform a small aspiration, then rinse the cannula with a pulsating jet, close the clamp, disconnect the syringe and replace the stopper.
Data was analysed with SPSS 26 (Chicago, Il)
Statistical significance was assumed if p<0.05.
Interval data presented in median with interquartile range. Mann - Whitney U test was used to find statistically significant difference online vs onsite groups for interval data. Pearson Chi square test and Fisher’s exact test were used for categorical and nominal data.
Results
Statistically significant data were: Age –19 years old (n =17) – 12 (63%) participants were in onsite group and 5(26%) in distance group. Age – 20 years old (n=15) – 12 (63%) participants were in distance group and 3 (16%) in onsite group.; Tightening the tourniquet – Correct (n=22): 15 (78,9%) participants from onsite group; 7(36,80%) participants from distance group. Incorrect (n=16): 4 (21,10%) participants from onsite group; 12(63,20%) from distance group.; Disinfection of puncture site – Correct (n=32): 19 (100%) from onsite and 13(68,40%) from distance group. Incorrect (n=5): 5 (26,30%) participants from distance learning group. Vein stabilisation – Correct (n=26): 16 (84,20%) from onsite and 10(52,60%) from distance group; Incorrect (n=10): 1 (5,30%) from onsite group and 9 (47,40%) from distance group. Evaluation of passing mandatory points and result of 55% to pass – Passed (n=10): 5(26,30%) participants from onsite and 5(26,30%) participants from distance group. Not passed (n=28): 14 (73,70%) from onsite group and 14(73,70%) from distance group.
Conclusions
Research results show that the acquisition of knowledge and practical skills through distance learning using a set of equipment at home and accompanied by an instructor is at the same level as face-to-face training, but the level is equally low. The low level of the overall result is related to a small amount of time for learning theory and practical skill (2 hours) and a short period of time between training and the exam, without the opportunity to train independently in spare time.
But the same result for students who learn practical skills remotely and face-to-face using the same equipment gives the basis for further research into remote training methods using equipment that could be sent home to students. It has been considered that there are many medical manipulations, the learning of which does not require clinical task trainers, but only medical equipment (for example, wearing sterile gloves and a gown), and in such a case, there is a reason to try the application of remote practical skills learning methods.
High-quality training of medical students in conditions where face-to-face onsite training is prohibited in the age of Covid-19 requires further study and complex methodology should be explored, which must be further adapted to other cases when face-to-face studies cannot take place for various reasons.
| Period | 17 Feb 2023 |
|---|---|
| Event title | МЕДИЧНА СИМУЛЯЦІЯ – ПОГЛЯД У МАЙБУТНЄ |
| Event type | Conference |
| Location | Chernivtsi, UkraineShow on map |
| Degree of Recognition | International |
Field of Science
- 3.2 Clinical medicine