Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas.
J Surg Res. 2013 Dec;185(2):555-60. doi: 10.1016/j.jss.2013.06.019. Epub 2013 Jul 1.
Educating medical students in surgical subspecialty fields can be challenging, and the optimal timing and curriculum remain unknown. Despite advocacy for earlier exposure, competing core clerkship rotations often leave little time for subspecialty fields. We report our experience with a novel, short, and focused curriculum in surgical oncology for the third-year medical students.
A 2-wk (2009-2010) and a 4-wk (2010-2011) curriculum in surgical oncology were developed for the third-year students at a tertiary-referral cancer center, including formal didactics, rotation in clinical service of students' choosing (breast, gastrointestinal, endocrine, or melanoma), and case-based learning and presentation. Paired pre- and postrotation questionnaires were prospectively completed, including 20 items assessing knowledge and four items assessing experience. Grading was anonymous, and change in score was assessed by Wilcoxon signed-rank test.
Paired questionnaires from 47 students (2-wk rotation, n = 26; 4-wk rotation, n = 21) showed a median improvement of three points (21.4%) from pre- to posttests (P < 0.001). The improvement did not differ by the length of rotation or by the specific clinical service. Nearly all (93%) reported a positive and inspiring experience. The most valuable avenue of learning was reported as the time spent with resident or fellow or attending (92%), followed by self-directed reading (62%) and didactic lectures (28%).
A short and focused curriculum in surgical oncology, including structured didactics and clinical rotation, had positive impact for the third-year students. Given the increasing work-hour limits, it is important to note that the time spent in the clinical setting continues to be ranked as the most educationally valuable by medical students.
在外科亚专业领域教育医学生具有挑战性,最佳时机和课程仍不清楚。尽管提倡更早接触,但竞争激烈的核心实习轮转通常几乎没有时间用于亚专业领域。我们报告了我们在第三年医学生中进行的一项新颖的、简短的、集中的肿瘤外科学课程的经验。
在一家三级转诊癌症中心,为第三年学生制定了为期 2 周(2009-2010 年)和 4 周(2010-2011 年)的肿瘤外科学课程,包括正式的教学、学生选择的临床服务轮转(乳腺、胃肠、内分泌或黑色素瘤)以及基于案例的学习和演示。前瞻性地完成了配对的预和后旋转问卷,包括 20 项评估知识和 4 项评估经验的项目。评分是匿名的,通过 Wilcoxon 符号秩检验评估得分的变化。
来自 47 名学生(2 周轮转,n = 26;4 周轮转,n = 21)的配对问卷显示,测试前到测试后的中位数改善了 3 分(21.4%)(P < 0.001)。这种改善与轮转时间或特定的临床服务无关。几乎所有人(93%)都报告说体验积极且鼓舞人心。学习最有价值的途径是与住院医师、研究员或主治医生共度时光(92%),其次是自我指导阅读(62%)和讲座(28%)。
包括结构化教学和临床轮转的肿瘤外科学简短而集中的课程对第三年学生产生了积极影响。鉴于工作时间限制的增加,值得注意的是,学生在临床环境中度过的时间继续被医学生评为最具教育价值的。