Dutta S, Wales P W, Fecteau A
Department of General Pediatric Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr Surg. 2004 May;39(5):717-20. doi: 10.1016/j.jpedsurg.2004.01.041.
With increasing medical school emphasis on generalist training and decreasing enrollment in surgical residency, the authors assessed the adequacy of a 2-week pediatric surgery rotation on meeting the learning and competency objectives outlined in The Canadian Association of Pediatric Surgeons' Self-Directed Evaluation Tool.
A prospective survey was conducted of 39 clinical clerks. An anonymous self-assessment scale measuring competency objectives (medical and psychosocial) was administered pre-and postrotation. Also, exposure to pediatric surgical conditions from a list of "essential" and "nonessential" learning objectives was measured. Statistical analysis was performed using paired t test with significance at.05 level.
Response rate was 77% and 54% for the competency and learning objectives, respectively. Students reported improvement in medical (P <.00001; 95% CI, 1.30, 1.90) and psychosocial (P =.00036; 95% CI 0.64, 1.28) competency objectives after the rotation. Almost all "essential" learning objectives were met. Overall, students reported an increased awareness of the breadth of pediatric surgical practice (P <.0001; 95% CI 2.06, 3.18).
A 2-week rotation in pediatric surgery appears adequate in fulfilling most competency and learning objectives, but discussion is needed about how to best assess student competency, which topics are considered essential, and the long-term effect on recruitment to the profession.
随着医学院校越来越重视全科医生培训,以及外科住院医师招生人数的减少,作者评估了为期2周的儿科外科轮转是否足以实现加拿大儿科外科医生协会自我评估工具中列出的学习和能力目标。
对39名临床实习生进行了一项前瞻性调查。在轮转前后使用一个衡量能力目标(医学和社会心理方面)的匿名自我评估量表。此外,还对学生接触“基本”和“非基本”学习目标清单中儿科外科病症的情况进行了评估。采用配对t检验进行统计分析,显著性水平为0.05。
能力目标和学习目标的回复率分别为77%和54%。学生报告称,轮转后医学能力目标(P <.00001;95%置信区间,1.30,1.90)和社会心理能力目标(P =.00036;95%置信区间0.64,1.28)均有所提高。几乎所有“基本”学习目标都得以实现。总体而言,学生报告称对儿科外科实践广度的认识有所提高(P <.0001;95%置信区间2.06,3.18)。
为期2周的儿科外科轮转似乎足以实现大多数能力和学习目标,但需要讨论如何最好地评估学生能力、哪些主题被视为基本内容以及对该专业招生的长期影响。