Hybridlab learning method. Residual value of obstetrical clinical skills

Abstract

Introduction: Medical students in Lithuania are expected to learn key obstetrical skills during their 5th-year Obstetrics/Gynecology rotation including an accurate evaluation of the fetus in utero via physical examination of the patient. The HybridLab method (peerteaching model including e-learning modules combined with online checklist-driven skills and decision flowcharts) was used to teach assessment of history taking, maternal condition and fetal status evaluation (position, presenting part, symphysis-fundal height, and heart rate). The aim of this study was to evaluate retention of skills over time with or without the use of a checklist reminder strategy. Methods: 240 students who successfully completed a standardized assessment of task performance during their clinical rotation during which they completed the HybridLab training were eligible to participate. A convenience sample of 62 students were reassessed at random times between 4-14 months after initial training and assessment. These students were randomly assigned to use a reminder checklist (Group A, n=27) or no checklist (Group B, n=35) to complete an identical clinical task. Results: In both A and B groups 1st assessment was completely performed 98.3%, 2nd assessment – 66.4%, a variation was 31.9 (20.7)%. In the group without a task reminder a variation of evaluation was lower in 43.9(18)% but in A group with a task reminder it was lower in 16.2 (11.6)%, (p<0.001). According to ROC test 20% is a threshold value of the evaluation variation. We detected that OR[95%CI] in A group need to be 30.476 [7.054-131.669] to get the variation of assessment less than 20%. The separate analysis of fetus position, presenting part, heart rate and symphysis-fundal height evaluation was done. The mean was 99.4(3.2)% and 85.2(26.3)% of 2nd assessment in A group. In B group it was 96.7(7.9)% of 1st and 81.0 (17.2)%, a variation of evaluation in both groups was significa