Lawry G V, Schuldt S S, Kreiter C D, Densen P, Albanese M A
Department of Internal Medicine, University of Iowa, Iowa City 52242, USA.
Acad Med. 1999 Feb;74(2):199-201. doi: 10.1097/00001888-199902000-00020.
To develop and test a program to teach a rapid screening musculoskeletal examination.
In 1995, 191 medical and physician assistant students were randomized to four intervention groups: written materials only (n = 47), written materials and videotape (n = 46), written materials and small-group sessions facilitated by fourth-year medical students (n = 55), and all three methods (n = 43). Assessments, in the form of a written test and standardized patient examinations, were conducted before the interventions (n = 40 randomly selected students), seven to ten days and again three months after the interventions (n = all 191 students), and 16 months after the interventions (n = 103 students).
While the four intervention groups' written test scores were approximately equal, their scores on the standardized patient examination differed significantly. The students taught in small groups demonstrated significantly superior examination skills compared with the students taught with written material or videotape at seven to ten days and retained this relative superiority after three and 16 months (p < .0001).
Small-group instruction with hands-on supervised practice is superior to more passive instructional methods for teaching musculoskeletal examination skills and can be successfully delivered by trained senior medical student facilitators with minimal direct expenditure of faculty time.
开发并测试一个教授快速肌肉骨骼检查的项目。
1995年，191名医学和医师助理专业学生被随机分为四个干预组：仅书面材料组（n = 47）、书面材料加录像带组（n = 46）、书面材料加由四年级医学生主持的小组讨论组（n = 55）以及所有三种方法都采用组（n = 43）。在干预前（随机抽取40名学生）、干预后7至10天和3个月后（所有191名学生）以及干预后16个月（103名学生）以书面测试和标准化患者检查的形式进行评估。
虽然四个干预组的书面测试成绩大致相当，但他们在标准化患者检查中的成绩差异显著。与仅使用书面材料或录像带教学的学生相比，接受小组教学的学生在7至10天时表现出明显更优的检查技能，并且在3个月和16个月后仍保持这种相对优势（p <.0001）。
对于教授肌肉骨骼检查技能，有实践指导的小组教学优于更被动的教学方法，并且可以由经过培训的高年级医学生成功实施，而教师只需投入极少的直接时间。
