Mughal Zahir, Isherwood John D, Boam Tristan D, Knight Stephen R, Yeung Justin M C
a SCRUBS Undergraduate Surgical Society , University of Leicester , Leicester , UK.
Teach Learn Med. 2015;27(1):85-90. doi: 10.1080/10401334.2014.979176.
Recognition and management of acutely unwell surgical patients is an important skill to which medical students have little exposure.
We present the evaluation of a novel national surgical workshop that consisted of high-fidelity simulations, lectures, case demonstrations, case discussions, and a basic surgical skills tutorial. The high-fidelity simulations re-created genuine patient encounters and were used to facilitate the acquisition of knowledge and skill in the early recognition and management of acutely unwell surgical patients.
The optional workshop was designed for senior medical students and delivered by surgical trainees. Students were asked to complete a 12-item evaluation questionnaire and a 26-item multiple-choice question (MCQ) quiz, which assessed their confidence; self-perceived competence; and knowledge prior to, immediately following, and 8 weeks after the workshop. Pre- and postdata were compared using student's two-tailed t test.
A total of 66 medical students from 6 UK universities attended, the majority of whom enjoyed the workshop (98.3%, n = 59). Participants' confidence rating (scale = 1-5) in assessing an unwell surgical patient improved from a mean of 2.5 (n = 47) to 4.4 (n = 60). Confidence in commencing initial management improved from a mean of 2.7 (n = 47) to 4.1 (n = 59). Confidence and self-perceived competence across 12 domains improved significantly following the workshop, two-tailed unpaired t test, t(22) = 8.64, p <.0001, d = 3.68. MCQ scores immediately following the workshop were a statistically significant improvement on the preworkshop MCQ scores (n = 44), paired two-tailed t test, t(43) = 7.76, p <.0001, d = 2.37, and the improvement was sustained 8 weeks following the workshop (n = 18), paired two-tailed t test, t(17) = 3.34, p =.0039, d = 1.62.
Feedback from students was very positive and clearly demonstrated that a workshop taught by surgical trainees improved medical students' confidence, self-perceived competence, and knowledge in the assessment and management of acutely unwell surgical patients.
识别和处理急重症外科患者是一项重要技能，但医学生很少有机会接触到。
我们展示了对一个新型全国性外科工作坊的评估，该工作坊包括高仿真模拟、讲座、病例演示、病例讨论以及基本外科技能教程。高仿真模拟重现了真实的患者情况，用于促进学生掌握识别和处理急重症外科患者的知识和技能。
这个选修工作坊是为高年级医学生设计的，由外科实习医生授课。学生们被要求完成一份包含12个条目的评估问卷和一份包含26个条目的多项选择题测验，以评估他们在工作坊之前、之后立即以及之后8周的信心、自我认知能力和知识水平。使用学生双尾t检验比较前后数据。
来自英国6所大学的66名医学生参加了该工作坊，其中大多数人喜欢这个工作坊（98.3%，n = 59）。参与者评估急重症外科患者的信心评分（范围为1 - 5）从平均2.5（n = 47）提高到了4.4（n = 60）。开始初始处理的信心从平均2.7（n = 47）提高到了4.1（n = 59）。工作坊之后，12个领域的信心和自我认知能力显著提高，双尾非配对t检验，t(22) = 8.64，p <.0001，d = 3.68。工作坊之后立即进行的多项选择题测验成绩与工作坊之前相比有统计学显著提高（n = 44），配对双尾t检验，t(43) = 7.76，p <.0001，d = 2.37，并且在工作坊之后8周这种提高仍然持续（n = 18），配对双尾t检验，t(17) = 3.34，p =.0039，d = 1.62。
学生的反馈非常积极，清楚地表明由外科实习医生授课的工作坊提高了医学生在评估和处理急重症外科患者方面的信心、自我认知能力和知识水平。
