Residents in tutored practice exchange groups have better medical reasoning as measured by script concordance test: a controlled, nonrandomized study.
OBJECTIVE
Clinical reasoning by anesthesiology residents in emergency situations where optimal management is uncertain could be improved by setting up a tutored practice exchange group. This study attempted to evaluate the impact of a practice exchange group (PEG), tutored by a senior anesthesiologist, on anesthesiology residents in emergency situations. Changes in clinical reasoning were measured by script concordance tests (SCT).


METHODS
We conducted a controlled, non-randomized study.


METHODS
Participants are residents in anesthesiology in Rouen, Caen and Amiens University Hospitals.


METHODS
Two resident groups were made up without randomization. The first group was the control group and consisted of residents from Amiens University Hospital and Caen University Hospital. The second study group (PEG group) consisted of residents from Rouen University Hospital, who followed weekly PEG sessions. Two groups had the same learning objectives except the PEG.


METHODS
In both the control group and the study group, each resident's clinical reasoning was assessed in the same formal manner by SCT. The primary outcome measurement of this study was to compare SCT results in the study group with PEG training (PEG group) with those without (control group).


RESULTS
Performance in the SCT, expressed as degree of concordance with the expert panel (95% CI), was better in the PEG group (64% [62.1%-66%]) than in control group (60% [57.5%-62.8%])) (P= .004).


CONCLUSIONS
Our study strongly suggests that an expert-directed, peer-conducted educational training program may improve the clinical reasoning of anesthesiology residents as measured by SCT.
Department of Anesthesiology and Intensive Care, Rouen University Hospital, France; Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, DC2N, EA4310, U982 Inserm, Federative Institute of Multidisciplinary Research on Neuropeptides 23 (IFRMP 23), Place Emile Blondel, University of Rouen, Mont-Saint-Aignan, France.
V
V
Compère
Department of Anesthesiology and Intensive Care, Rouen University Hospital, France. Electronic address: julien.abily@chu-rouen.fr.
J
J
Abily
Department of Anesthesiology and Intensive Care, Rouen University Hospital, France.
J
J
Moriceau
Department of Anesthesiology and Intensive Care, Rouen University Hospital, France.
A
A
Gouin
Department of Anesthesiology and Intensive Care, Rouen University Hospital, France.
B
B
Veber
Department of Anesthesiology and Intensive Care, Amiens University Hospital, France.
H
H
Dupont
Department of Anesthesiology and Intensive Care, Amiens University Hospital, France.
E
E
Lorne
Department of Anesthesiology and Intensive Care, EA4650, Caen University Hospital, France.
J L
JL
Fellahi
Department of Anesthesiology and Intensive Care, EA4650, Caen University Hospital, France.
J L
JL
Hanouz
Department of Anesthesiology and Intensive Care, EA4650, Caen University Hospital, France.
J L
JL
Gerard
Department of Medical Pedagogy, University of Rouen, Rouen, France.
L
L
Sibert
Department of Anesthesiology and Intensive Care, Rouen University Hospital, France.
B
B
Dureuil
D000776:Anesthesiology / Q000193:education*; D002983:Clinical Competence; D003657:Decision Making; D004630:Emergencies; D005602:France; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D013337:Students, Medical
Medical reasoning; Practice exchange group; Script concordance test