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医学专业最后一年学生对直肠指检的经验与态度

Experience and attitudes of final-year medical students to digital rectal examination.

作者信息

Lawrentschuk Nathan, Bolton Damien M

机构信息

Department of Surgery and Urology, University of Melbourne, Austin Hospital, Studley Rd, Heidelberg, Victoria 3084, Australia.

出版信息

Med J Aust. 2004 Sep 20;181(6):323-5. doi: 10.5694/j.1326-5377.2004.tb06299.x.

Abstract

OBJECTIVE

To assess the attitudes of final-year medical students to digital rectal examination (DRE) and their experience of performing DRE during clinical training.

DESIGN

Questionnaire-based survey.

SETTING AND PARTICIPANTS

All students in the final year of medical school at the University of Melbourne in 2003.

OUTCOME MEASURES

Agreement with statements about attitude to DRE; number of DREs performed and abnormalities palpated; and ratings of frequency of supervision and perceived barriers to performing DRE.

RESULTS

222 of 256 students (87%) responded. Almost all (97%) believed that DRE is an essential requirement for a medical practitioner, and 94% that they should have the skill before graduating, while 92% said they had been taught how to perform it. The median number of DREs performed was two, with 17% of students performing none. Sixty-three per cent had palpated a prostate, 24% a prostate cancer, 19% a rectal tumour, and 11% faecal constipation. Half the students (52%) felt they could give a reasonable or confident opinion based on their DRE findings. The most often cited reason for not performing DREs was the lack of a doctor to act as a supervisor.

CONCLUSIONS

A concerted effort is needed from academics, supervising doctors and students to improve medical students' proficiency in performing DRE and confidence about their findings.

摘要

目的

评估医学专业最后一年学生对直肠指检(DRE)的态度以及他们在临床培训期间进行直肠指检的经验。

设计

基于问卷的调查。

地点和参与者

2003年墨尔本大学医学院最后一年的所有学生。

观察指标

对直肠指检态度相关陈述的认同度;进行直肠指检的次数及触及异常情况;监督频率及进行直肠指检时感知到的障碍的评分。

结果

256名学生中有222名(87%)做出回应。几乎所有学生(97%)认为直肠指检是医生的一项基本要求,94%的学生认为他们在毕业前应掌握此项技能,而92%的学生表示他们已接受过如何进行直肠指检的教导。进行直肠指检的中位数次数为2次,17%的学生未进行过。63%的学生触及过前列腺,24%触及过前列腺癌,19%触及过直肠肿瘤,11%触及过粪便嵌塞。一半的学生(52%)觉得他们能根据直肠指检结果给出合理或自信的意见。最常被提及的未进行直肠指检的原因是缺乏带教医生。

结论

学者、带教医生和学生需要共同努力,以提高医学生进行直肠指检的熟练程度及其对检查结果的信心。

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