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6. Sınıf Tıp Fakültesi Öğrencilerine Verilen “Sepsis Yönetiminin Birinci Saati” Eğitiminde, Simülasyon Destekli Ters Yüz Sınıf Modelinin Etkinliğinin Değerlendirilmesi

Year 2024, Volume: 77 Issue: 3, 279 - 284, 10.10.2024

Abstract

Amaç: Sepsis, enfeksiyona kontrolsüz bir konak yanıtının neden olduğu hayatı tehdit eden organ işlev bozukluğudur. Tıp fakültelerinde, özellikle
sepsis gibi teorik bilgi yükünün yoğun olduğu bir konuda uygulanan eğitimde, geleneksel eğitim dışında bir eğitim yönteminin etkinliğinin ölçülmesi
amaçlanmıştır.

Gereç ve Yöntem: Çalışmaya, 01.02.2021-31.03.2021 tarihleri arasında, Ankara Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı’nda staj yapmakta
olan intörn doktorlar dahil edilmiştir. Katılımcılara çalışmanın başında ön-test yapılmıştır. Katılımcılar, blok randomizasyon yöntemi kullanılarak iki
gruba ayrılmıştır: Simülasyon tabanlı pratik ile ters-yüz eğitim (n=39) ve didaktik eğitim grubu (n=40). Ters-yüz + simülasyon modelinde, önce sepsis
yönetiminin ilk saati ile ilgili kaynaklar verilmiştir, sonrasında simülasyon tabanlı bir senaryo ile pratik eğitim verilmiştir. Diğer gruba da aynı konu ile
ilgili didaktik eğitim verilmiştir. Katılımcılara Acil Tıp rotasyonunun sonunda bir son-test yapılmıştır. Verilerin istatistiksel analizi için SPSS StatVersion 22 (IBM, USA) kullanılmıştır. Eşleştirilmiş örneklerde, kategorik değişkenler için McNemar testi, ordinal değişkenler için de Wilcoxon testi
kullanılmıştır. Gruplar arası değerlendirmeler için ise iki yönlü Mann-Whitney U testi ile ki-kare testi kullanılmıştır.

Bulgular: Gruplar arasında cinsiyet, yaş ve daha önce simülasyon tabanlı eğitime katılmış olma durumu arasında fark saptanmamıştır. Son-testteki
puan ortalaması, son-testteki puanın artış ortalaması, son- testte doğru cevaplanan zor soru sayısındaki değişimde; anlamlı bir fark saptanmamış
olsa da ters-yüz + simülasyon modeli ile eğitim alan grup, kontrol grubuna kıyasla bu parametrelere göre daha başarılı bulunmuştur. Son-testteki
zor sorular içerisinde doğru yanıtlanan soru sayısında, son- testte başarılı olma oranında, ön- teste göre son- testteki başarılı olma durumundaki
değişiklikte ve eğitimden elde edildiği düşünülen faydanın değerlendirilmesinde verilen puanda; ters-yüz + simülasyon ile eğitim alan katılımcılar,
kontrol grubuna göre istatistiksel olarak anlamlı bir şekilde daha yüksek değerler kaydetmiştir.

Sonuç: Çalışma sonucunda öğrencilerin, tıp fakültelerinde simülasyon tabanlı pratik ile ters-yüz sınıf modeli ile verilecek eğitimden didaktik
yöntemle verilecek eğitime kıyasla, daha fazla yarar sağlayacağını gösteren önemli deliller elde edilmiştir.

Ethical Statement

The research conducted at Ankara University Faculty of Medicine has been reviewed and approved by the Human Research Ethics Committee under the reference number I11-662-20.

