Ginzburg Samara B, Brenner Judith, Cassara Michael, Kwiatkowski Thomas, Willey Joanne M
Department of Science Education, Hofstra Northwell School of Medicine, Hempstead.
Department of Emergency Medicine, Northwell Health, Great Neck, NY, USA.
Adv Med Educ Pract. 2017 Jan 18;8:79-84. doi: 10.2147/AMEP.S124851. eCollection 2017.
There has been a call for increased integration of basic and clinical sciences during preclinical years of undergraduate medical education. Despite the recognition that clinical simulation is an effective pedagogical tool, little has been reported on its use to demonstrate the relevance of basic science principles to the practice of clinical medicine. We hypothesized that simulation with an integrated science and clinical debrief used with early learners would illustrate the importance of basic science principles in clinical diagnosis and management of patients.
Small groups of first- and second-year medical students were engaged in a high-fidelity simulation followed by a comprehensive debrief facilitated by a basic scientist and clinician. Surveys including anchored and open-ended questions were distributed at the conclusion of each experience.
The majority of the students agreed that simulation followed by an integrated debrief illustrated the clinical relevance of basic sciences (mean ± standard deviation: 93.8% ± 2.9% of first-year medical students; 96.7% ± 3.5% of second-year medical students) and its importance in patient care (92.8% of first-year medical students; 90.4% of second-year medical students). In a thematic analysis of open-ended responses, students felt that these experiences provided opportunities for direct application of scientific knowledge to diagnosis and treatment, improving student knowledge, simulating real-world experience, and developing clinical reasoning, all of which specifically helped them understand the clinical relevance of basic sciences.
Small-group simulation followed by a debrief that integrates basic and clinical sciences is an effective means of demonstrating the relationship between scientific fundamentals and patient care for early learners. As more medical schools embrace integrated curricula and seek opportunities for integration, our model is a novel approach that can be utilized.
在本科医学教育的临床前阶段,一直有人呼吁加强基础科学与临床科学的整合。尽管人们认识到临床模拟是一种有效的教学工具,但关于利用它来证明基础科学原理与临床医学实践相关性的报道却很少。我们假设,对早期学习者使用综合科学与临床汇报的模拟将阐明基础科学原理在患者临床诊断和管理中的重要性。
将一、二年级医学生分成小组进行高保真模拟,随后由基础科学家和临床医生进行全面汇报。在每次体验结束时发放包括锚定问题和开放式问题的调查问卷。
大多数学生认为,模拟后进行综合汇报阐明了基础科学的临床相关性(平均±标准差:一年级医学生为93.8%±2.9%;二年级医学生为96.7%±3.5%)及其在患者护理中的重要性(一年级医学生为92.8%;二年级医学生为90.4%)。在对开放式回答的主题分析中,学生们认为这些体验为将科学知识直接应用于诊断和治疗、提高学生知识水平、模拟现实世界体验以及培养临床推理能力提供了机会,所有这些都特别有助于他们理解基础科学的临床相关性。
对早期学习者来说,小组模拟后进行基础与临床科学整合的汇报是一种有效方式,可证明科学基础知识与患者护理之间的关系。随着越来越多医学院采用整合课程并寻求整合机会,我们的模式是一种可供利用的新方法。