Department of Neurology and Neurosurgery, Department of Medicine, Centre for Medical Education, McGill University, Montréal, Quebec, Canada.
Can J Neurol Sci. 2012 Jan;39(1):83-6. doi: 10.1017/s0317167100012749.
Determine if distributed practice of of neurological exam (NE) skills in first year medical school produces sustained improvements in the skills of second year students.
A prospective, controlled, non-blinded study conducted at McGill University (class size = 180 students). Expanded teaching of muscle stretch reflexes was provided to first year medical students. A structured examination of muscle stretch reflexes (max score = 100) was administered in second year medical school after a required two week rotation in Neurology. Results for class A (received the intervention in first year) were compared to the results for the preceding class B (had not received the intervention).
77 of 177 (44%) eligible in class A and 69 of 166 (42%) eligible students in class B participated. Results were analyzed separately for each of the two examiners. Mean (SD) scores were 95.2 (5.6) for class A (intervention) and 81.7 (11.1) for class B (control) for the first examiner and 90.4 (8.2) for class A and 83.8 (11.7) for class B for the second examiner. Results were statistically significant (Mann-Whitney test z = 5.27, p<0.0001 first examiner and z = 2.67, p<0.0038 second examiner).
Distributed practice of muscle stretch reflexes during first year medical school results in improved performance by second year medical students after their mandatory clinical rotation in neurology, even when examined up to 14 months after the intervention. This finding has implications for the teaching of the NE.
确定在医学生第一年中进行神经检查（NE）技能的分布式实践是否会持续提高第二年学生的技能。
在麦吉尔大学（班级规模= 180 名学生）进行了一项前瞻性、对照、非盲研究。为第一年医学生提供了肌肉拉伸反射的扩展教学。在神经科必修两周轮转后，在第二年医学院进行了结构化的肌肉拉伸反射检查（满分为 100 分）。结果与前一班 B（未接受干预）进行了比较。
在 A 班（在第一年接受了干预）中，有 77 名/177 名（44%）符合条件的学生和 B 班（未接受干预）中 69 名/166 名（42%）符合条件的学生参加了考试。分别分析了两位考官的考试结果。对于第一位考官，A 班（干预）的平均（SD）分数为 95.2（5.6），B 班（对照）的平均分数为 81.7（11.1）；对于第二位考官，A 班的平均分数为 90.4（8.2），B 班的平均分数为 83.8（11.7）。结果具有统计学意义（Mann-Whitney 检验 z = 5.27，p <0.0001 位考官和 z = 2.67，p <0.0038 第二位考官）。
在医学生第一年中进行肌肉拉伸反射的分布式实践，在他们强制性的神经科临床轮转后，会提高第二年医学生的表现，即使在干预后长达 14 个月进行检查也是如此。这一发现对 NE 的教学有影响。
