Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD 20814, USA.
Med Educ. 2012 Jul;46(7):689-97. doi: 10.1111/j.1365-2923.2012.04283.x.
This study was conducted to assess the associations between several clerkship process measures and students' clinical and examination performance in an internal medicine clerkship.
We collected data from the internal medicine clerkship at one institution over a 3-year period (classes of 2010-2012; n = 507) and conducted correlation and multiple regression analyses. We examined the associations between clerkship process measures (student-reported number of patients evaluated, percentage of core problems encountered, total number of core problems encountered, total number of clinics attended) and four clerkship outcomes (clinical points [a weighted summation of a student's clinical grade recommendations], ambulatory clinical points [the out-patient portion of clinical points], examination points [a weighted summation of scores on three clerkship examinations], and National Board of Medical Examiners examination score).
After controlling for pre-clerkship ability and gender, percentage of core problems was significantly associated with ambulatory clinical points (b = 3.84, total model R(2) = 0.14). Further, number of patients evaluated was significantly associated with clinical points (b = 0.19, total model R(2) = 0.22), but only for students who undertook first-quarter clerkships, who reported higher numbers of patients.
Notwithstanding a few positive (but small) associations, the results from this study suggest that clinical exposure is, at best, weakly associated with internal medicine clerkship performance.
本研究旨在评估内科实习过程中的几个指标与学生临床和考试表现之间的关系。
我们在三年内(2010-2012 年)从一个机构的内科实习中收集数据,并进行了相关和多元回归分析。我们考察了实习过程指标(学生报告评估的患者数量、遇到的核心问题的百分比、遇到的核心问题总数、参加的诊所总数)与四个实习结果(临床分数[学生临床成绩推荐的加权总和]、门诊临床分数[临床分数的门诊部分]、考试分数[三门实习考试得分的加权总和]和全国医师考试委员会考试分数)之间的关系。
在控制实习前能力和性别后,核心问题的百分比与门诊临床分数显著相关(b=3.84,总模型 R²=0.14)。此外,评估的患者数量与临床分数显著相关(b=0.19,总模型 R²=0.22),但仅适用于报告评估更多患者的第一季度实习学生。
尽管有一些积极的(但很小)关联,但本研究的结果表明,临床暴露与内科实习表现的相关性很弱。