van der Vlugt Theresa M, Harter Phillip M
Stanford University School of Medicine, Stanford, CA 94304, USA.
Ann Emerg Med. 2002 Jul;40(1):41-9. doi: 10.1067/mem.2002.125613.
We examine the effect of a preclinical emergency procedures course on students' clinical procedural skills and medical knowledge.
This is a retrospective review of evaluation forms for a cohort of 86 students graduating from medical school at an academic center. A cross section of students (n=57) taking a clinical emergency medicine rotation over a 4-year period was also studied. Numeric scores (1 to 9 on a Likert scale) in procedural skills and medical knowledge categories were extracted from evaluations for internal medicine, surgery, obstetrics and gynecology, and emergency medicine rotations. Scores of students who had taken an elective course, Essential Procedures in Emergency Medicine (EPEM), were compared with scores of students who did not take this course. US Medical Licensing Examination Step I scores for both groups were also compared.
Students who took EPEM scored significantly higher in the procedural skills category during the emergency medicine rotation (P =.04) and during both months of the internal medicine rotation (P =.02; P =.02). Students scored on average higher in the surgery and obstetrics and gynecology rotations, but these differences were not statistically significant. Students who took EPEM scored significantly higher in the medical knowledge category for emergency medicine (P =.01; P =.002), both months of internal medicine (P =.03; P =.006), and 1 of 2 months of surgery (P =.01) rotations. Students in obstetrics and gynecology rotations scored higher, although not significantly. US Medical Licensing Examination Step I scores were not different between students taking or not taking EPEM.
Students taking EPEM achieved higher procedural skill and medical knowledge scores in clinical rotations. Emergency medicine is a specialty well suited to study procedures teaching and performance.
我们研究临床前急救程序课程对学生临床操作技能和医学知识的影响。
这是一项对某学术中心医学院86名毕业生评估表的回顾性研究。还对在4年期间参加临床急诊医学轮转的一组学生(n = 57)进行了横断面研究。从内科、外科、妇产科和急诊医学轮转评估中提取操作技能和医学知识类别的数字评分(李克特量表1至9分)。将参加选修课程“急诊医学基本程序”(EPEM)的学生成绩与未参加该课程的学生成绩进行比较。还比较了两组学生的美国医学执照考试第一步成绩。
参加EPEM的学生在急诊医学轮转期间(P = 0.04)以及内科轮转的两个月期间(P = 0.02;P = 0.02),操作技能类别得分显著更高。学生在外科和妇产科轮转中的平均得分更高,但这些差异无统计学意义。参加EPEM的学生在急诊医学(P = 0.01;P = 0.002)、内科的两个月(P = 0.03;P = 0.006)以及外科轮转的两个月中的一个月(P = 0.01)的医学知识类别得分显著更高。妇产科轮转的学生得分更高,尽管不显著。参加或未参加EPEM的学生的美国医学执照考试第一步成绩没有差异。
参加EPEM的学生在临床轮转中获得了更高的操作技能和医学知识分数。急诊医学是一个非常适合学习程序教学和操作的专业。