Burns Rebekah, Adler Mark, Mangold Karen, Trainor Jennifer
Pediatrics, Seattle Children's Hospital - University of Washington School of Medicine.
Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Cureus. 2016 Feb 9;8(2):e488. doi: 10.7759/cureus.488.
The transition from medical student to intern is a challenging process characterized by a steep learning curve. Focused courses targeting skills necessary for success as a resident have increased self-perceived preparedness, confidence, and medical knowledge. Our aim was to create a brief educational intervention for 4th-year medical students entering pediatric, family practice, and medicine/pediatric residencies to target skills necessary for an internship. The curriculum used a combination of didactic presentations, small group discussions, role-playing, facilitated debriefing, and simulation-based education. Participants completed an objective structured clinical exam requiring synthesis and application of multiple boot camp elements before and after the elective. Participants completed anonymous surveys assessing self-perceived preparedness for an internship, overall and in regards to specific skills, before the elective and after the course. Participants were asked to provide feedback about the course. Using checklists to assess performance, students showed an improvement in performing infant lumbar punctures (47.2% vs 77.0%; p < 0.01, 95% CI for the difference 0.2, 0.4%) and providing signout (2.5 vs. 3.9 (5-point scale) p < 0.01, 95% CI for the difference 0.6, 2.3). They did not show an improvement in communication with a parent. Participants demonstrated an increase in self-reported preparedness for all targeted skills, except for obtaining consults and interprofessional communication. There was no increase in reported overall preparedness. All participants agreed with the statements, "The facilitators presented the material in an effective manner," "I took away ideas I plan to implement in internship," and "I think all students should participate in a similar experience." When asked to assess the usefulness of individual modules, all except order writing received a mean Likert score > 4. A focused boot camp addressing key knowledge and skills required for pediatric-related residencies was well received and led to improved performance of targeted skills and increased self-reported preparedness in many targeted domains.
从医学生到实习生的转变是一个具有挑战性的过程,其特点是学习曲线陡峭。针对住院医师成功所需技能的重点课程提高了自我认知的准备程度、信心和医学知识。我们的目标是为进入儿科、家庭医学和医学/儿科住院医师项目的四年级医学生创建一个简短的教育干预措施,以针对实习所需技能。该课程采用了理论讲授、小组讨论、角色扮演、引导式汇报和基于模拟的教育相结合的方式。参与者在选修课程前后完成了一项客观结构化临床考试,该考试要求综合运用多个新兵训练营元素。参与者在选修课程前和课程结束后完成了匿名调查,评估他们对实习的自我认知准备程度,包括总体准备程度和特定技能的准备程度。参与者被要求提供对课程的反馈。使用检查表评估表现,学生在进行婴儿腰椎穿刺方面有了改善(47.2%对77.0%;p<0.01,差异的95%置信区间为0.2,0.4%),在进行交班方面也有改善(2.5对3.9(5分制),p<0.01,差异的95%置信区间为0.6,2.3)。他们在与家长沟通方面没有表现出改善。除了获取会诊和跨专业沟通外,参与者在所有目标技能的自我报告准备程度上都有所提高。报告的总体准备程度没有提高。所有参与者都同意以下陈述:“ facilitators以有效的方式呈现了材料”、“我学到了计划在实习中实施的想法”以及“我认为所有学生都应该参加类似的体验”。当被要求评估各个模块的有用性时,除了医嘱书写外,所有模块的平均李克特评分都>4。一个针对儿科相关住院医师所需关键知识和技能的重点新兵训练营受到了好评,并导致目标技能的表现得到改善,在许多目标领域的自我报告准备程度也有所提高。