Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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The Change of perception according to the fidelity of simulation in Objective Structured Clinical Examination for Procedural Skill of 4th Medical Students

의전원 4학년 학생의 과정기술 객관구조화진료시험에 도입된 시뮬레이션의 충실도에 따른 인식 변화

  • Son, Hee-Jeong (Department of Anesthesiology, School of Medicine, Kangwon National University) ;
  • Kim, Jin-Uk (Department of Emergency Medical technology, Seonam University) ;
  • Yi, Yu-Ri (Department of Anesthesiology, School of Medicine, Kangwon National University) ;
  • Hwang, Byeong-Moon (Department of Anesthesiology, School of Medicine, Kangwon National University)
  • 손희정 (강원대학교 의전원 마취통증의학과) ;
  • 김진욱 (서남대학교 응급구조학과) ;
  • 이유리 (강원대학교 의전원 마취통증의학과) ;
  • 황병문 (강원대학교 의전원 마취통증의학과)
  • Received : 2012.02.14
  • Accepted : 2012.03.08
  • Published : 2012.03.31
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Abstract

The 4th year medical students were randomly divided and designated as group HF and LF, representing high and low fidelity simulations respectfully. Both groups performed OSCE on 2 topics(adult intubation and IV cannulation) with each composed of the same scenario. Each scenario was developed by a faculty in charge of clinical skill education with supervision from 2 other faculty members. High fidelity simulations were designed as in-situ simulations in real OR. Low fidelity simulations had the same scenarios but the environment was simulated only with a simple task trainer in the classroom. All students participated in series of survey using a Likert scale before and after the simulations. The provided data was anlayzed with paired T-test and Mann-Whiteney test(p<0.05). The post simulations self evaluation score for group HF was lower than pre-simulation self confidence score for both topics of adult intubation and IV cannulation where as for group LF, it was lower only for adult intubation(p<0.05). In group HF, the needs for clinical training on both topics increased after the simulation. In group LF, there was no significant change of needs for clinical training between pre and post simulation survey. This suggest that fidelity may be a helpful factor to improve the motivation of the students and further study on economical aspect should be addressed.

본 연구는 마취과 임상실습을 마친 의전원 4학년 학생들을 대상으로 충실도를 달리한 과정기술 객관구조화 진료시험에서 보여지는 자기평가와 학습동기의 변화 유무를 비교해 보고자 시행되었다. 학생들을 무작위로 두 군으로 나누어 HF군에서는 고충실도의, LF군에서는 저충실도의 과정기술 객관구조화진료시험을 시행하였다. 사례는 기관삽관과 정맥관삽관의 두 주제로 임상술기교육을 맡은 책임교수가 개발한 후 다른 두 교수가 검토, 수정하였다. 두 주제에 대해 고충실도 사례는 실제 수술실에서 in-situ 시뮬레이션으로, 저충실도 사례는 일반 교실에서 단순과업모형을 이용하여 충실도만 달리하여 시행하였다. 학생들은 수행 전 후로 5점 척도로 구성된 설문조사에 응하였고, 자료의 분석은 Man-Whiteney test와 Paired T-test를 이용하였다. 연구 결과, 의전원 4학년 학생들의 술기 수행능력에 대한 자기평가는 저충실도 사례보다 고충실도 사례에서 평가 전에 보여준 자신감보다 낮게 평가되었고, 고충실도 사례 후에 연습의 필요성을 더 느꼈다. 고충실도 사례의 도입은 학생들의 술기연습에 대한 동기 부여에 도움이 될 것으로 여겨지지만 경제적인 효율도 고려해야 할 것이다.

Keywords

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