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801.
  • 2. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis. JAMA. 2016;315:762-774.
  • 3. Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:775.
  • 4. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, vd. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43:304-377
  • 5. Dellinger RP. Cardiovascular management of septic shock. Crit Care Med. 2003;31:946-955.
  • 6. Gordon JA, Oriol NE, Cooper JB. Bringing good teaching cases “to life”: a simulator-based medical education service. Acad Med. 2004;79:23-27.
  • 7. Kundra P, Kurdi M, Mehrotra S, Jahan N, Kiran S, Vadhanan P. Newer teaching-learning methods and assessment modules in anaesthesia education. Indian J Anaesth. 2022;66:47.
  • 8. Ten Eyck RP, Tews M, Ballester JM, Hamilton GC. Improved Fourth-Year Medical Student Clinical Decision-Making Performance as a Resuscitation Team Leader After a Simulation-Based Curriculum. Simulation in Healthcare. 2010;5:139-145.
  • 9. Eng AJ, Namba JM, Box KW, Lane JR, Kim DY, Davis DP, vd. High-Fidelity Simulation Training in Advanced Resuscitation for Pharmacy Residents. A J Pharm Educ [Internet]. April 17, 2014 [a.yer January 10, 2021];78. Access address: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996391/
  • 10. Perkins GD. Simulation in resuscitation training. Resuscitation. May 2007;73:202-211.
  • 11. Kim JH, Kim WO, Min KT, Yang JY, Nam YT. Learning by Computer Simulation Does Not Lead to Better Test Performance on Advanced Cardiac Life Support Than Textbook Study. J Educ Perioper Med [Internet]. January 01, 2002 [taken from January 11, 2021];4(1). Access address: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC4865364/
  • 12. Wilson KE, Hobbs JR. Innovative use of a flipped-classroom approach to teach fundamental nursing skills. Teaching and Learning in Nursing. 2022;S1557308722000932.
  • 13. Zownorega SJ. Effectiveness Of Flipping The Classroom In A Honors Level, Mechanics-Based Physics Class. :26.
  • 14. Blanie A, Shoaleh C, Marquion F, Benhamou D. Comparison of multimodal active learning and single-modality procedural simulation for central venous catheter insertion for incoming residents in anesthesiology: a prospective and randomized study. BMC Med Educ. 2022;22:357.
  • 15. Hasançebi B, Terzi Y, Küçük Z. Madde Güçlük İndeksi ve Madde Ayırt Edicilik İndeksine Dayalı Çeldirici Analizi. Gümüşhane Üniversitesi Fen Bilimleri Enstitüsü Dergisi [Internet]. January 15, 2020 [taken from May 31, 2021]; Access address: https://dergipark.org.tr/tr/doi/10.17714/ gumusfenbil.615465
  • 16. Salomão R, Ferreira BL, Salomão MC, Santos SS, Azevedo LCP, Brunialti MKC. Sepsis: evolving concepts and challenges. Braz J Med Biol Res. 2019;52(4):e8595.
  • 17. Tromp M, Bleeker-Rovers CP, van Achterberg T, et al. Internal medicine residents’ knowledge about sepsis: effects of a teaching intervention. Neth J Med. 2009;67:312-315.
  • 18. Riddell J, Jhun P, Fung CC, et al. Does the Flipped Classroom Improve Learning in Graduate Medical Education? J Grad Med Educ. 2017;9:491-496.
  • 19. Angadi NB, Kavi A, Shetty K, Hashilkar NK. Effectiveness of flipped classroom as a teaching-learning method among undergraduate medical students - An interventional study. J Educ Health Promot. 2019;8:211.
  • 20. Liebert CA, Lin DT, Mazer LM, Bereknyei S, Lau JN. Effectiveness of the Surgery Core Clerkship Flipped Classroom: a prospective cohort trial. The American Journal of Surgery. 2016;211:451-457.e1.
  • 21. Zhao W, He L, Deng W, Zhu J, Su A, Zhang Y. The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease. BMC Med Educ. 2020;20:381.
  • 22. Bassily-Marcus A, Kohli-Seth R, Petrinko I, Oropello JM, Manasia A, Ellozi S, vd. Knowledge Retention Among Medical Students After Simulation-Based vs Traditional Critical Care Teaching. Chest. 2010;138:197A.
  • 23. Gordon JA, Shaffer DW, Raemer DB, Pawlowski J, Hurford WE, Cooper JB. A randomized controlled trial of simulation-based teaching versus traditional instruction in medicine: a pilot study among clinical medical students. Ad Health Sci Educ Theory Pract. 2006;11:33-39.
  • 24. Wong G, Jenkins C, Yao TJ, Irwin M. A trend toward improved learning of cardiovascular pathophysiology in medical students from using a human patient simulator: results of a pilot study. Adv Physiol Educ. 2007;31:372.
  • 25. McCoy CE, Menchine M, Anderson C, Kollen R, Langdorf MI, Lotfipour S. Prospective randomized crossover study of simulation vs. didactics for teaching medical students the assessment and management of critically ill patients. J Emerg Med. April 2011;40:448-455.
  • 26. Alluri RK, Tsing P, Lee E, Napolitano J. A randomized controlled trial of highfidelity simulation versus lecture-based education in preclinical medical students. Med Teach. 2016;38:404-409.
  • 27. Ramnanan CJ, Pound LD. Advances in medical education and practice: student perceptions of the flipped classroom. Adv Med Educ Pract. 2017;8:63-73.
  • 28. Fahy BG, Vasilopoulos T, Chau DF. Use of Flipped Classroom and Screen- Based Simulation for Interdisciplinary Critical Care Fellow Teaching of Electroencephalogram Interpretation. Neurocrit Care. 2020;33:298-302.

