Nango Eishu, Tanaka Yujiro
Department of General Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
J Med Dent Sci. 2010 Mar;57(1):109-18.
The effect of multidisciplinary education on clinical decision making by medical students is not well known.
Twenty of fourth, fifth or sixth year medical students were randomly assigned to multidisciplinary groups (MultiG, n = 7) with two medical, pharmacy and nursing students or medical student groups (MedG, n = 10) with six medical students only and given a two-day PBL program using evidence-based medicine (EBM) methodology. The main outcome measure is clinical decision making by medical students for the case, measured by a 100 mm visual analog scale (VAS). Additional patient information requested and self-evaluation of the PBL program were also measured.
Correct answers to assess clinical epidemiology knowledge increased significantly in both groups (4.1 to 9.9 points in MultiG, p < 0.001: 3.6 to 9.7 points in MedG, p = 0.002), while scores at baseline and post-program were not significantly different. The number of additional patient information cards requested was not significantly different (p = 0.10). After the program, the VAS for clinical decision making was significantly different (54 mm and 89 mm, p = 0.013), although preprogram values for both groups were similar.
Pharmacy and nursing students may have potential to change the clinical decision making by medical students.
多学科教育对医学生临床决策的影响尚不明确。
将20名四、五或六年级医学生随机分为多学科组（MultiG，n = 7），每组有两名医学、药学和护理专业学生，或医学专业学生组（MedG，n = 10），每组仅六名医学专业学生，并为他们提供为期两天的基于循证医学（EBM）方法的问题导向学习（PBL）课程。主要观察指标是医学生针对该病例的临床决策，通过100毫米视觉模拟量表（VAS）进行测量。还测量了额外询问的患者信息以及对PBL课程的自我评估。
两组评估临床流行病学知识的正确答案均显著增加（MultiG组从4.1分提高到9.9分，p < 0.001；MedG组从3.6分提高到9.7分，p = 0.002），而基线和课程后的分数无显著差异。额外询问的患者信息卡数量无显著差异（p = 0.10）。课程结束后，临床决策的VAS有显著差异（54毫米和89毫米，p = 0.013），尽管两组课程前的值相似。
药学和护理专业学生可能有改变医学生临床决策的潜力。
