Stain Steven C, Mitchell Marcia, Belue Rhonda, Mosley Vicki, Wherry Shari, Adams Carlton Z, Lomis Kim, Williams Pamela C
Department of Surgery, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Boulevard, Nashville, TN 37205, USA.
Am J Surg. 2005 Jan;189(1):81-4. doi: 10.1016/j.amjsurg.2004.04.012.
A challenge to the practice of third-year clerkship rotations at remote locations is the maintenance of equivalent didactic lectures, especially in subspecialty components. There has been little objective assessment of the results of videoconference lectures on medical student clerkship education.
Third-year surgical clerkship students, randomly assigned to a 4-week rotation 75 miles from the medical school, received subspecialty lectures by interactive teleconference via an ISDN line at 128 kb/s. Weekly quiz results (% correct) of students who received videoconference lectures were compared with students receiving conventional lectures, and were analyzed by 2-tailed t tests for equality of means.
A mean of 12 students were tested per quiz (range, 5-21 students) after videoconference lectures, and 98 students were tested after conventional lectures (range, 41-146 students). The mean quiz score of students receiving video lectures was 70.5% (range, 65.4% to 73.6%); and after conventional lectures the mean quiz score was 71.4% (range, 69.5% to 76.8%). There were no significant differences in the mean scores of the individual quizzes (P = .16-.92) or between the totals (P = .65).
Telemedicine, using interactive videoconferencing, is an effective method for didactic lectures in a surgical clerkship. This technology allows students to receive interactive lectures at distant clinical sites and limit their travel.
在偏远地区进行三年级临床实习轮转面临的一项挑战是如何维持同等水平的理论授课，尤其是在亚专业课程方面。关于视频会议授课对医学生临床实习教育效果的客观评估很少。
三年级外科临床实习学生被随机分配到距离医学院75英里处进行为期4周的轮转，通过综合业务数字网（ISDN）线路以128千比特每秒的速度接受交互式远程会议的亚专业讲座。将接受视频会议授课的学生的每周测验成绩（正确百分比）与接受传统授课的学生进行比较，并通过双尾t检验分析均值是否相等。
视频会议授课后每次测验平均有12名学生参加测试（范围为5 - 21名学生），传统授课后有98名学生参加测试（范围为41 - 146名学生）。接受视频授课的学生的平均测验成绩为70.5%（范围为65.4%至73.6%）；传统授课后平均测验成绩为71.4%（范围为69.5%至76.8%）。各次测验的平均成绩之间（P = 0.16 - 0.92）或总成绩之间（P = 0.65）均无显著差异。
使用交互式视频会议的远程医疗是外科临床实习理论授课的一种有效方法。这项技术使学生能够在偏远临床地点接受交互式讲座并减少出行。
