York N L, Niehaus A H, Markwell S J, Folse J R
Department of Surgery, Southern Illinois University School of Medicine, Springfield, USA.
Am J Surg. 1999 Mar;177(3):240-3. doi: 10.1016/s0002-9610(99)00005-7.
Faculty often presume that students possess adequate physical examination skills upon graduation. Yet assessments of their performance with these skills often reveal deficiencies. This study was designed to determine if students' physical examination skills improved during their clerkship year.
Sixty-six students performed four specific physical examinations on patients during the first and last week of their surgery clerkship. Four consecutive clerkship rotations were examined. Encounters were videotaped and evaluated by faculty members.
Posttest mean percent correct scores significantly improved for three examinations (P <0.01). Analysis of variance found no significant differences between clerkship mean percent correct scores.
Students' physical examination skills improved slightly during their clerkship, however, no relationship was found between clerkship rotation and performance. These findings suggest unsupervised experiences during the third year do not positively influence student performance with physical examination skill proficiency.
教师通常假定学生毕业时具备足够的体格检查技能。然而,对他们这些技能表现的评估往往揭示出不足之处。本研究旨在确定学生的体格检查技能在实习年期间是否有所提高。
66名学生在外科实习的第一周和最后一周对患者进行了四项特定的体格检查。对连续四个实习轮转进行了检查。会诊过程被录像并由教师进行评估。
三项检查的后测平均正确得分百分比显著提高(P<0.01)。方差分析发现实习平均正确得分百分比之间没有显著差异。
学生的体格检查技能在实习期间略有提高,然而,未发现实习轮转与表现之间存在关联。这些发现表明,三年级时无监督的经历不会对学生体格检查技能熟练程度的表现产生积极影响。