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学习医学的法国学生知道如何正确进行简易精神状态检查表评分吗?

Do medical French students know how to properly score a mini mental state examination?

作者信息

Hernandorena Intza, Chauvelier Sophie, Vidal Jean-Sébastien, Piccoli Matthieu, Coulon Joséphine, Hugonot-Diener Laurence, Rigaud Anne-Sophie, Hanon Olivier, Duron Emmanuelle

机构信息

Service de gériatrie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, France, EA 4468, Faculté de médecine, Université Paris Descartes, France.

Service de gériatrie, Hôpital Broca, Assistance Publique-Hôpitaux de Paris, France.

出版信息

Geriatr Psychol Neuropsychiatr Vieil. 2017 Jun 1;15(2):163-169. doi: 10.1684/pnv.2017.0673.

Abstract

The mini mental state examination (MMSE) is a validated tool to assess global cognitive function. Training is required before scoring. Inaccurate scoring can lead to inappropriate medical decisions. In France, MMSE is usually scored by medical students. To assess if medical French students know how to properly score a mini mental state examination. Two « physician-patient » role playings performed by 2 specialized physicians, were performed in front of University Paris V medical students. Role playing A: Scoring of a MMSE according to a script containing five tricks; Role playing B: Find the 5 errors committed in a pre-filled MMSE form, according to the second script. One hundred and five students (64.4% of women, 49.5% in fifth medical school year) anonymously participated. Eighty percent of students had already scored a MMSE and 40% had been previously trained to MMSE scoring. Forty five percent of students previously scored an MMSE, without previously being trained. In test A, 16% of students did not commit any errors, 45.7% one error and 38.1% two errors. In test B, the proportion of students who provided 0, 1, 2, 3, 4 and 5 good answers was 3.3%, 29.7%, 29.7%, 25.3%, 7.7% and 4.4% respectively. No association between medical school year, previous training to MMSE scoring and performances at both tests were found. French students do not properly score MMSE. MMSE scoring is not enough or accurately taught (by specialists). The university will provide on line the tests and a short filmed teaching course performed by neuropsychological specialists.

摘要

简易精神状态检查表(MMSE)是一种经过验证的评估整体认知功能的工具。在评分前需要进行培训。评分不准确可能导致不恰当的医疗决策。在法国,MMSE通常由医学生进行评分。为了评估法国医学生是否知道如何正确地对简易精神状态检查表进行评分,两名专科医生进行了两场“医患”角色扮演,并在巴黎第五大学的医学生面前进行。角色扮演A:根据包含五个技巧的脚本对MMSE进行评分;角色扮演B:根据第二个脚本找出预先填写的MMSE表格中出现的5个错误。105名学生(64.4%为女性,49.5%处于医学五年级)匿名参与。80%的学生已经对MMSE进行过评分,40%的学生之前接受过MMSE评分培训。45%的学生之前对MMSE进行过评分,但之前未接受过培训。在测试A中,16%的学生没有犯任何错误,45.7%的学生犯了一个错误,38.1%的学生犯了两个错误。在测试B中,给出0、1、2、3、4和5个正确答案的学生比例分别为3.3%、29.7%、29.7%、25.3%、7.7%和4.4%。未发现医学年级、之前接受的MMSE评分培训与两项测试成绩之间存在关联。法国学生没有正确地对MMSE进行评分。MMSE评分没有得到足够或准确的教授(由专家教授)。该大学将在线提供测试以及由神经心理学专家制作的简短教学视频课程。

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