Evaluation of Simulation-Supported Flipped Classroom Model in the “First Hour of Sepsis Management” Training for 6th Year Medical Students

Year 2024, Volume: 77 Issue: 3, 279 - 284, 10.10.2024

Abstract

Objectives: This study aims to evaluate the effectiveness of a non-traditional medical education method, as simulation-based training combined
with flipped classroom model compared with traditional didactic lecture.

Materials and Methods: A pre-test was applied to all participants at the beginning of the clerkship and a post- test at the end. Participants were
divided into two groups; intervention group and control group. The intervention group had access to guidelines about sepsis and the practical
training was provided with a simulation-based scenario session. A traditional lecture was provided to the control group. Last year medical students
who were doing their compulsory clerkship of Department of Emergency Medicine at Ankara University Faculty of Medicine between February 1,
2021 and March 31, 2021, were included in the study. SPSS Statistics Version 22 (IBM, USA) was used for statistical analysis. McNemar test was used
for categorical variables and Wilcoxon test for ordinal variables in paired samples. Two tailed Mann-Whitney U test and chi-square test were used
for inter-group evaluations.

Results: Participants in the intervention group were more successful than the control group considering post-tests results. Success in the difficult
questions was higher in the intervention group. Participants trained with sim+ flipped model were more satisfied regarding the training from the
control group. No statistically significant difference was found between the groups in other compared parameters.
Conclusion: Students would benefit more from the education given with simulation based training combined with flipped classroom, compared to
conventional didactic method.

Ethical Statement

The research conducted at Ankara University Faculty of Medicine has been reviewed and approved by the Human Research Ethics Committee under the reference number I11-662-20.

