Liddell Merilyn J, Davidson Sandra K, Taub Henry, Whitecross Lyndall E
Department of General Practice, Monash University, Victoria, Australia.
Med Educ. 2002 Nov;36(11):1035-41. doi: 10.1046/j.1365-2923.2002.01306.x.
A substantial proportion of medical students enter their intern year without any basic skills experience. Lack of experience is a significant source of stress for many junior doctors.
To evaluate the effect of a basic procedural skills tutorial for Year 3 medical students on their competence in relevant skills at Year 5.
The control group consisted of 93 medical students who completed Year 3 in 1996. The intervention group consisted of 92 medical students who completed Year 3 in 1997. The intervention group received a practical skills tutorial in Year 3; the control group did not. Both groups were assessed on their practical skills competence during Year 5.
A 3-hour practical tutorial on injection and suturing techniques was delivered to the intervention group. The effectiveness of the intervention was assessed by self-reported experience of giving injections, inserting sutures and sustaining needlestick injuries, and by teacher-rated competency in four basic procedural skills.
Students who received the Year 3 tutorial were significantly more likely to record a satisfactory assessment for their performance in all four basic skills compared with students who did not receive the tutorial. They were less likely than controls to refuse invitations to give injections, but not invitations to insert a suture, during Years 4 and 5.
A single session of formalised teaching in procedural skills in the early stages of a medical degree can have long-term effectiveness in basic skills competence and may increase students' confidence to practise their skills.
相当一部分医学生在进入实习年时没有任何基本技能经验。缺乏经验是许多初级医生压力的重要来源。
评估为三年级医学生开展的基本操作技能教程对其在五年级时相关技能能力的影响。
对照组由93名在1996年完成三年级学业的医学生组成。干预组由92名在1997年完成三年级学业的医学生组成。干预组在三年级时接受了实践技能教程;对照组未接受。两组在五年级时均接受了实践技能能力评估。
为干预组提供了一个为期3小时的关于注射和缝合技术的实践教程。通过自我报告的注射、缝合和遭受针刺伤的经历,以及教师对四项基本操作技能的评分来评估干预的效果。
与未接受教程的学生相比,接受三年级教程的学生在所有四项基本技能方面更有可能对自己的表现给出满意的评价。在四年级和五年级期间,他们比对照组更不太可能拒绝注射邀请,但在缝合邀请方面并非如此。
在医学学位早期阶段进行一次关于操作技能的正规教学可以在基本技能能力方面产生长期效果,并可能增强学生实践技能的信心。