Rogers J, Dains J, Corboy J, Chang T
Department of Family and Community Medicine, Baylor College of Medicine, Houston, USA.
Fam Med. 1999 Jun;31(6):391-7.
A school-wide curriculum renewal led to a new clerkship curriculum that teaches core family practice competencies by focusing on the process of care in generalist practice. The organizing framework consists of five prototypic visits and their encounter tasks: 1) new problem visit, 2) checkup visit, 3) chronic illness visit, 4) psychosocial problem visit, and 5) behavioral change visit.
The seminars occur at the beginning of the rotation and use active learning techniques. Evaluation includes student perceptions of the seminars and teachers and student performance on a clinical performance examination (CPX).
Students rated the usefulness of the seminars and the seminar leaders' teaching behaviors favorably. The CPX checklist scores showed that students could perform most of the behaviors expected for each prototypic visit. The students listed the appropriate encounter tasks nearly half of the time when describing what tasks they tried to accomplish during the CPX cases. The students listed concrete behaviors just over 50% of the time.
The students learned the material presented in the seminars and applied it during the CPX. Students can do most of the behaviors but do not seem to describe the tasks as abstractly as faculty. These results come from one class cohort in one medical school, so the generalizability is limited until further work, including other learners, confirms these findings.
一场全校范围的课程更新催生了一门新的临床实习课程,该课程通过聚焦全科医疗中的照护流程来教授核心家庭医疗能力。其组织框架由五次典型问诊及其问诊任务组成:1)新问题问诊,2)体检问诊,3)慢性病问诊,4)心理社会问题问诊,以及5)行为改变问诊。
研讨会在轮转开始时举行,并采用主动学习技巧。评估包括学生对研讨会及教师的看法,以及学生在临床技能考核(CPX)中的表现。
学生对研讨会的实用性以及研讨会领导者的教学行为评价良好。CPX检查表得分显示,学生能够完成每项典型问诊所期望的大部分行为。在描述他们在CPX病例中试图完成的任务时,学生将近一半的时间列出了恰当的问诊任务。学生列出具体行为的时间略超过50%。
学生学习了研讨会上呈现的内容,并在CPX中加以应用。学生能够完成大部分行为,但似乎不像教师那样抽象地描述任务。这些结果来自一所医学院的一个班级群体,因此在包括其他学习者的进一步研究证实这些发现之前,其普遍性有限。