Vogel Daniela, Harendza Sigrid
Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Deutschland.
GMS J Med Educ. 2016 Aug 15;33(4):Doc64. doi: 10.3205/zma001063. eCollection 2016.
Practical skills are an essential part of physicians' daily routine. Nevertheless, medical graduates' performance of basic skills is often below the expected level. This review aims to identify and summarize teaching approaches of basic practical skills in undergraduate medical education which provide evidence with respect to effective students' learning of these skills.
Basic practical skills were defined as basic physical examination skills, routine skills which get better with practice, and skills which are also performed by nurses. We searched PubMed with different terms describing these basic practical skills. In total, 3467 identified publications were screened and 205 articles were eventually reviewed for eligibility.
43 studies that included at least one basic practical skill, a comparison of two groups of undergraduate medical students and effects on students' performance were analyzed. Seven basic practical skills and 15 different teaching methods could be identified. The most consistent results with respect to effective teaching and acquisition of basic practical skills were found for structured skills training, feedback, and self-directed learning. Simulation was effective with specific teaching methods and in several studies no differences in teaching effects were detected between expert or peer instructors. Multimedia instruction, when used in the right setting, also showed beneficial effects for basic practical skills learning.
A combination of voluntary or obligatory self-study with multimedia applications like video clips in combination with a structured program including the possibility for individual exercise with personal feedback by peers or teachers might provide a good learning opportunity for basic practical skills.
实践技能是医生日常工作的重要组成部分。然而,医学毕业生的基本技能表现往往低于预期水平。本综述旨在识别和总结本科医学教育中基本实践技能的教学方法,为学生有效学习这些技能提供证据。
基本实践技能被定义为基本体格检查技能、通过练习会提高的常规技能以及护士也会执行的技能。我们用描述这些基本实践技能的不同术语在PubMed上进行搜索。总共筛选了3467篇已识别的出版物,最终对205篇文章进行了资格审查。
分析了43项研究,这些研究至少包括一项基本实践技能、两组本科医学生的比较以及对学生表现的影响。可以识别出七种基本实践技能和15种不同的教学方法。在有效教学和掌握基本实践技能方面,最一致的结果是结构化技能培训、反馈和自主学习。模拟在特定教学方法下是有效的,并且在一些研究中未发现专家或同伴指导教师在教学效果上有差异。多媒体教学在合适的环境中使用时,对基本实践技能学习也显示出有益效果。
将自愿或强制的自学与视频片段等多媒体应用相结合,再加上一个结构化的项目,包括同伴或教师提供个人反馈的个人练习机会,可能会为基本实践技能提供良好的学习机会。