Force Jade, Thomas Ian, Buckley Frances
Raigmore Hospital, Inverness, UK.
Clin Teach. 2014 Apr;11(2):109-15. doi: 10.1111/tct.12071.
Learning in the clinical environment is an important feature of medical education. Ward-round teaching leads to relevant, applied and lasting learning of knowledge, skills and attitudes; however, on fast-paced ward rounds in specialties such as general surgery, the student experience is often suboptimal, and teaching can be overlooked. Clinical teaching fellows (CTFs) are postgraduate doctors ranging from foundation year-2 (FY2) level through to specialty trainees, who have elected to spend up to 2 years out of the programme to teach medical undergraduates. This article explores whether CTFs can successfully support the regular delivery of undergraduate medical teaching on the busy post-take surgical ward round (PTSWR).
The CTFs at Raigmore Hospital, Inverness, planned and facilitated weekly, structured teaching sessions to accompany the PTSWR. This educational intervention was evaluated using pre- and post-intervention student questionnaires. The questionnaires focused on student enjoyment and depth of learning using Likert scales and free-text components. Students were also asked about barriers to learning on typical PTSWRs. The consultant surgeons leading on these rounds were issued separate questionnaires, to gauge their evaluation of CTF support.
The main barrier to effective undergraduate ward round teaching was a lack of time on the part of clinical staff. Ward rounds accompanied by CTF support significantly increased student enjoyment (p < 0.0001) and perceived learning (p < 0.0001). Consultant surgeons were supportive of the teaching initiative.
Support from CTFs on busy PTSWRs optimised student satisfaction, and was welcomed by clinical staff. CTF support could be widened to other busy ward rounds, e.g. acute medical takes, to enhance student learning and reduce the teaching burden on clinical faculty staff.
在临床环境中学习是医学教育的一个重要特征。查房教学能够带来与知识、技能和态度相关的、实用且持久的学习效果；然而，在普通外科等专科快节奏的查房过程中，学生的体验往往不尽如人意，教学也容易被忽视。临床教学研究员（CTF）是从基础第2年（FY2）水平到专科受训医生阶段的研究生医生，他们选择在计划外抽出长达两年的时间来教授医学本科生。本文探讨了临床教学研究员能否成功支持在繁忙的术后外科查房（PTSWR）中定期开展本科医学教学。
因弗内斯拉伊格莫尔医院的临床教学研究员计划并协助每周开展与术后外科查房相结合的结构化教学课程。使用干预前后的学生问卷对这一教育干预措施进行评估。问卷通过李克特量表和自由文本部分聚焦于学生的学习乐趣和学习深度。还向学生询问了在典型的术后外科查房中学习的障碍。主导这些查房的外科顾问医生收到了单独的问卷，以衡量他们对临床教学研究员支持的评价。
本科病房查房有效教学的主要障碍是临床工作人员缺乏时间。有临床教学研究员支持的查房显著提高了学生的学习乐趣（p < 0.0001）和感知到的学习效果（p < 0.0001）。外科顾问医生对该教学举措表示支持。
临床教学研究员在繁忙的术后外科查房中的支持优化了学生满意度，并受到临床工作人员的欢迎。临床教学研究员的支持可以扩展到其他繁忙的查房，如急性内科接诊，以提高学生的学习效果并减轻临床教师的教学负担。
