Objective:Acupuncture is an efficient treatment modality for many different training,but the technique can be challenging to master.Identification of the different acupuncture points can now be practiced in a standard...Objective:Acupuncture is an efficient treatment modality for many different training,but the technique can be challenging to master.Identification of the different acupuncture points can now be practiced in a standardized and patient-safe simulation-based environment.We aim to gather additional evidence regarding simulation-based training of acupuncture skills and hope that the simulation-based test developed and will be used for simulation-based mastery learning in future develop.Methods:The aim of this study was to develop a test of acupuncture skills using the TCM(Traditional Chinese Medicine) Meridians & Acupoints Anatomy Teaching Platform and gather validity evidence using Messick’s framework.Novice medical students without prior experience in acupuncture(n=43),intermediate medical students who had finished the mandatory acupuncture course(n=24),and skilled acupuncture doctors(n=17) were included in the study.One-hundred and seven acupuncture points were presented to the participants in identical randomized order and they were asked to identify each point by touching the correct anatomical location on the simulator.The simulator automatically registered the accuracy of participants’ answers.Results:The reliability of the final test(66 acupuncture points) was at a high level with a Cronbach’s alpha of 0.98 and only 16 acupuncture points were needed to ensure a reliability of 0.90.The test could discriminate significantly between all three groups and a credible pass/fail-score of 34 points was determined which resulted in eight out of 43(19%) novices passing the test and only two out of 17(12%)experienced failing the test.These consequences were statistically significant(P <0.001).Conclusion:Based on Messick’s framework we demonstrated strong validity evidence for a newly developed simulation-based test of acupuncture points localization skills.The test can be used as an aid to decide when trainees are ready to progress to more advanced training and clinical practice.Compared with the traditional point-point test,the point-point evaluation of the simulator can be more objective and reduce the effort of teachers.展开更多
AIM: To study technical skills of colonoscopists using a Microsoft Kinect? for motion analysis to develop a tool to guide colonoscopy education.RESULTS: Ten experienced endoscopists(gastroenterologists, n = 2; colorec...AIM: To study technical skills of colonoscopists using a Microsoft Kinect? for motion analysis to develop a tool to guide colonoscopy education.RESULTS: Ten experienced endoscopists(gastroenterologists, n = 2; colorectal surgeons, n = 8) and 11 novices participated in the study. A Microsoft Kinect? recorded the movements of the participants during the insertion of the colonoscope. We used a modified script from Microsoft to record skeletal data. Data were saved and later transferred to MatLab for analysis and the calculation of statistics. The test was performed on a physical model, specifically the "Kagaku Colonoscope Training Model"(Kyoto Kagaku Co. Ltd, Kyoto, Japan). After the introduction to the scope and colonoscopy model, the test was performed. Seven metrics were analyzed to find discriminative motion patterns between the novice and experienced endoscopists: hand distance from gurney, number of times the right hand wasused to control the small wheel of the colonoscope, angulation of elbows, position of hands in relation to body posture, angulation of body posture in relation to the anus, mean distance between the hands and percentage of time the hands were approximated to each other.RESULTS: Four of the seven metrics showed discriminatory ability: mean distance between hands [45 cm for experienced endoscopists(SD 2) vs 37 cm for novice endoscopists(SD 6)], percentage of time in which the two hands were within 25 cm of each other [5% for experienced endoscopists(SD 4) vs 12% for novice endoscopists(SD 9)], the level of the right hand below the sighting line(z-axis)(25 cm for experienced endoscopists vs 36 cm for novice endoscopists, P < 0.05) and the level of the left hand below the z-axis(6 cm for experienced endoscopists vs 15 cm for novice endoscopists, P < 0.05). By plotting the distributions of the percentages for each group, we determined the best discriminatory value between the groups. A pass score was set at the intersection of the distributions, and the consequences of the standard were explored for each test. By using the contrasting group method, we showed a discriminatory value of Z = 1.51 to be the pass/fail value of the data showing discriminatory ability. The pass score allowed all ten experienced endoscopists as well as five novice endoscopists to pass the test.CONCLUSION: Identified metrics can be used to discriminate between experienced and novice endoscopists and to provide non-biased feedback. Whether it is possible to use this tool to train novices in a clinical setting requires further study.展开更多
