Hoellein Andrew R, Griffith Charles H, Lineberry Michelle J, Wilson John F, Haist Steven A
Department of Internal Medicine, University of Kentucky, Lexington, USA.
Altern Ther Health Med. 2009 Nov-Dec;15(6):30-4.
OBJECTIVES: As the use of complementary and alternative medicine (CAM) has increased in the general population, so has the interest in CAM education among medical students and medical educators. The purpose of this study is to determine the impact of a CAM workshop using standardized patients (SP) on knowledge and clinical skills of third-year medical students. DESIGN: A 4-hour CAM workshop was developed as part of a new curriculum for a required third-year 4-week primary care internal medicine clerkship. The CAM workshop and 3 other novel workshops were randomized for delivery to half of the rotational groups. The CAM workshop incorporates 4 SP cases representing different clinical challenges. All students in every rotation group are assigned CAM readings. At the end of the rotation, all students take a 100-item written exam (7 CAM items) and 9-station SP exam (1 CAM station) including a post-SP encounter open-ended written exercise. Scores on the written exam CAM items, CAM SP checklist, and CAM open-ended written exercise of workshop participants and nonparticipants were analyzed with simple means, standard deviations, and multiple regression approaches. RESULTS: The CAM workshop was delivered to 12 of the 24 rotation groups during the 2004-2005 and 2005-2006 academic years. Ninety-two students participated in the workshop, and 94 did not. Workshop participants performed significantly better than nonparticipants on the CAM-specific SP checklist items (58 vs 36.6%, P<.0001), post-SP encounter written exercise (76.9 vs 63.3%, P<.0001), and 7 CAM written exam items (84.8 vs 76.3%, P<.0001). CONCLUSIONS: Students participating in a 4-hour SP workshop exhibit superior CAM knowledge as assessed by SP checklist, open-ended exercises, and multiple choice items. It appears that practice with SPs assists in acqusition and application of CAM knowledge and deferential counseling skills.
目的:随着补充和替代医学(CAM)在普通人群中的使用增加,医学生和医学教育工作者对CAM教育的兴趣也在增加。本研究的目的是确定使用标准化病人(SP)的CAM工作坊对三年级医学生知识和临床技能的影响。 设计:一个4小时的CAM工作坊被开发出来,作为三年级为期4周的内科初级保健实习新课程的一部分。该CAM工作坊和其他3个新颖的工作坊被随机分配给一半的轮转小组。CAM工作坊包含4个代表不同临床挑战的SP病例。每个轮转小组的所有学生都被分配了CAM阅读材料。在轮转结束时,所有学生都要参加一场100道题的笔试(7道CAM题目)和一场9站的SP考试(1个CAM站),包括SP问诊后的开放式书面练习。使用简单均值、标准差和多元回归方法分析工作坊参与者和非参与者在笔试CAM题目、CAM SP检查表和CAM开放式书面练习上的得分。 结果:在2004 - 2005年和2005 - 2006学年,24个轮转小组中有12个接受了CAM工作坊。92名学生参加了工作坊,94名学生未参加。在特定于CAM的SP检查表项目上(58%对36.6%,P <.0001)、SP问诊后书面练习上(76.9%对63.3%,P <.0001)以及7道CAM笔试题目上(84.8%对76.3%,P <.0001),工作坊参与者的表现显著优于非参与者。 结论:通过SP检查表、开放式练习和多项选择题评估,参加4小时SP工作坊的学生表现出更卓越的CAM知识。与标准化病人的实践似乎有助于获取和应用CAM知识以及尊重性咨询技能。
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