Huhn D, Lauter J, Roesch Ely D, Koch E, Möltner A, Herzog W, Resch F, Herpertz S C, Nikendei C
Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, Thibautstraße 4, D-69115, Heidelberg, Germany.
Department of General Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
BMC Med Educ. 2017 Jul 10;17(1):111. doi: 10.1186/s12909-017-0950-z.
Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students.
All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making.
International medical students scored significantly poorer than their local peers (p < .001; η = .042). Within the specific professional domains assessed, they showed poorer scores, with differences in conversational skills showing the highest effect (p < .001; η = .053). No differences emerged within the multiple-choice examination (p = .127).
International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship.
尤其是在学习初期，国际医学生面临诸多与语言、社会和跨文化相关的挑战。因此，在内科和外科领域的笔试、口试以及客观结构化临床考试（OSCE）中，他们的表现不如本地学生。与本地同学相比，国际学生在社会心理医学领域的OSCE中的表现如何，目前仍不清楚。
分析纳入了2012年至2015年期间在第八或第九学期参加社会心理医学领域OSCE及相应笔试的所有学生（N = 1033）。OSCE由四个不同的站点组成，学生必须在其中与患有以下疾病的模拟患者进行互动并管理患者情况：1）创伤后应激障碍，2）精神分裂症，3）边缘型人格障碍，4）自杀倾向或痴呆症。由训练有素的讲师使用评估特定专业领域的总体检查表对学生进行评估，这些领域包括与患者建立关系、沟通技巧、病史采集，以及精神病理学发现和决策制定。
国际医学生的得分明显低于本地同龄人（p <.001；η =.042）。在评估的特定专业领域内，他们的得分较低，沟通技巧方面的差异显示出最大的影响（p <.…
