Nakamura Mio, Altshuler David, Chadwell Margit, Binienda Juliann
Wayne State University School of Medicine, Detroit 48201, MI, USA.
BMC Med Educ. 2014 Dec 12;14:250. doi: 10.1186/s12909-014-0250-9.
At Wayne State University School of Medicine (WSU SOM), the Robert R. Frank Student Run Free Clinic (SRFC) is one place preclinical students can gain clinical experience. There have been no published studies to date measuring the impact of student-run free clinic (SRFC) volunteerism on clinical skills development in preclinical medical students.
Surveys were given to first year medical students at WSU SOM at the beginning and end of Year 1 to assess perception of clinical skills, including self-confidence, self-reflection, and professionalism. Scores of the Year 1 Objective Structured Clinical Exam (OSCE) were compared between SRFC volunteers and non-volunteers.
There were a total of 206 (68.2%) and 80 (26.5%) survey responses at the beginning and end of Year 1, respectively. Of the 80 students, 31 (38.7%) volunteered at SRFC during Year 1. Statistically significant differences were found between time points in self-confidence (p < 0.001) in both groups. When looking at self-confidence in skills pertaining to SRFC, the difference between groups was statistically significant (p = 0.032) at both time points. A total of 302 students participated in the Year 1 OSCE, 27 (9%) of which were SRFC volunteers. No statistically significant differences were found between groups for mean score (p = 0.888) and established level of rapport (p = 0.394).
While this study indicated no significant differences in clinical skills in students who volunteer at the SRFC, it is a first step in attempting to measure clinical skill development outside of the structured medical school setting. The findings lend themselves to development of research designs, clinical surveys, and future studies to measure the impact of clinical volunteer opportunities on clinical skills development in future physicians.
在韦恩州立大学医学院（WSU SOM），罗伯特·R·弗兰克学生运营免费诊所（SRFC）是临床前学生可以获得临床经验的场所之一。迄今为止，尚无已发表的研究测量学生运营免费诊所（SRFC）志愿服务对临床前医学生临床技能发展的影响。
在第一年开始和结束时，对WSU SOM的一年级医学生进行调查，以评估对临床技能的认知，包括自信、自我反思和专业精神。比较了SRFC志愿者和非志愿者在第一年客观结构化临床考试（OSCE）中的成绩。
第一年开始和结束时分别有206份（68.2%）和80份（26.5%）调查问卷回复。在80名学生中，31名（38.7%）在第一年期间在SRFC做志愿者。两组在自信方面的时间点之间存在统计学显著差异（p < 0.001）。在查看与SRFC相关技能的自信时，两组在两个时间点的差异均具有统计学显著性（p = 0.032）。共有302名学生参加了第一年的OSCE，其中27名（9%）是SRFC志愿者。两组在平均分数（p = 0.888）和既定的融洽程度（p = 0.394）方面未发现统计学显著差异。
虽然这项研究表明在SRFC做志愿者的学生在临床技能方面没有显著差异，但这是试图测量在结构化医学院环境之外的临床技能发展的第一步。这些发现有助于开展研究设计、临床调查以及未来研究，以测量临床志愿者机会对未来医生临床技能发展的影响。
