Sandquist Mary K, Way David P, Patterson Anna F, Caniano Donna A, Arnold Mark W, Nwomeh Benedict C
The Ohio State University, Columbus, OH 43205, USA.
J Surg Res. 2009 May 1;153(1):152-5. doi: 10.1016/j.jss.2008.03.028. Epub 2008 Apr 22.
The most common 3rd-year surgery clerkship uses general surgery services while limiting the involvement of subspecialty services. A novel surgery clerkship in which students were assigned to either general surgery or subspecialty services for the entire clerkship was tried at a large Midwestern medical school. The purpose of this study was to investigate the outcomes of clerks from subspecialty services and compare them with clerks from general surgery services.
Outcome measures included scores on the National Board of Medical Examiners Surgery Content Examination, faculty evaluation scores, and residency match results. A multivariate analysis of covariance compared National Board of Medical Examiners test scores and faculty evaluation ratings across service groups. United States Medical Licensing Examination Step 1 scores served as a covariate.
Results showed significant differences between groups on faculty evaluation scores (F = 28.03; P <or= 0.001), while controlling for initial differences in academic performance. However, no differences were observed on examination score (F = 2.32, ns), or residency match results (chi(2) = 2.05, ns).
These findings inform surgical educators to consider a more prominent role of subspecialty surgery in teaching 3rd-year medical students. However, caution is advised to accommodate the difference in stringency observed between subspecialty and general surgery faculty in rating medical student performance. Faculty development in student evaluation for subspecialty surgical faculty is recommended.
普通外科服务是三年级外科实习中最常见的教学方式，同时限制了专科服务的参与。一所位于美国中西部的大型医学院尝试了一种新型的外科实习模式，即让学生在整个实习期间被分配到普通外科或专科服务科室。本研究的目的是调查专科服务科室实习生的实习成果，并将其与普通外科服务科室的实习生进行比较。
结果指标包括美国医学考试委员会外科内容考试的成绩、教师评价分数和住院医师匹配结果。多变量协方差分析比较了不同服务科室组的美国医学考试委员会测试成绩和教师评价等级。美国医师执照考试第一步的成绩作为协变量。
在控制学术表现的初始差异后，结果显示不同组之间在教师评价分数上存在显著差异（F = 28.03；P≤0.001）。然而，在考试成绩（F = 2.32，无统计学意义）或住院医师匹配结果方面未观察到差异（χ² = 2.05，无统计学意义）。
这些发现促使外科教育工作者考虑专科手术在三年级医学生教学中发挥更突出的作用。然而，建议谨慎对待专科外科教师和普通外科教师在评估医学生表现时所观察到的严格程度差异。建议开展针对专科外科教师学生评估方面的师资培训。
