Alamiri Nasser N, Maliska Charles Miles, Chancellor-McIntosh Heather, Sclabas Guido
Department of Surgery, University of Oklahoma College of Medicine, Tulsa, Oklahoma.
Department of Surgery, University of Oklahoma College of Medicine, Tulsa, Oklahoma.
J Surg Educ. 2017 May-Jun;74(3):466-470. doi: 10.1016/j.jsurg.2016.11.006. Epub 2017 Feb 13.
Third-year medical students (MS-III) and second-year physician assistant students (PA-S) have similar core clinical rotations during their education. Uniquely at our institution, both groups rotate together and are assessed by the same evaluation and grading standards. This study compares the performance of MS-III and PA-S during their combined surgical clerkship rotation.
A retrospective analysis on students' final clerkship grades, individual grades for clinical performance evaluation, objective structured clinical examination, faculty tutorials, and National Board of Medical Education (NBME) general surgery examination for academic years 2013 and 2014. Statistical analysis using the Statistical Package for Social Sciences (SPSS) was used. A p < 0.05 was considered statistically significant.
The study took place in the Department of Surgery at the University of Oklahoma School of Community Medicine, Tulsa, Oklahoma.
All MS-III and PA-S that performed a clinical rotation in the Department of Surgery at the University of Oklahoma School of Community Medicine, Tulsa were included in the study. Fourth-year medical students on elective rotations were excluded. A total of 95 students were included, 51 MS-III and 44 PA-S.
The results indicated that MS-III had statistically significant higher clinical performance evaluation (p = 0.005), NBME (p < 0.001), and tutorial scores (p = 0.03) as compared to PA-S. However, there were no statistically significant findings between final grades and objective structured clinical examination scores. In comparing 2013 to 2014 MS-III classes, no statistically significant differences existed, but the 2014 PA-S class had statistically significant higher NBME (p = 0.022) and tutorial scores (p = 0.015) as compared to 2013 PA-S class.
MS-III performed better in tests evaluating medical knowledge, possibly a reflection of more in-depth different organ systems physiology and pathophysiology education that MS-III receive. No significant difference in clerkship performance was found. This could be attributed to similar clinical education both receiving as well as PA-S often having a history of prior professional health care experience. Over time of the study, PA-S performance seems to have improved. These observations might help to improve future curricula for MS-III as well as for PA-S.
三年级医学生（MS-III）和二年级医师助理学生（PA-S）在其教育过程中有着相似的核心临床轮转经历。在我们院校，独特的是这两组学生一起轮转，并按照相同的评估和评分标准进行考核。本研究比较了MS-III和PA-S在联合外科实习轮转期间的表现。
对2013年和2014年学生的实习期末成绩、临床表现评估的单项成绩、客观结构化临床考试成绩、教师辅导成绩以及美国医学教育委员会（NBME）普通外科考试成绩进行回顾性分析。使用社会科学统计软件包（SPSS）进行统计分析。p<0.05被认为具有统计学意义。
研究在俄克拉荷马州塔尔萨市俄克拉荷马大学社区医学院外科进行。
所有在俄克拉荷马大学社区医学院外科进行临床轮转的MS-III和PA-S均纳入本研究。排除了参加选修轮转的四年级医学生。共纳入95名学生，其中51名MS-III和44名PA-S。
结果表明，与PA-S相比，MS-III在临床表现评估（p = 0.005）、NBME（p<0.001）和辅导成绩（p = 0.03）方面具有统计学显著更高的分数。然而，在期末成绩和客观结构化临床考试成绩之间没有统计学显著差异。在比较2013年和2014年的MS-III班级时，未发现统计学显著差异，但与2013年的PA-S班级相比，2014年的PA-S班级在NBME（p = 0.022）和辅导成绩（p = 0.015）方面具有统计学显著更高的分数。
MS-III在评估医学知识的测试中表现更好，这可能反映了MS-III接受的不同器官系统生理学和病理生理学教育更深入。在实习表现方面未发现显著差异。这可能归因于两者接受的相似临床教育以及PA-S通常有之前专业医疗保健经验的背景。随着研究时间的推移，PA-S的表现似乎有所提高。这些观察结果可能有助于改进未来MS-III和PA-S的课程设置。