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:801.
  • 2. Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of Clinical Criteria for Sepsis. JAMA. 2016;315:762-774.
  • 3. Shankar-Hari M, Phillips GS, Levy ML, et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315:775.
  • 4. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, vd. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43:304-377
  • 5. Dellinger RP. Cardiovascular management of septic shock. Crit Care Med. 2003;31:946-955.
  • 6. Gordon JA, Oriol NE, Cooper JB. Bringing good teaching cases “to life”: a simulator-based medical education service. Acad Med. 2004;79:23-27.
  • 7. Kundra P, Kurdi M, Mehrotra S, Jahan N, Kiran S, Vadhanan P. Newer teaching-learning methods and assessment modules in anaesthesia education. Indian J Anaesth. 2022;66:47.
  • 8. Ten Eyck RP, Tews M, Ballester JM, Hamilton GC. Improved Fourth-Year Medical Student Clinical Decision-Making Performance as a Resuscitation Team Leader After a Simulation-Based Curriculum. Simulation in Healthcare. 2010;5:139-145.
  • 9. Eng AJ, Namba JM, Box KW, Lane JR, Kim DY, Davis DP, vd. High-Fidelity Simulation Training in Advanced Resuscitation for Pharmacy Residents. A J Pharm Educ [Internet]. April 17, 2014 [a.yer January 10, 2021];78. Access address: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996391/
  • 10. Perkins GD. Simulation in resuscitation training. Resuscitation. May 2007;73:202-211.
  • 11. Kim JH, Kim WO, Min KT, Yang JY, Nam YT. Learning by Computer Simulation Does Not Lead to Better Test Performance on Advanced Cardiac Life Support Than Textbook Study. J Educ Perioper Med [Internet]. January 01, 2002 [taken from January 11, 2021];4(1). Access address: https://www.ncbi. nlm.nih.gov/pmc/articles/PMC4865364/
  • 12. Wilson KE, Hobbs JR. Innovative use of a flipped-classroom approach to teach fundamental nursing skills. Teaching and Learning in Nursing. 2022;S1557308722000932.
  • 13. Zownorega SJ. Effectiveness Of Flipping The Classroom In A Honors Level, Mechanics-Based Physics Class. :26.
  • 14. Blanie A, Shoaleh C, Marquion F, Benhamou D. Comparison of multimodal active learning and single-modality procedural simulation for central venous catheter insertion for incoming residents in anesthesiology: a prospective and randomized study. BMC Med Educ. 2022;22:357.
  • 15. Hasançebi B, Terzi Y, Küçük Z. Madde Güçlük İndeksi ve Madde Ayırt Edicilik İndeksine Dayalı Çeldirici Analizi. Gümüşhane Üniversitesi Fen Bilimleri Enstitüsü Dergisi [Internet]. January 15, 2020 [taken from May 31, 2021]; Access address: https://dergipark.org.tr/tr/doi/10.17714/ gumusfenbil.615465
  • 16. Salomão R, Ferreira BL, Salomão MC, Santos SS, Azevedo LCP, Brunialti MKC. Sepsis: evolving concepts and challenges. Braz J Med Biol Res. 2019;52(4):e8595.
  • 17. Tromp M, Bleeker-Rovers CP, van Achterberg T, et al. Internal medicine residents’ knowledge about sepsis: effects of a teaching intervention. Neth J Med. 2009;67:312-315.
  • 18. Riddell J, Jhun P, Fung CC, et al. Does the Flipped Classroom Improve Learning in Graduate Medical Education? J Grad Med Educ. 2017;9:491-496.
  • 19. Angadi NB, Kavi A, Shetty K, Hashilkar NK. Effectiveness of flipped classroom as a teaching-learning method among undergraduate medical students - An interventional study. J Educ Health Promot. 2019;8:211.
  • 20. Liebert CA, Lin DT, Mazer LM, Bereknyei S, Lau JN. Effectiveness of the Surgery Core Clerkship Flipped Classroom: a prospective cohort trial. The American Journal of Surgery. 2016;211:451-457.e1.
  • 21. Zhao W, He L, Deng W, Zhu J, Su A, Zhang Y. The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease. BMC Med Educ. 2020;20:381.
  • 22. Bassily-Marcus A, Kohli-Seth R, Petrinko I, Oropello JM, Manasia A, Ellozi S, vd. Knowledge Retention Among Medical Students After Simulation-Based vs Traditional Critical Care Teaching. Chest. 2010;138:197A.
  • 23. Gordon JA, Shaffer DW, Raemer DB, Pawlowski J, Hurford WE, Cooper JB. A randomized controlled trial of simulation-based teaching versus traditional instruction in medicine: a pilot study among clinical medical students. Ad Health Sci Educ Theory Pract. 2006;11:33-39.
  • 24. Wong G, Jenkins C, Yao TJ, Irwin M. A trend toward improved learning of cardiovascular pathophysiology in medical students from using a human patient simulator: results of a pilot study. Adv Physiol Educ. 2007;31:372.
  • 25. McCoy CE, Menchine M, Anderson C, Kollen R, Langdorf MI, Lotfipour S. Prospective randomized crossover study of simulation vs. didactics for teaching medical students the assessment and management of critically ill patients. J Emerg Med. April 2011;40:448-455.
  • 26. Alluri RK, Tsing P, Lee E, Napolitano J. A randomized controlled trial of highfidelity simulation versus lecture-based education in preclinical medical students. Med Teach. 2016;38:404-409.
  • 27. Ramnanan CJ, Pound LD. Advances in medical education and practice: student perceptions of the flipped classroom. Adv Med Educ Pract. 2017;8:63-73.
  • 28. Fahy BG, Vasilopoulos T, Chau DF. Use of Flipped Classroom and Screen- Based Simulation for Interdisciplinary Critical Care Fellow Teaching of Electroencephalogram Interpretation. Neurocrit Care. 2020;33:298-302.
There are 28 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Articles
Authors

