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通过基于猪的心脏基础科学综合项目提高医学生的知识应用和临床决策能力。

Improving Medical Students' Application of Knowledge and Clinical Decision-Making Through a Porcine-Based Integrated Cardiac Basic Science Program.

作者信息

Stott Martyn Charles, Gooseman Michael Richard, Briffa Norman Paul

机构信息

Academic Unit of Medical Education, The Medical School, The University of Sheffield, Sheffield, United Kingdom.

Academic Unit of Medical Education, The Medical School, The University of Sheffield, Sheffield, United Kingdom.

出版信息

J Surg Educ. 2016 Jul-Aug;73(4):675-81. doi: 10.1016/j.jsurg.2016.04.021.

Abstract

OBJECTIVE

Despite the concerted effort of modern undergraduate curriculum designers, the ability to integrate basic sciences in clinical rotations is an ongoing problem in medical education. Students and newly qualified doctors themselves report worry about the effect this has on their clinical performance. There are examples in the literature to support development of attempts at integrating such aspects, but this "vertical integration" has proven to be difficult. We designed an expert-led integrated program using dissection of porcine hearts to improve the use of cardiac basic sciences in clinical medical students' decision-making processes. To our knowledge, this is the first time in the United Kingdom that an animal model has been used to teach undergraduate clinical anatomy to medical students to direct wider application of knowledge.

METHODS

Action research methodology was used to evaluate the local curriculum and assess learners needs, and the agreed teaching outcomes, methods, and delivery outline were established. A total of 18 students in the clinical years of their degree program attended, completing precourse and postcourse multichoice questions examinations and questionnaires to assess learners' development.

RESULTS

Student's knowledge scores improved by 17.5% (p = 0.01; students t-test). Students also felt more confident at applying underlying knowledge to decision-making and diagnosis in clinical medicine. An expert teacher (consultant surgeon) was seen as beneficial to students' understanding and appreciation.

CONCLUSIONS

This study outlines how the development of a teaching intervention using porcine-based methods successfully improved both student's knowledge and application of cardiac basic sciences. We recommend that clinicians fully engage with integrating previously learnt underlying sciences to aid students in developing decision-making and diagnostic skills as well as a deeper approach to learning.

摘要

目的

尽管现代本科课程设计者共同努力,但在临床轮转中整合基础科学的能力仍是医学教育中一个持续存在的问题。学生和新获得资格的医生自己表示担心这会对他们的临床能力产生影响。文献中有支持整合这些方面尝试的例子,但这种“纵向整合”已被证明是困难的。我们设计了一个由专家主导的综合课程,利用猪心脏解剖来改善临床医学专业学生在决策过程中对心脏基础科学的运用。据我们所知,这是英国首次使用动物模型向医学生教授本科临床解剖学,以指导知识的更广泛应用。

方法

采用行动研究方法评估当地课程并评估学习者需求,确定商定的教学成果、方法和授课大纲。共有18名处于学位课程临床阶段的学生参加,完成课前和课后的多项选择题考试及问卷,以评估学习者的发展情况。

结果

学生的知识得分提高了17.5%(p = 0.01;学生t检验)。学生们在将基础知识应用于临床医学决策和诊断时也感觉更有信心。一位专家教师(顾问外科医生)被认为对学生的理解和认识有帮助。

结论

本研究概述了使用基于猪的方法开发的教学干预如何成功提高了学生对心脏基础科学的知识和应用能力。我们建议临床医生充分参与整合先前所学的基础科学知识,以帮助学生培养决策和诊断技能以及更深入的学习方法。

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