Mariolis Anargiros, Mihas Constantinos, Alevizos Alevizos, Papathanasiou Marek, Mariolis-Sapsakos Theodoros, Marayiannis Konstantinos, Koutsilieris Michael
Health Center of Vyronas, Greece.
Med Teach. 2008;30(7):e202-7. doi: 10.1080/01421590802208883.
It seems that there is a trend in undergraduate medical education towards including clinical attachments in primary health care (PHC) worldwide. The benefits of such initiatives are already well described. The aim of this study was to evaluate the effect of a clinical attachment in undergraduate medical students in a European country with an odd medical educational system that essentially lacks any kind of academic PHC departments.
The study was undertaken during 2005-2007. A non-mandatory 1-week clinical attachment in PHC/general practice was organized in an urban PHC unit by general practitioners with educational experience in collaboration with the Department of Physiology of the local medical school. The participants were a prospective cohort of medical students in the 2nd year of undergraduate studies. All participating students sat a pre-defined clinical exam which consisted of multiple choice questions, mini case papers and an objective-structured clinical examination before and after the attachment. In addition, the students rated the whole process.
The response ratio was 77.06%. The mean score on objective structured clinical examination of participants increased from 30.70/100 to 62.28/100 (p < 0.001). The students' impression of the study was rather positive (4.39/5).
The educational intervention of including a clinical attachment in an undergraduate curriculum seems to have encouraging results, considering the peculiarity of inexistence of academic departments of PHC or General Practice in the national medical schools and the inexperience of students regarding similar concepts.
在全球范围内,本科医学教育似乎有将临床实习纳入初级卫生保健(PHC)的趋势。此类举措的益处已得到充分描述。本研究的目的是评估在一个医学教育体系奇特且基本没有任何学术性初级卫生保健部门的欧洲国家,本科医学生临床实习的效果。
该研究于2005年至2007年期间进行。在城市初级卫生保健单位,由具有教育经验的全科医生与当地医学院生理学系合作,组织了为期1周的非强制性初级卫生保健/全科临床实习。参与者是本科二年级的医学生前瞻性队列。所有参与学生在实习前后都参加了一次预先定义的临床考试,考试包括多项选择题、小型病例试卷和客观结构化临床考试。此外,学生们对整个过程进行了评分。
回应率为77.06%。参与者客观结构化临床考试的平均成绩从30.70/100提高到62.28/100(p<0.001)。学生对该研究的印象相当积极(4.39/5)。
考虑到该国医学院校不存在初级卫生保健或全科的学术部门这一特殊性以及学生对类似概念缺乏经验,在本科课程中纳入临床实习的教育干预似乎取得了令人鼓舞的成果。