Immunization competence retention in medical students: a comparation between conventional lectures and lectures with simulations method
Abstract
Background Immunization is recognized as one of the strategies to reduce vaccine preventable diseases. Competency related to immunization are consequently important for medical students and the medical school needs to assure the competence acquisition. Objective To assess competence related to immunization and its retention following lectures with simulations compared to lectures only. Methods A quasi-experimental study was conducted to the 5th year students of University of Indonesia Medical School during the Child Adolescent Health Module in 2012-2013. The intervention group had lectures with simulations and the control group had lectures only. Immunization knowledge was assessed with a 30 multiple choice question (MCA) items performed before and after the module. Competence retention was assessed by MCQ (knowledge) and OSCE (skills) 2-6 months afterwards. Results Sixty eight subjects for each group with similar characteristics were analyzed. There was significant difference after module MCQ score between two groups. Competence retention in 2-6 months after module completion was better in intervention group, both for the knowledge (median MCQ score of 70.00 (range 37-93) vs. mean score of 58.01 (SD 12.22), respectively; P<0.001) and skill (OSCE mean scores of 75.21 (SD 10.74) vs. 62.62 (SD 11.89), respectively; P < 0.001). Proportion of subjects in the intervention group who passed both the MCQ and OSCE were also significantly greater. Conclusion Lectures with simulations are proved to be more effective in improving medical students’ immunization competence as well as its retention compared to lectures only approach.
References
Orenstein W, Pickering L. Immunization practices. In: Kliegman RM, Behrman R, Jenson H, BF S, editors. Nelson textbook of pediatrics. 18th ed. Philadelphia: Saunders; 2007. p. 1058-71.
Ismael S, Hadinegoro SR. Program imunisasi nasional. In: Ranuh I, Suyitno H, Hadinegoro SR, Kartasasmita CB, Ismoedijanto, Soedjatmiko, eds. Pedoman imunisasi di Indonesia. 4th ed. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2011.p.39-46.
Ranuh I. Imunisasi : upaya pencegahan primer. In: Ranuh I, Suyitno H, Hadinegoro SR, Kartasasmita CB, Ismoedijanto, Soedjatmiko, editors. Pedoman imunisasi di Indonesia. 4th ed. Jakarta: Badan Penerbit Ikatan Dokter Anak Indonesia; 2011. p. 2-9.
Bradley P. The history of simulation in medical education and possible future directions. Medical education. Hartono Gunardi et al: Immunization competence retention in medical students 2006;40:254-62.
Fraser K, Ma I, Teteris E, Baxter H, Wright B, McLaughlin K. Emotion, cognitive load and learning outcomes during simulation training. Medical education. 2012;46:1055-62.
Siebeck M, Schwald B, Frey C, Röding S, Stegmann K, Fischer F. Teaching the rectal examination with simulations: effects on knowledge acquisition and inhibition. Medical education. 2011;45:1025-31.
McQueen AA, Mitchell DL, Joseph-Griffin MA. “Not Little Adultsâ€: Pediatric considerations in medical simulation. Dm- Dis Mon. 2011;57:780-8.
Maran NJ, Glavin RJ. Low- to high-fidelity simulation – a continuum of medical education? Medical education. 2003;37:22-8.
Fernandez N, Dory V, Ste-Marie L-G, Chaput M, Charlin B, Boucher A. Varying conceptions of competence: an analysis of how health sciences educators define competence. Medical education. 2012;4:357-65.
Wass V, Van der Vleuten C, Shatzer J, Jones R. Assessment of clinical competence. Lancet. 2001;357:945-9.
Cox M, Irby DM, Epstein RM. Assessment in medical education. New Engl J Med. 2007;356:387-96.
Cheng A, Hunt EA, Donoghue A, Nelson-McMillan K, Nishisaki A, LeFlore J, et al. Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial. JAMA Pediatr. 2013;167:528-36.
Cook DA. How much evidence does it take? A cumulative meta-analysis of outcomes of simulation-based education. Medical education. 2014;48:750-60.
Weller JM. Simulation in undergraduate medical education: bridging the gap between theory and practice. Medical education. 2004;38:32-8.
Wayne DB, Didwania A, Feinglass J, Fudala MJ, Barsuk JH, McGaghie WC. Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case-control study. Chest. 2008;133:56-61.
Barsuk JH, Cohen ER, McGaghie WC, Wayne DB. Longterm retention of central venous catheter insertion skills after simulation-based mastery learning. Acad Med. 2010;85:S9-S12.
Carr J, Martin M, Clements C, Ritchie P. Behavioural factors in immunization. Behavioural Science Learning Modules. 2000:1-10.
Martin IG, Jolly B. Predictive validity and estimated cut score of an objective structured clinical examination (OSCE) used as an assessment of clinical skills at the end of the first clinical year. Medical education. 2002;36:418-25.
McBride ME, Waldrop WB, Fehr JJ, Boulet JR, Murray DJ. Simulation in pediatrics: the reliability and validity of a multiscenario assessment. Pediatrics. 2011;128:335-43.
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Accepted 2016-02-12
Published 2016-11-30