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牙科学学生颅颌面外科实践技能培训及首次客观结构化临床考试的长期前瞻性教学效果

Long-term prospective teaching effectivity of practical skills training and a first OSCE in cranio maxillofacial surgery for dental students.

作者信息

Landes Constantin A, Hoefer Sebastian, Schuebel Florian, Ballon Alexander, Teiler Anna, Tran Andreas, Weber Roxane, Walcher Felix, Sader Robert

机构信息

Cranio-Maxillofacial and Plastic Facial Surgery (Head: Sader, Robert MD, DMD, PhD, FEBOMFS), J. W. Goethe-University of Frankfurt Medical Centre, Frankfurt, Germany.

Cranio-Maxillofacial and Plastic Facial Surgery (Head: Sader, Robert MD, DMD, PhD, FEBOMFS), J. W. Goethe-University of Frankfurt Medical Centre, Frankfurt, Germany.

出版信息

J Craniomaxillofac Surg. 2014 Jul;42(5):e97-104. doi: 10.1016/j.jcms.2013.07.004. Epub 2013 Sep 5.

Abstract

Basic skills in oral/CMF surgery should be taught effectively to dental students as surgical skills training is traditionally under-represented in the dental curriculum compared to its later need in daily clinical practice. Rigid curricular time frames and prospectively condensed professional education foster new effective teaching and examination formats. Transmitting and assessing clinical competence objectively (independent of subjective bias), reliably (repeatable, inter-rater consistency) and valid (representative, structured task selection) was intended and evaluated in oral/CMF surgery skills acquisition starting in summer 2009. A small-group practical skills training (PST) day initiated a one-week practical training course, covering previously formulated learning objectives. An objective structured clinical evaluation (OSCE) was held at the end of each semester. Theoretical background knowledge and clinical skills should have to be memorized within a representative number of practical tasks (test stations). A first semester (26 students) used classical practical training alone as controls, the following semesters (171 students) had PST, considered as a study group. All 197 students were assessed with OSCE's over a 3-year period. An instructor held PST based on presentations, videos and practical training, including mannequins, with pairs of students. This included history taking, communication and interpretation of laboratory/image diagnostics, structured clinical facial examination, fracture diagnosis, venipuncture, suturing, biopsy and wire loops on pig jaws for manual and clinical skills, which were later incorporated in OSCE stations. OSCE average results increased from 63.3 ± 9.7% before and to 75.5 ± 10% after the inclusion of PST (p < 0.05). Knowledge diffusion between sittings on the same test date and between consecutive semesters was insignificant. Students and faculty rated their learning/teaching experience "very good" to "good". PST was effective in optimizing clinical skills as evaluated by OSCE.

摘要

应向牙科学生有效地传授口腔/颌面外科的基本技能,因为与日后日常临床实践中的需求相比,传统上牙科课程中手术技能培训的比重不足。严格的课程时间框架和前瞻性压缩的专业教育催生了新的有效教学和考试形式。自2009年夏季起,在口腔/颌面外科技能培养中,旨在客观(不受主观偏见影响)、可靠(可重复、评分者间一致性)和有效(具有代表性、结构化任务选择)地传授和评估临床能力,并进行了评估。一个小组实践技能培训(PST)日开启了为期一周的实践培训课程,涵盖先前制定的学习目标。每学期末进行客观结构化临床评估(OSCE)。理论背景知识和临床技能应在具有代表性数量的实践任务(测试站)中得以掌握。第一学期(26名学生)仅采用传统实践培训作为对照,随后的学期(171名学生)采用PST,视为研究组。在3年时间里,对所有197名学生进行了OSCE评估。一名教师基于演示文稿、视频和实践培训开展PST,包括使用人体模型,学生两两一组。这包括病史采集、实验室/影像诊断的沟通与解读、结构化临床面部检查、骨折诊断、静脉穿刺、缝合、活检以及在猪颌骨上进行钢丝环扎以训练手动和临床技能,这些内容随后被纳入OSCE测试站。纳入PST后,OSCE平均成绩从之前的63.3±9.7%提高到75.5±10%(p<0.05)。在同一考试日期的不同场次之间以及连续学期之间,知识传播不显著。学生和教师对他们的学习/教学体验评价为“非常好”至“好”。如通过OSCE评估所示,PST在优化临床技能方面是有效的。

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