基金Supported by Guangdong Higher Education Teaching Reform Project (2020)No.20National Examination of Traditional Chinese Medicine Scientific Research Project (TB2021002)。
文摘Objective:Acupuncture is an efficient treatment modality for many different training,but the technique can be challenging to master.Identification of the different acupuncture points can now be practiced in a standardized and patient-safe simulation-based environment.We aim to gather additional evidence regarding simulation-based training of acupuncture skills and hope that the simulation-based test developed and will be used for simulation-based mastery learning in future develop.Methods:The aim of this study was to develop a test of acupuncture skills using the TCM(Traditional Chinese Medicine) Meridians & Acupoints Anatomy Teaching Platform and gather validity evidence using Messick’s framework.Novice medical students without prior experience in acupuncture(n=43),intermediate medical students who had finished the mandatory acupuncture course(n=24),and skilled acupuncture doctors(n=17) were included in the study.One-hundred and seven acupuncture points were presented to the participants in identical randomized order and they were asked to identify each point by touching the correct anatomical location on the simulator.The simulator automatically registered the accuracy of participants’ answers.Results:The reliability of the final test(66 acupuncture points) was at a high level with a Cronbach’s alpha of 0.98 and only 16 acupuncture points were needed to ensure a reliability of 0.90.The test could discriminate significantly between all three groups and a credible pass/fail-score of 34 points was determined which resulted in eight out of 43(19%) novices passing the test and only two out of 17(12%)experienced failing the test.These consequences were statistically significant(P <0.001).Conclusion:Based on Messick’s framework we demonstrated strong validity evidence for a newly developed simulation-based test of acupuncture points localization skills.The test can be used as an aid to decide when trainees are ready to progress to more advanced training and clinical practice.Compared with the traditional point-point test,the point-point evaluation of the simulator can be more objective and reduce the effort of teachers.
文摘AIM: To study technical skills of colonoscopists using a Microsoft Kinect? for motion analysis to develop a tool to guide colonoscopy education.RESULTS: Ten experienced endoscopists(gastroenterologists, n = 2; colorectal surgeons, n = 8) and 11 novices participated in the study. A Microsoft Kinect? recorded the movements of the participants during the insertion of the colonoscope. We used a modified script from Microsoft to record skeletal data. Data were saved and later transferred to MatLab for analysis and the calculation of statistics. The test was performed on a physical model, specifically the "Kagaku Colonoscope Training Model"(Kyoto Kagaku Co. Ltd, Kyoto, Japan). After the introduction to the scope and colonoscopy model, the test was performed. Seven metrics were analyzed to find discriminative motion patterns between the novice and experienced endoscopists: hand distance from gurney, number of times the right hand wasused to control the small wheel of the colonoscope, angulation of elbows, position of hands in relation to body posture, angulation of body posture in relation to the anus, mean distance between the hands and percentage of time the hands were approximated to each other.RESULTS: Four of the seven metrics showed discriminatory ability: mean distance between hands [45 cm for experienced endoscopists(SD 2) vs 37 cm for novice endoscopists(SD 6)], percentage of time in which the two hands were within 25 cm of each other [5% for experienced endoscopists(SD 4) vs 12% for novice endoscopists(SD 9)], the level of the right hand below the sighting line(z-axis)(25 cm for experienced endoscopists vs 36 cm for novice endoscopists, P < 0.05) and the level of the left hand below the z-axis(6 cm for experienced endoscopists vs 15 cm for novice endoscopists, P < 0.05). By plotting the distributions of the percentages for each group, we determined the best discriminatory value between the groups. A pass score was set at the intersection of the distributions, and the consequences of the standard were explored for each test. By using the contrasting group method, we showed a discriminatory value of Z = 1.51 to be the pass/fail value of the data showing discriminatory ability. The pass score allowed all ten experienced endoscopists as well as five novice endoscopists to pass the test.CONCLUSION: Identified metrics can be used to discriminate between experienced and novice endoscopists and to provide non-biased feedback. Whether it is possible to use this tool to train novices in a clinical setting requires further study.
