Skarparis Yiannis, Findlay Callum A, Demetriades Andreas K
General Surgery, NHS Grampian, Aberdeen Royal Infirmary, Aberdeen, UK, AB25 2ZN.
, 53 Westburn Road, Aberdeen, AB25 2SH, UK.
Acta Neurochir (Wien). 2016 Jan;158(1):27-34; discussion 34. doi: 10.1007/s00701-015-2651-x. Epub 2015 Nov 26.
A great variability exists in the clinical exposure of neurosurgery across all academic years in UK medical schools, although the effects of this on knowledge level and confidence in referring cases appropriately to specialists have not been reported.
A cross-sectional study was carried out involving students in years 1-5 across nine British medical schools. An electronic questionnaire was sent out which consisted of questions concerning the teaching of the subject; and questions assessing the knowledge of basic neurosurgery through mini clinical scenarios testing which specialty should receive a referral.
Of 417 participants, 60 were excluded due to incomplete participation. Senior years outperformed students in junior years for correctly answered questions on five neurosurgical scenarios (mean score: years 1-3 (184/357) = 3.33/5, years 4-5 (173/357) = 3.79/5, p < 0.05). Participants in years 1-5 with prior clinical exposure in neurosurgery scored higher than participants who had no exposure (mean score: exposed (247/357) = 4.21/5, not-exposed (110/357) = 3 · 50/5, p < 0.05). Sixty-one percent prefer receiving neurosurgical teaching via increased exposure to operations. Students in years 4-5 with exposure in both classroom and operating theatre scored higher than students with classroom-only experience (mean classroom (69/131) = 3.62/5, mean classroom and operating theatre (62/131) = 4.21/5, p < 0.05); 33.3 % of final-year students reported difficulty in identifying patients that require neurosurgical referral.
Students with exposure to an operating theatre outperformed those students exposed to just classroom teaching. Students indicated an increased preference for teaching through the operating theatre scene. One in three final-year medical students had difficulty identifying the need for a neurosurgical referral.If neurosurgical teaching were further enhanced at medical school, it could lead to increased confidence and efficiency in junior-year doctors when facing the neurosurgical referral process. Increased exposure to clinical neurosurgery may significantly improve the ability of future doctors to tackle neurosurgical scenarios.
英国医学院各学年神经外科临床实习情况差异很大，不过其对知识水平以及将病例合理转诊给专科医生时的信心的影响尚无相关报道。
对九所英国医学院1至5年级的学生开展了一项横断面研究。发放了一份电子问卷，其中包含有关该学科教学的问题；以及通过小型临床情景测试评估基本神经外科知识的问题，测试内容为应将病例转诊至哪个专科。
417名参与者中，60名因参与不完整被排除。在关于五个神经外科情景的正确回答问题方面，高年级学生表现优于低年级学生（平均分：1至3年级（184/357）=3.33/5，4至5年级（173/357）=3.79/5，p<0.05）。有神经外科临床实习经历的1至5年级参与者得分高于无实习经历的参与者（平均分：有实习经历者（247/357）=4.21/5，无实习经历者（110/357）=3.50/5，p<0.05）。61%的人更倾向于通过增加手术观摩来接受神经外科教学。有课堂和手术室实习经历的4至5年级学生得分高于只有课堂实习经历的学生（课堂实习平均得分（69/131）=3.62/5，课堂和手术室实习平均得分（62/131）=4.21/5，p<0.05）；33.3%的最后一年学生表示难以识别需要神经外科转诊的患者。
有手术室实习经历的学生表现优于仅接受课堂教学的学生。学生们表示越来越倾向于通过手术室场景进行教学。三分之一的最后一年医学生在识别神经外科转诊需求方面存在困难。如果医学院进一步加强神经外科教学，可能会提高低年级医生在面对神经外科转诊过程时的信心和效率。增加临床神经外科实习经历可能会显著提高未来医生应对神经外科情景的能力。
