多中心泌尿妇科教育研究：教育成果与临床实习中心特征之间的关联
The multicenter urogynecology study on education: associations between educational outcomes and clerkship center characteristics.
作者信息
Smith Tovia Martirosian, Trowbridge Elisa R, Pastore Lisa M, Smith Steven C, Brennan Matthew C, Dooley Yashika, Matthews Catherine A, Ozel Begum, Sutkin Gary, Hullfish Kathie L
机构信息
From the *Obstetrics and Gynecology, †Urology, University of Virginia, Charlottesville, VA; ‡Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM; §Obstetrics and Gynecology, Brooke Army Medical Center, San Antonio, TX; ∥Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC; ¶Obstetrics and Gynecology, University of Southern California, Los Angeles, CA; and #Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA.
出版信息
Female Pelvic Med Reconstr Surg. 2011 May;17(3):134-8. doi: 10.1097/SPV.0b013e31821cf2b3.
OBJECTIVE
: The objective of the study was to examine the effect of center characteristics on educational experiences and female pelvic medicine knowledge changes in third-year students at 6 medical schools.
METHODS
: In this secondary analysis of data acquired during a prospective, multicenter study conducted from May 2008 through June 2009, preclerkship and postclerkship third-year medical students scored their knowledge of 12 female pelvic medicine topics and 4 office procedures (knowledge scores [KSs]). Postclerkship, students also reported the number and type of learning experiences they had encountered. Participating investigators provided data on length of clerkship, number of residents, number of fellowship-trained urogynecologists, presence of a fellowship program, clerkship grading system type, presence of a urogynecology clerkship rotation, and presence of a urogynecology lecture. Analyses used Wilcoxon tests/Spearman correlation, with an α = 0.05.
RESULTS
: Paired preclerkship and postclerkship survey data were available for 323 students. Increased numbers of learning experiences were positively associated with number of clerkship weeks (rs = 0.22, P < 0.001), presence of a urogynecology rotation (P = 0.03), and urogynecology lecture (P < 0.001). Knowledge scores were positively associated with the number of fellowship-trained urogynecology faculty (rs = 0.17, P = 0.002) and grading system (letter grades > pass/fail) (P < 0.001). Knowledge scores were negatively associated with increasing numbers of residents (rs = -0.29, P < 0.001) and presence of a urogynecology fellowship program (P < 0.001). The center characteristics of fellowship program and number of residents were highly correlated (rs = 0.74, P < 0.001); thus, multivariate modeling was not performed.
CONCLUSIONS
: The presence of fellowship-trained faculty, urogynecology rotation, longer duration of clerkship, and urogynecology lecture were positively correlated with higher subjective KSs. The inverse association of KS with increased resident number and presence of fellowship was an unexpected finding.
目的
本研究的目的是检验6所医学院校的中心特征对三年级学生教育经历及女性盆底医学知识变化的影响。
方法
在对2008年5月至2009年6月进行的一项前瞻性多中心研究期间获取的数据进行的二次分析中，临床实习前和临床实习后的三年级医学生对12个女性盆底医学主题和4种门诊操作的知识进行了评分（知识得分[KSs]）。临床实习后，学生们还报告了他们遇到的学习经历的数量和类型。参与研究的调查人员提供了关于临床实习时长、住院医师数量、接受过专科培训的女性盆底病学专家数量、是否存在专科培训项目、临床实习评分系统类型、是否存在女性盆底病学临床实习轮转以及是否存在女性盆底病学讲座的数据。分析采用Wilcoxon检验/ Spearman相关性分析，α = 0.05。
结果
有323名学生提供了临床实习前和临床实习后的配对调查数据。学习经历数量的增加与临床实习周数（rs = 0.22，P < 0.001）、女性盆底病学轮转的存在（P = 0.03）以及女性盆底病学讲座的存在（P < 0.001）呈正相关。知识得分与接受过专科培训的女性盆底病学教员数量（rs = 0.17，P = 0.002）和评分系统（字母评分>通过/不及格）（P < 0.001）呈正相关。知识得分与住院医师数量的增加（rs = -0.29，P < 0.001）和女性盆底病学专科培训项目的存在（P < 0.001）呈负相关。专科培训项目和住院医师数量的中心特征高度相关（rs = 0.74，P < 0.001）；因此，未进行多变量建模。
结论
接受过专科培训的教员的存在、女性盆底病学轮转、较长的临床实习时长以及女性盆底病学讲座与较高的主观KSs呈正相关。KS与住院医师数量增加和专科培训存在的负相关是一个意外发现。
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