McCloskey Marguerite, Maxwell Peter, Gormley Gerry
Department of Medicine, Queens University Belfast, UK.
Regional Nephrology Unit, Belfast City Hospital, Belfast, UK.
Clin Teach. 2015 Aug;12(4):250-4. doi: 10.1111/tct.12306. Epub 2015 May 12.
It is well recognised that medical students and junior doctors find fluid prescription a challenging topic. This study was designed to gain a greater understanding of the experiences that medical students face related to learning about fluid prescribing.
A qualitative approach, using focus groups, was employed in this research. Final-year medical students in academic year 2011-12 at Queen's University Belfast were invited to participate during their 'Assistantship' placement in March 2012. Discussions in focus groups, consisting of between six and eight students, were recorded and transcribed verbatim. The research team, consisting of three separate investigators, conducted thematic analysis independently. A final consensus regarding emerging themes was reached by discussion within the whole research team. Medical students and junior doctors find fluid prescription a challenging topic
Five prominent themes emerged: 'Teaching experience: a disruptive variation'; 'Curricular disconnections'; 'The driving test: Theory-practice transformation'; 'Role modelling: which standard to aspire to?'; and finally 'Reconciling the perceived risk'.
This re search provided insights into medical students' opinions of the teaching practices and learning experiences related to fluid prescribing. The learning of prescribing skills is complex and contextual. In the development of such skills, medical students are often exposed to conflicting educational experiences that challenge the novice learner in making judgements on best prescribing practice. This study adds to the body of evidence that fluid prescription is a difficult topic, and has generated a number of multifaceted and strategic recommendations to potentially improve fluid prescription teaching.
众所周知，医学生和初级医生发现液体处方是一个具有挑战性的主题。本研究旨在更深入地了解医学生在学习液体处方方面所面临的经历。
本研究采用焦点小组的定性方法。邀请了贝尔法斯特女王大学2011 - 12学年的最后一年医学生在2012年3月的“助理实习”期间参与。由六至八名学生组成的焦点小组讨论被记录下来并逐字转录。由三名独立研究人员组成的研究团队独立进行主题分析。通过整个研究团队内部的讨论，就新出现的主题达成了最终共识。医学生和初级医生发现液体处方是一个具有挑战性的主题
出现了五个突出的主题：“教学经验：一种破坏性的变化”；“课程脱节”；“驾驶考试：理论 - 实践转化”；“榜样作用：应追求哪种标准？”；最后是“调和感知到的风险”。
本研究深入了解了医学生对与液体处方相关的教学实践和学习经历的看法。处方技能的学习是复杂且依赖情境的。在这些技能的培养过程中，医学生经常会接触到相互冲突的教育经历，这对新手学习者在判断最佳处方实践时构成了挑战。本研究补充了证据，证明液体处方是一个困难的主题，并提出了一些多方面的战略性建议，以潜在地改进液体处方教学。
