Larios Mendoza Heriberto, Trejo Mejía Juan Andrés, Gaviño Ambriz Salvador, Cortés Gutiérrez Ma Teresa
Facultad de Medicina, UNAM, Departamento de Internado de la Secretaría de Enseñanza Clínica, Internado y Servicio Social (SECISS).
Ginecol Obstet Mex. 2002 Nov;70:558-65.
Assess the clinical competence in Gynecology and obstetrics to the Internship students of the Faculty of Medicine, UNAM.
The study design was descriptive, transverse type. We assessed 64 students, which had finished their gynecology field rotation with the objective structured clinical examination. The criteria to consider a competent performance level, was arbitrarily set up in 60%, both for individual problems and for the exam's global result.
In 15 stations, the result was a 56.2 global average. The best performances were achieved in the following stations: take the pap smear (74.7), Pregnancy diagnostic (67.9), history of Gynecology and obstetrics (67.1), self examination of breast explanation (62.2) preclampsia (61.7) and cervicovaginitis (60). All the rest got a mark lower than 60.
The results are lower than the ones obtained in written exams, because these cannot assess clinical skills. It could be observed that a student's performance in a clinical problem does not certainly predict his performance in other, so it seems to be determined more by the specific knowledge and the student's experience related to the case, than by a general problem-solving skill.
The results show the advantages of this instrument to assess clinical skills, that justify its application in the formative process. This work evidences that its necessary to improve the acquisition of basic clinical skills trough systematic instructionals strategies and greater opportunities of learning.
评估墨西哥国立自治大学医学院实习学生在妇产科方面的临床能力。
研究设计为描述性横断面研究。我们对64名完成妇产科临床轮转的学生进行了客观结构化临床考试评估。对于个人问题和考试整体结果,将达到合格表现水平的标准任意设定为60%。
在15个考站中,整体平均成绩为56.2分。在以下考站取得了最佳成绩:进行巴氏涂片检查(74.7分)、妊娠诊断(67.9分)、妇产科病史(67.1分)、乳房自我检查讲解(62.2分)、先兆子痫(61.7分)和宫颈阴道炎(60分)。其余所有考站的成绩均低于60分。
结果低于笔试成绩,因为笔试无法评估临床技能。可以观察到,学生在一个临床问题上的表现并不能肯定地预测他在其他问题上的表现,所以似乎更多地是由与该病例相关的特定知识和学生的经验决定,而不是由一般的解决问题能力决定。
结果显示了该评估临床技能工具的优势,证明了其在形成性过程中的应用价值。这项工作表明,有必要通过系统的教学策略和更多的学习机会来提高基本临床技能的掌握。