Department of Surgery, Boonshoft School of Medicine, Wright State University, Dayton, Ohio.
J Surg Res. 2013 Nov;185(1):97-101. doi: 10.1016/j.jss.2013.05.102. Epub 2013 Jun 22.
In 2000, the Liaison Committee on Medical Education required that all medical schools provide experiential training in end-of-life care. To adhere to this mandate and advance the professional development of medical students, experiential training in communication skills at the end-of-life was introduced into the third-year surgical clerkship curriculum at Wright State University Boonshoft School of Medicine.
In the 2007-08 academic year, 97 third-year medical students completed six standardized end-of-life care patient scenarios commonly encountered during the third-year surgical clerkship. Goals and objectives were outlined for each scenario, and attending surgeons graded student performances and provided formative feedback.
All 97 students, 57.7% female and average age 25.6 ± 2.04 y, had passing scores on the scenarios: (1) Adult Hospice, (2) Pediatric Hospice, (3) Do Not Resuscitate, (4) Dyspnea Management/Informed Consent, (5) Treatment Goals and Prognosis, and (6) Family Conference. Scenario scores did not differ by gender or age, but students completing the clerkship in the first half of the year scored higher on total score for the six scenarios (92.8% ± 4.8% versus 90.5% ± 5.0%, P = 0.024).
Early training in end-of-life communication is feasible during the surgical clerkship in the third-year of medical school. Of all the scenarios, "Conducting a Family Conference" proved to be the most challenging.
2000 年，医学教育联络委员会要求所有医学院提供临终关怀体验式培训。为了遵守这一规定，推进医学生的专业发展，我们在莱特州立大学布恩肖夫特医学院的三年级外科学实习课程中引入了临终沟通技能的体验式培训。
在 2007-08 学年，97 名三年级医学生完成了六个标准化的临终关怀患者情景，这些情景在三年级外科学实习中经常遇到。为每个情景制定了目标和目的，主治外科医生对学生的表现进行评分，并提供形成性反馈。
所有 97 名学生（57.7%为女性，平均年龄 25.6 ± 2.04 岁）在情景测试中均取得了及格分数：（1）成人临终关怀，（2）儿科临终关怀，（3）不复苏，（4）呼吸困难管理/知情同意，（5）治疗目标和预后，以及（6）家庭会议。情景测试的分数不因性别或年龄而异，但在学年上半年完成实习的学生在六个情景的总分上得分更高（92.8% ± 4.8%比 90.5% ± 5.0%，P = 0.024）。
在医学生三年级外科学实习中，早期进行临终沟通培训是可行的。在所有情景中，“进行家庭会议”被证明是最具挑战性的。
