Mir M A, Saeed A K
Department of Medicine, University of Wales College of Medicine, Cardiff.
J Audiov Media Med. 1990 Jan;13(1):20-4. doi: 10.3109/17453059009055098.
The efficacy of videotapes, recorded in Cardiff, in improving the clinical performance of final-year medical students in Abbottabad (Pakistan) was tested, by carrying out a structured, stepwise, clinical assessment before and after video teaching in 32 students. All students examined eight systems/subsystems at eight stations and spent 5 min with each patient, during which their performance was checked against structured check-lists by eight examiners. These students had not received any clinical instruction from a specialist rheumatologist, neurologist or endocrinologist during their clinical apprenticeship. Before the video teaching they performed poorly when examining the knee joint, motor system, hands and thyroid status, but when tested again 2 days after video teaching, there was a transformation in their clinical behaviour and their mean (s.d.) score improved from 40 (6.6 per cent) to 57.6 (9.4 per cent; P = 0.001). In contrast to their pre-video performance, they interacted well with the patients and examiners providing a running commentary of their findings, as demonstrated in the videotapes. Among the residual problems were a poor technique of testing tendon reflexes and percussion. All the examiners and 21 of 32 students thought that the structured examination was fairer than the conventional examination. Of the 32 students, 20 thought that video teaching was less effective than personal bedside teaching, while 12 students thought that video was structured better than bedside instruction. All students would welcome video teaching to supplement their existing teaching and would like the structured examination introduced to their curriculum. This study suggests that videotaped demonstrations can be used effectively in transmitting clinical skills to students not exposed to clinical teaching by specialists in various subjects.
通过对32名学生在视频教学前后进行结构化、逐步的临床评估，测试了在加的夫录制的录像带对巴基斯坦阿伯塔巴德最后一年医学生临床操作表现的提升效果。所有学生在八个站点检查八个系统/子系统，每个患者花费5分钟，在此期间八名考官根据结构化检查表检查他们的操作。这些学生在临床实习期间没有接受过专科风湿病学家、神经学家或内分泌学家的任何临床指导。在视频教学前，他们在检查膝关节、运动系统、手部和甲状腺状况时表现不佳，但在视频教学两天后再次测试时，他们的临床行为发生了转变，平均（标准差）得分从40（6.6%）提高到了57.6（9.4%；P = 0.001）。与视频教学前的表现相比，他们与患者和考官互动良好，对自己的检查结果进行了连续的解说，录像带中可以看到这一点。遗留的问题包括测试肌腱反射和叩诊的技术不佳。所有考官和32名学生中的21名认为结构化考试比传统考试更公平。在32名学生中，20名认为视频教学不如个人床边教学有效，而12名学生认为视频教学的结构化程度优于床边教学。所有学生都欢迎视频教学来补充他们现有的教学，并希望将结构化考试引入他们的课程。这项研究表明，录像示范可以有效地用于向未接受各学科专家临床教学的学生传授临床技能。
