Learning the skills of flexible sigmoidoscopy -- the wider perspective.

BACKGROUND: Nurse-led gastrointestinal endoscopy is a priority clinical area in the UK. Endoscopic procedures are challenging to learn, requiring a combination of technical competence (manipulating a flexible endoscope and interpreting the findings) and interpersonal skills (engaging effectively wit...

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Publicado en:Medical Education Vol. 37; pp. 50 - 59
Autores principales: Kneebone RL, Nestel D, Moorthy K, Taylor P, Bann S, Munz Y, Darzi A
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Nov2003 Supplement 1
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: Learning the skills of flexible sigmoidoscopy -- the wider perspective.
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          Kneebone RL
          Nestel D
          Moorthy K
          Taylor P
          Bann S
          Munz Y
          Darzi A
        affil: Senior Lecturer in Surgical Education, Dept of Surgical Oncology & Technology, Imperial College London, 10th Floor QEQM Wing, St Mary's Hospital, Praed St, London, W2 1NY, UK; r.kneebone@imperial.ac.uk
      sug:
        subj:
          Nurse Practitioners Education
          Sigmoidoscopy Education
          Teaching Methods
          Audiorecording
          Communication Skills Training
          Course Evaluation
          Curriculum Development
          Endoscopy, Gastrointestinal Education
          Field Notes
          Friedman Test
          Observational Methods
          P-Value
          Pilot Studies
          Pretest-Posttest Design
          Semi-Structured Interview
          Wilcoxon Rank Sum Test
          Human
      ab: BACKGROUND: Nurse-led gastrointestinal endoscopy is a priority clinical area in the UK. Endoscopic procedures are challenging to learn, requiring a combination of technical competence (manipulating a flexible endoscope and interpreting the findings) and interpersonal skills (engaging effectively with a conscious patient who is frequently apprehensive). This paper explores the potential of an innovative, scenario-based approach which links a simulated patient with a computer-driven virtual reality (VR) training device for flexible sigmoidoscopy. Within this safe yet realistic quasi-clinical environment, learners carry out the procedure while interacting with the 'patient'. Communication skills are assessed by simulated patients, while quantitative performance data relating to the procedure is generated automatically by the VR simulator. METHODS: This pilot study took place within a nurse practitioner endoscopy course. A mixed methodology combined qualitative and quantitative data (observation and interview studies, communication rating scales and a range of computer-generated output measures from the VR simulator) in a multifaceted evaluation. RESULTS: Seven nurses took part in the study. Participants found the scenarios to be a convincing and powerful learning experience. All experienced high levels of anxiety. Simulated patients identified strengths in participants' communication skills, together with areas for development. Simulator-based practice led to an improvement in objective performance measures. DISCUSSION: Scenario-based training provides a powerful learning experience, allowing participants to build their technical expertise and apply it within a holistic clinical context without the risk of causing harm. We used this pilot study as a springboard for discussions over wider implications of procedure-based skills training, locating it within the literature on expertise and situated learning.
      pubtype: Academic Journal
      doctype:
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        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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