Aydın Gönülcan This is me 0000-0002-4702-7417

Project Number -
Publication Date October 10, 2024
Submission Date June 26, 2024
Acceptance Date August 14, 2024
Published in Issue Year 2024 Volume: 77 Issue: 3

Cite

APA Gönülcan, A. (2024). Evaluation of Simulation-Supported Flipped Classroom Model in the “First Hour of Sepsis Management” Training for 6th Year Medical Students. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 77(3), 279-284. https://doi.org/10.4274/atfm.galenos.2024.77200
AMA Gönülcan A. Evaluation of Simulation-Supported Flipped Classroom Model in the “First Hour of Sepsis Management” Training for 6th Year Medical Students. Ankara Üniversitesi Tıp Fakültesi Mecmuası. October 2024;77(3):279-284. doi:10.4274/atfm.galenos.2024.77200
Chicago Gönülcan, Aydın. “Evaluation of Simulation-Supported Flipped Classroom Model in the ‘First Hour of Sepsis Management’ Training for 6th Year Medical Students”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77, no. 3 (October 2024): 279-84. https://doi.org/10.4274/atfm.galenos.2024.77200.
EndNote Gönülcan A (October 1, 2024) Evaluation of Simulation-Supported Flipped Classroom Model in the “First Hour of Sepsis Management” Training for 6th Year Medical Students. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77 3 279–284.
IEEE A. Gönülcan, “Evaluation of Simulation-Supported Flipped Classroom Model in the ‘First Hour of Sepsis Management’ Training for 6th Year Medical Students”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 77, no. 3, pp. 279–284, 2024, doi: 10.4274/atfm.galenos.2024.77200.
ISNAD Gönülcan, Aydın. “Evaluation of Simulation-Supported Flipped Classroom Model in the ‘First Hour of Sepsis Management’ Training for 6th Year Medical Students”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 77/3 (October 2024), 279-284. https://doi.org/10.4274/atfm.galenos.2024.77200.
JAMA Gönülcan A. Evaluation of Simulation-Supported Flipped Classroom Model in the “First Hour of Sepsis Management” Training for 6th Year Medical Students. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;77:279–284.
MLA Gönülcan, Aydın. “Evaluation of Simulation-Supported Flipped Classroom Model in the ‘First Hour of Sepsis Management’ Training for 6th Year Medical Students”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 77, no. 3, 2024, pp. 279-84, doi:10.4274/atfm.galenos.2024.77200.
Vancouver Gönülcan A. Evaluation of Simulation-Supported Flipped Classroom Model in the “First Hour of Sepsis Management” Training for 6th Year Medical Students. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2024;77(3):279-84.