Matthews Julia, Kadish William, Barrett Susan V, Mazor Kathleen, Field Deborah, Jonassen Julie
Office of Psychiatric Education and Training, Department of Psychiatry, University of Massachusetts Medical School, Worcester, 01655, USA.
Acad Med. 2002 May;77(5):419-26. doi: 10.1097/00001888-200205000-00017.
To examine the immediate and delayed impact of an intensive one- or two-day interclerkship on substance abuse (SA) for third-year medical students. The program is a response to the problem of inadequacy of substance abuse education in the standard curriculum.
Each year since 1997-98 all third-year students at the University of Massachusetts Medical School have participated in a one- or two-day SA interclerkship to enhance their knowledge and competence with SA assessment and brief intervention. Students' knowledge, attitudes, and confidence were assessed immediately before and after the interclerkship. In addition, during 1998-99, each student's clinical skills in SA assessment and intervention were evaluated at the completion of the student's six-week psychiatry clerkship using objective standardized clinical examinations (OSCEs) with two simulated patients, one with and one without active SA issues. Students who took the psychiatry clerkship in the first half of the year had not yet participated in the interclerkship. Students' pooled performances before and after the interclerkship were compared.
Students' attitudes toward and knowledge about SA disorders and their confidence about SA assessment and intervention all showed significant positive changes immediately after the interclerkship. The OSCE performance data demonstrated a significant sustained improvement in clinical skills in SA assessment and intervention as measured up to six months following the interclerkship.
These data suggest that brief intensive training in SA during the clinical years of medical school can have a positive and lasting impact on students' clinical performances.
研究为期一天或两天的强化临床实习对三年级医学生药物滥用问题的即时和延迟影响。该项目是对标准课程中药物滥用教育不足问题的回应。
自1997 - 1998年起，马萨诸塞大学医学院的所有三年级学生每年都参加为期一天或两天的药物滥用临床实习，以增强他们在药物滥用评估和简短干预方面的知识和能力。在临床实习前后立即对学生的知识、态度和信心进行评估。此外，在1998 - 1999年期间，在学生完成为期六周的精神病学临床实习时，使用客观标准化临床考试（OSCE）对两名模拟患者（一名有药物滥用问题，一名没有）评估每个学生在药物滥用评估和干预方面的临床技能。上半年参加精神病学临床实习的学生尚未参加该临床实习。比较了学生在临床实习前后的综合表现。
学生对药物滥用障碍的态度和知识以及他们对药物滥用评估和干预的信心在临床实习后立即都有显著的积极变化。OSCE表现数据表明，在临床实习后长达六个月的时间里，药物滥用评估和干预方面的临床技能有显著的持续提高。
这些数据表明，医学院临床阶段对药物滥用进行简短强化培训可以对学生的临床表现产生积极且持久的影响。
