Peyre Sarah E, Peyre Christian G, Sullivan Maura E, Towfigh Shirin
Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA 90089-9202, USA.
J Surg Res. 2006 Jun 1;133(1):11-5. doi: 10.1016/j.jss.2006.02.022. Epub 2006 Mar 31.
A focused surgical resident readiness curriculum for senior medical students can improve confidence in surgical skills compared to current surgical interns.
A 3-week surgical skills lab elective enrolled senior medical students applying to surgical residency programs, with the purpose of improving surgical skills and easing anxiety prior to surgical internship. Students were surveyed before and after the elective regarding their confidence in performing 21 skills covered by the curriculum. A similar confidence survey was administered to the incoming surgical intern class. Interns were also surveyed regarding prior skills lab instruction during medical school. Statistical analyses included Student's paired t-test and two-way analysis of variance.
Six medical students and 23 interns were surveyed. All medical students significantly improved their confidence by the end of the resident readiness curriculum (P = 0.0004). Although students initially had lower confidence than surgical interns in performing surgical skills and in their knowledge of anatomy prior to the course, their confidence after the course was significantly higher than that of the incoming surgical interns (P = 0.035). Surgical interns with prior skills lab experience in their medical school reported higher confidence than those who did not have a skills lab experience (P = 0.019). Among all subgroups, medical students with skills lab experience had the highest confidence score, followed by interns with previous skills lab experience, then by interns with no previous skills lab experience, and last, by medical student with no skills lab experience.
Surgical interns often feel unprepared to perform skills necessary for residency. A focused skills lab elective during medical school can bridge the gap and improve confidence prior to internship.
与当前的外科实习医生相比，针对高年级医学生的重点外科住院医师准备课程可以提高他们对外科技能的信心。
一个为期3周的外科技能实验室选修课招收了申请外科住院医师项目的高年级医学生，目的是提高外科技能并缓解外科实习前的焦虑情绪。在选修课前后对学生进行了调查，询问他们对课程涵盖的21项技能操作的信心。对即将入学的外科实习班级进行了类似的信心调查。还对外科实习医生在医学院期间接受的先前技能实验室指导进行了调查。统计分析包括学生配对t检验和双向方差分析。
对6名医学生和23名实习医生进行了调查。所有医学生在住院医师准备课程结束时信心都有显著提高（P = 0.0004）。尽管学生在课程开始前在外科技能操作和解剖学知识方面最初的信心低于外科实习医生，但课程结束后他们的信心显著高于即将入学的外科实习医生（P = 0.035）。在医学院有过技能实验室经验的外科实习医生报告的信心高于没有技能实验室经验的实习医生（P = 0.019）。在所有亚组中，有技能实验室经验的医学生信心得分最高，其次是有先前技能实验室经验的实习医生，然后是没有先前技能实验室经验的实习医生，最后是没有技能实验室经验的医学生。
外科实习医生常常觉得自己没有做好准备去执行住院医师所需的技能。医学院期间的重点技能实验室选修课可以弥合差距并提高实习前的信心。
