Abstract
Study design:
Interventional training sessions.
Objectives:
To examine the effectiveness of training medical students in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI).
Setting:
A Peking University teaching hospital.
Methods:
A total of 46 medical students were involved in the study. First, they had a 2-h self-study session with the ISNCSCI booklet, followed by a 10-item questionnaire. The booklet was allowed for use as a reference during this assessment. Two days later, the questionnaire was repeated without the use of reference. Students then had a session with case discussion, followed by a final questionnaire.
Results:
After the initial self-study session, the mean score (max. 10) on the questionnaire was 7.67±1.49. Two days later, the mean score of the second test was 7.96±1.15. All key points of the ISNCSCI were supplemented during the second session with case presentations. The mean score of the final test increased significantly to 9.61±0.88 (P<0.01) in comparison with the previous tests. The overall correct response rates by students in determining sensory level, motor level and American Spinal Injury Association Impairment Scale of the training case were 89.1%, 84.8% and 91.3%, respectively.
Conclusion:
The training effectiveness of ISNCSCI through self-study is reliable. The correct answers to key points could remain for at least 2 days without the need to use a reference. However, some specialized knowledge could not be transmitted without more detailed discussions and case presentations. Utilization of cases is a valuable method in training ISNCSCI and can improve the overall training effectiveness.
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References
American Spinal Injury Association.. Standards for Neurological Classification Of Spinal Injured Patients. ASIA: Chicago, IL, USA. 1982.
Kirshblum SC, Waring W, Biering-Sorensen F, Burns SP, Johansen M, Schmidt-Read M et al. Reference for the 2011 revision of the International Standards for Neurological Classification of Spinal Cord Injury. J Spinal Cord Med 2011; 34: 547–554.
Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A et al. International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med 2011; 34: 535–546.
Ditunno JF, Young WS, Donovan WH, Bracken MB, Brown M, Creasey G et al International Standards for Neurological and Functional Classification of Spinal Cord Injury, Revised. American Spinal Injury Association: Chicago, IL, USA. 1992.
Waring WP 3rd, Biering-Sorensen F, Burns S, Donovan W, Graves D, Jha A et al. 2009 review and revisions of the international standards for the neurological classification of spinal cord injury. J Spinal Cord Med 2010; 33: 346–352.
Ditunno JF, Young WS, Donovan WH, Bracken MB, Brown M, Creasey G et al Reference Manual for the International Standards for Neurological and Functional Classification of Spinal Cord Injury. American Spinal Injury Association: Chicago, IL, USA. 1994.
American Spinal Injury Association.. Reference Manual for the International Standards for Neurological Classification of Spinal Cord Injury. American Spinal Injury Association: Chicago, IL, USA. 2003.
Jonsson M, Tollbäck A, Gonzales H, Borg J . Inter-rater reliability of the 1992 international standards for neurological and functional classification of incomplete spinal cord injury. Spinal Cord 2000; 38: 675–679.
Mulcahey MJ, Gaughan JP, Chafetz RS, Vogel LC, Samdani AF, Betz RR . Interrater reliability of the international standards for neurological classification of spinal cord injury in youths with chronic spinal cord injury. Arch Phys Med Rehabil 2011; 92: 1264–1269.
Savic G, Bergström EM, Frankel HL, Jamous MA, Jones PW . Inter-rater reliability of motor and sensory examinations performed according to American Spinal Injury Association standards. Spinal Cord 2007; 45: 444–451.
Marino RJ, Jones L, Kirshblum S, Tal J, Dasgupta A . Reliability and repeatability of the motor and sensory examination of the international standards for neurological classification of spinal cord injury. J Spinal Cord Med 2008; 31: 166–170.
Mulcahey MJ, Gaughan J, Betz RR . Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with complete spinal cord injury. Spinal Cord 2009; 47: 56–61.
Vogel L, Samdani A, Chafetz R, Gaughan J, Betz R, Mulcahey MJ . Intra-rater agreement of the anorectal exam and classification of injury severity in children with spinal cord injury. Spinal Cord 2009; 47: 687–691.
Chafetz RS, Gaughan JP, Vogel LC, Betz R, Mulcahey MJ . The international standards for neurological classification of spinal cord injury: intra-rater agreement of total motor and sensory scores in the pediatric population. J Spinal Cord Med 2009; 32: 157–161.
Mulcahey MJ, Gaughan J, Betz RR, Johansen KJ . The International Standards for Neurological Classification of Spinal Cord Injury: reliability of data when applied to children and youths. Spinal Cord 2007; 45: 452–459.
Cohen ME, Ditunno JF Jr, Donovan WH, Maynard FM Jr . A test of the 1992 International Standards for Neurological and Functional Classification of Spinal Cord Injury. Spinal Cord 1998; 36: 554–560.
Mulcahey MJ, Gaughan J, Betz RR, Vogel LC . Rater agreement on the ISCSCI motor and sensory scores obtained before and after formal training in testing technique. J Spinal Cord Med 2007; 30 (Suppl 1): S146–S149.
Chafetz RS, Vogel LC, Betz RR, Gaughan JP, Mulcahey MJ . International standards for neurological classification of spinal cord injury: training effect on accurate classification. J Spinal Cord Med 2008; 31: 538–542.
American Spinal Injury Association, International Spinal Cord Society Li JJ, Zhou HJ, Sun YC, Zhang X et al. International Standards for Neurological Classification of Spinal Cord Injury. [Article in Chinese] Chin J Rehabil Theory Practice 2007; 13: 1–6.
Ditunno JF, Little JW, Tessler A, Burns AS . Spinal shock revisited: a four-phase model. Spinal Cord. 2004; 42: 383–395.
Custers EJ . Long-term retention of basic science knowledge: a review study. Adv Health Sci Educ Theory Pract 2010; 15: 109–128.
Biering-Sørensen F, Alexander MS, Burns S, Charlifue S, Devivo M, Dietz V et al. Recommendations for translation and reliability testing of international spinal cord injury data sets. Spinal Cord 2011; 49: 357–360.
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Appendix 1
Appendix 1
The ISNCSCI key point questionnaire (with answers and corrections). Instructions: there are 10 questions about the ISNCSCI which are given below. Please determine for each question whether it is true or false and check in the corresponding boxes. Each correct answer will score 1 point and in total 10 points.
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Liu, N., Zhou, MW., Krassioukov, A. et al. Training effectiveness when teaching the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) to medical students. Spinal Cord 51, 768–771 (2013). https://doi.org/10.1038/sc.2013.75
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DOI: https://doi.org/10.1038/sc.2013.75
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