Luther Ryan, Richardson Lisa
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Clin Teach. 2018 Apr;15(2):132-135. doi: 10.1111/tct.12650. Epub 2017 May 9.
Medical students do not have many formal opportunities to practise physical examinations during their pre-clerkship years. Consequently, they often practise their examination skills with peers outside of formal teaching sessions. There are also few opportunities for observation and feedback on their skills in this area.
The undergraduate medical programme at the University of Toronto is a 4-year programme where students learn clinical skills in the first 2 years prior to beginning clinical rotations.
We describe a web-based, mobile device-friendly tool to facilitate structured peer-peer observation and feedback of physical examination skills. The tool is designed for use by pre-clerkship medical students, and includes assessment criteria for select physical examinations based on expectations for pre-clerkship medical students. In addition, supplemental instructional material was developed to aid the students' learning. The tool was piloted with first-year medical students as they prepared for their autumn objective structured clinical examination (OSCE) at the University of Toronto. Its use was voluntary.
The tool has been used enthusiastically by students, and their feedback has been positive. This tool is an innovation that guides students as they practise their physical examination skills, and gives them a framework to provide feedback to one another during this process. It also encourages students to reflect critically on their own skills, as well as those of their peers, through the use of an engaging digital platform. The tool will be expanded to include history-taking vignettes, photos and videos. The tool is sustainable, and could be easily implemented at other institutions without a substantial investment. Students often practise their examination skills with peers outside of formal teaching sessions.
医学生在临床实习前的几年里没有太多正式机会练习体格检查。因此，他们经常在正式教学课程之外与同伴一起练习检查技能。在这方面，观察他们的技能并给予反馈的机会也很少。
多伦多大学的本科医学课程为期4年，学生在开始临床轮转前的前两年学习临床技能。
我们描述了一种基于网络、对移动设备友好的工具，以促进体格检查技能的结构化同伴间观察和反馈。该工具专为临床实习前的医学生设计，包括基于对临床实习前医学生的期望为选定体格检查制定的评估标准。此外，还开发了补充教学材料以帮助学生学习。该工具在一年级医学生为多伦多大学秋季客观结构化临床考试（OSCE）做准备时进行试点使用。其使用是自愿的。
该工具受到学生的热烈欢迎，他们给予了积极反馈。这个工具是一项创新，在学生练习体格检查技能时为他们提供指导，并在这个过程中为他们提供一个相互反馈的框架。它还通过使用一个引人入胜的数字平台，鼓励学生批判性地反思自己以及同伴的技能。该工具将扩展到包括病史采集案例、照片和视频。该工具具有可持续性，无需大量投资即可在其他机构轻松实施。学生经常在正式教学课程之外与同伴一起练习检查技能。
