Centre for Rheumatic Disease, Department of Immunology, Infection and Inflammation, Glasgow Royal Infirmary, Alexandra Parade, Glasgow G31 2ER, UK.
Rheumatology (Oxford). 2010 Sep;49(9):1756-61. doi: 10.1093/rheumatology/keq166. Epub 2010 Jun 4.
There is a need to improve competence of musculoskeletal system (MSS) examination in medical students and junior doctors. Peer-assisted learning (PAL) is a technique whereby students learn from and with each other. This study aimed to determine whether PAL can be integrated into standard undergraduate medical curricula to improve MSS examination using the gait, arms, legs, spine (GALS) screening tool.
Fifty final-year students (trainers) were trained using GALS for MSS examination while attending a standard clinical medical attachment at Glasgow Royal Infirmary. These students delivered GALS training to a further 159 students (trainees). Pre/post-confidence questionnaire (100-mm visual analogue scale) and written feedback were obtained. Final Objective Structured Clinical Examination (OSCE) scores from an MSS station were compared with a control group of 229 students randomized to other hospitals for the standard MSS training.
Analysis of completed trainer questionnaires (30/50) showed increased confidence in all parts of GALS after training [<47 (19) cf. >88 (12); P < 0.005]. Similarly, confidence in trainees (136/159) who answered the questionnaire increased [<43 (19) cf. >85 (15); P < 0.005]. Written comments highlighted that students would recommend PAL. OSCE results showed 84% (192/229) of students in the control group passed the MSS station, with 87% (139/159) of trainees (P = 0.3) and 100% (50/50) of trainers (P < 0.01).
MSS examination skills are improved by integrating PAL into the undergraduate medical curriculum, with student confidence being increased, and higher OSCE scores.
需要提高医学生和初级医生的肌肉骨骼系统 (MSS) 检查能力。同伴辅助学习 (PAL) 是一种学生相互学习的技术。本研究旨在确定 PAL 是否可以整合到标准的本科医学课程中，以使用步态、手臂、腿部、脊柱 (GALS) 筛查工具来提高 MSS 检查。
50 名即将毕业的学生（培训师）在格拉斯哥皇家医院参加标准临床医疗实习的同时接受 GALS 用于 MSS 检查的培训。这些学生对另外 159 名学生（学员）进行 GALS 培训。在培训前后，使用 100 毫米视觉模拟量表进行信心问卷调查，并获得书面反馈。对 MSS 站的最终客观结构化临床考试 (OSCE) 分数与随机分配到其他医院进行标准 MSS 培训的 229 名学生的对照组进行比较。
对完成的培训师问卷（30/50）进行分析显示，培训后，所有 GALS 部分的信心均有所提高 [<47（19）cf. >88（12）；P < 0.005]。同样，接受问卷调查的学员（136/159）的信心也有所提高 [<43（19）cf. >85（15）；P < 0.005]。书面评论强调，学生将推荐 PAL。OSCE 结果显示，对照组 229 名学生中有 84%（192/229）通过 MSS 站，学员中有 87%（139/159）（P = 0.3），培训师中有 100%（50/50）（P < 0.01）。
将 PAL 整合到本科医学课程中可以提高 MSS 检查技能，同时提高学生的信心和更高的 OSCE 分数。
