Lehmann Ronny, Seitz Anke, Bosse Hans Martin, Lutz Thomas, Huwendiek Sören
Center for Pediatric and Adolescent Medicine, Department of General Pediatrics, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.
Center for Pediatric and Adolescent Medicine, Department of General Pediatrics, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.
Ann Anat. 2016 Nov;208:179-182. doi: 10.1016/j.aanat.2016.05.009. Epub 2016 Jun 17.
Physical examination skills are crucial for a medical doctor. The physical examination of children differs significantly from that of adults. Students often have only limited contact with pediatric patients to practice these skills. In order to improve the acquisition of pediatric physical examination skills during bedside teaching, we have developed a combined video-based training concept, subsequently evaluating its use and perception.
Fifteen videos were compiled, demonstrating defined physical examination sequences in children of different ages. Students were encouraged to use these videos as preparation for bedside teaching during their pediatric clerkship. After bedside teaching, acceptance of this approach was evaluated using a 10-item survey, asking for the frequency of video use and the benefits to learning, self-confidence, and preparation of bedside teaching as well as the concluding OSCE.
N=175 out of 299 students returned survey forms (58.5%). Students most frequently used videos, either illustrating complete examination sequences or corresponding focus examinations frequently assessed in the OSCE. Students perceived the videos as a helpful method of conveying the practical process and preparation for bedside teaching as well as the OSCE, and altogether considered them a worthwhile learning experience. Self-confidence at bedside teaching was enhanced by preparation with the videos. The demonstration of a defined standardized procedural sequence, explanatory comments, and demonstration of infrequent procedures and findings were perceived as particularly supportive. Long video segments, poor alignment with other curricular learning activities, and technical problems were perceived as less helpful. Students prefer an optional individual use of the videos, with easy technical access, thoughtful combination with the bedside teaching, and consecutive standardized practice of demonstrated procedures.
Preparation with instructional videos combined with bedside teaching, were perceived to improve the acquisition of pediatric physical examination skills.
体格检查技能对医生至关重要。儿童的体格检查与成人有显著差异。学生通常只有有限的机会接触儿科患者来练习这些技能。为了在床边教学期间提高儿科体格检查技能的掌握程度，我们开发了一种基于视频的联合培训概念，并随后评估其使用情况和接受度。
编制了15个视频，展示不同年龄段儿童特定的体格检查顺序。鼓励学生在儿科实习期间使用这些视频为床边教学做准备。床边教学后，通过一项包含10个项目的调查评估这种方法的接受度，调查内容包括视频使用频率、对学习、自信心、床边教学准备以及结业客观结构化临床考试（OSCE）的益处。
299名学生中有175名（58.5%）返回了调查问卷。学生最常使用的视频，要么是展示完整检查顺序的，要么是展示OSCE中经常评估的相应重点检查的。学生认为这些视频是传达实践过程以及为床边教学和OSCE做准备的有用方法，总体上认为它们是一次有价值的学习经历。通过使用视频做准备，床边教学时的自信心得到了增强。特定标准化程序顺序的演示、解释性评论以及罕见程序和发现的演示被认为特别有帮助。长视频片段、与其他课程学习活动的协调性差以及技术问题被认为帮助较小。学生更喜欢可选择的个人使用视频，视频要有便捷的技术获取途径，要与床边教学进行精心结合，并对演示的程序进行连贯的标准化练习。
使用教学视频结合床边教学被认为可以提高儿科体格检查技能的掌握程度。
