Fitch Michael T, Kearns Stephen, Manthey David E
Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Med Teach. 2009 Apr;31(4):342-7. doi: 10.1080/01421590802520964.
Clinical procedures taught in the undergraduate medical curriculum are important for subsequent residency training and clinical practice. Published reports suggest that medical schools may not be adequately teaching procedures. This study identifies procedures considered essential by residents completing internship and by medical school faculty, and determines agreement on their importance for medical student education.
Two hundred and thirty-five physicians (184 new physicians who recently completed internship and 51 medical school teaching faculty) categorized 31 clinical procedures based on the importance for internship. New physicians who had completed internship reported the level of training received in medical school for each procedure.
Survey responses were 76% (faculty) and 70% (new physicians who had completed internship). The faculty majority identified 14 procedures as 'Must Know.' New physicians disagreed on 8 of these and categorized an additional 5 as essential. There was 32% concordance for the 19 procedures identified by either group. New physicians reported 'Limited Hands-On Training' for all 19 procedures but 'Comprehensive Hands-On Training' for only two.
New physicians who have completed internship and medical school faculty do not agree on procedures essential for internship. A core educational list of 19 procedures was identified using the responses from these two groups.
本科医学课程中教授的临床操作对后续的住院医师培训和临床实践很重要。已发表的报告表明医学院校可能未充分教授临床操作。本研究确定了完成实习的住院医师和医学院教师认为必不可少的操作，并确定了他们对医学生教育重要性的共识。
235名医生（184名最近完成实习的新医生和51名医学院教师）根据对实习的重要性对31项临床操作进行分类。完成实习的新医生报告了医学院针对每项操作提供的培训水平。
调查回复率为76%（教师）和70%（完成实习的新医生）。大多数教师将14项操作确定为“必须掌握”。新医生对其中8项操作存在分歧，并将另外5项操作归类为必不可少。两组确定的19项操作的一致性为32%。新医生报告对所有19项操作都“实践培训有限”，但仅对两项操作有“全面的实践培训”。
完成实习的新医生和医学院教师对实习必不可少的操作没有达成共识。利用这两组的回复确定了一份包含19项操作的核心教育清单。
