Barrett Susan V, Zapka Jane G, Mazor Kathleen M, Luckmann Roger S
Office of Medical Evaluation, Division of Research and Evaluation, University of Massachusetts Medical School, Worcester 01655, USA.
Acad Med. 2002 Sep;77(9):905-10. doi: 10.1097/00001888-200209000-00022.
This study assesses the relationship between students' confidence and competency in breast screening practices, compares different measurement approaches to these competencies, and assesses the effect on clinical breast examination (CBE) performance of an additional training session with a standardized patient.
In the spring of 1998, 96 third-year medical students (47 men and 49 women) at the University of Massachusetts Medical School completed knowledge items on breast cancer epidemiology and on perceived confidence in their counseling and CBE skills. The students were also rated on their performances of counseling and CBE skills.
Higher levels of confidence in mammography counseling skills and higher interview skills scores were associated with higher mammography counseling scores. Confidence levels in performing CBE, however, were not related to the actual performances of CBE. Students' knowledge of breast cancer was modestly related to their CBE scores. Finally, the students with one extra training session with a standardized patient performed significantly better on the CBE.
It is important to directly measure students' breast cancer screening and physical examination skills because students' reported self-confidence for some skills might not accurately reflect their actual levels of performance. Additionally, while knowledge may be an important step to acquiring skills, knowledge may not be a good indicator of students' performances of risk assessment, counseling, or physical examination. Although confidence in counseling was related to counseling performance, the stability of this perception and how that translates into future cancer-control practices remain in question.
本研究评估学生在乳腺筛查实践中的信心与能力之间的关系，比较这些能力的不同测量方法，并评估与标准化患者进行额外培训课程对临床乳腺检查（CBE）表现的影响。
1998年春季，马萨诸塞大学医学院的96名三年级医学生（47名男性和49名女性）完成了关于乳腺癌流行病学以及对其咨询和CBE技能的感知信心的知识项目。学生们的咨询和CBE技能表现也得到了评分。
对乳腺X线摄影咨询技能的更高信心水平和更高的访谈技能得分与更高的乳腺X线摄影咨询得分相关。然而，进行CBE的信心水平与CBE的实际表现无关。学生对乳腺癌的知识与他们的CBE得分有适度的相关性。最后，与标准化患者进行了一次额外培训课程的学生在CBE上表现得明显更好。
直接测量学生的乳腺癌筛查和体格检查技能很重要，因为学生报告的某些技能的自信心可能无法准确反映他们的实际表现水平。此外，虽然知识可能是获得技能的重要一步，但知识可能不是学生风险评估、咨询或体格检查表现的良好指标。虽然咨询方面的信心与咨询表现相关，但这种认知的稳定性以及它如何转化为未来的癌症控制实践仍存在疑问。
