Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Teach Learn Med. 2012;24(4):298-302. doi: 10.1080/10401334.2012.715263.
Largely due to regulatory requirements, medical students increasingly document patient encounters in logs. Prior studies demonstrated value in achieving course objectives but not regarding objective learning outcomes.
The purpose of this article is to assess the associations between students' log data and clerkship outcomes.
We assessed ambulatory, internal medicine-pediatrics clerkship logs. Students recorded patients' diagnoses, preceptor's teaching content and performing histories and physicals (H&P). We examined associations between log data and National Board of Medical Examiners Subject Exams (NBME), Objective Structured Clinical Exams (OSCE), and clinical evaluations.
All 272 students completed logs (M diagnoses = 146.5, SD = 24.9). In univariate analysis number of diagnoses, preceptors' teaching patient management and performing H&P independently correlated with OSCE scores (r = .13-.24, p < .05). NBME scores correlated with diagnoses, performing H&P independently (r = .13-.18, p < .05). Teaching patient management, diagnoses, performing H&P independently were associated with clinical evaluations (all ps < .05). Regressions demonstrated that performing physicals independently was associated with NBME and OSCE scores (p < .05, R (2) = .03 and .05, respectively). Teaching disease management and pediatric diagnoses were associated with clinical evaluations (p < .05) in medicine and pediatrics, respectively.
Aspects of teaching, increased clinical involvement, and student autonomy were associated with clerkship performance.
由于监管要求,医学生越来越多地在日志中记录患者就诊情况。先前的研究表明,这些日志在实现课程目标方面具有价值,但对客观学习成果的影响不大。
本文旨在评估学生日志数据与实习成绩之间的关系。
我们评估了内科-儿科实习日志。学生记录了患者的诊断、导师的教学内容、进行病史和体检(H&P)的情况。我们考察了日志数据与美国医师执照考试委员会学科考试(NBME)、客观结构化临床考试(OSCE)和临床评估之间的关联。
所有 272 名学生都完成了日志记录(M 诊断数=146.5,SD=24.9)。在单变量分析中,诊断数量、导师教授患者管理和进行 H&P 独立与 OSCE 分数相关(r=0.13-0.24,p<0.05)。NBME 分数与诊断数量、进行 H&P 独立相关(r=0.13-0.18,p<0.05)。导师教授患者管理、诊断数量、进行 H&P 独立与临床评估相关(均 p<0.05)。回归分析表明,进行体检独立与 NBME 和 OSCE 分数相关(p<0.05,R²=0.03 和 0.05)。教授疾病管理和儿科诊断与内科和儿科的临床评估相关(p<0.05)。
教学的各个方面、增加临床参与度和学生自主性与实习表现相关。