Świerszcz Jolanta, Stalmach-Przygoda Agata, Kuźma Marcin, Jabłoński Konrad, Cegielny Tomasz, Skrzypek Agnieszka, Wieczorek-Surdacka Ewa, Kruszelnicka Olga, Chmura Kaja, Chyrchel Bernadeta, Surdacki Andrzej, Nowakowski Michał
Department of Medical Education, Jagiellonian University Medical College, Cracow, Poland.
Students' Scientific Group at the Second Department of Cardiology, School of Medicine in English, Jagiellonian University Medical College, Cracow, Poland.
BMJ Open. 2017 Sep 1;7(8):e017748. doi: 10.1136/bmjopen-2017-017748.
As a result of a curriculum reform launched in 2012 at our institution, preclinical training was shortened to 2 years instead of the traditional 3 years, creating additional incentives to optimise teaching methods. In accordance with the new curriculum, a semester-long preclinical module of clinical skills (CS) laboratory training takes place in the second year of study, while an introductory clinical course (ie, brief introductory clerkships) is scheduled for the Fall semester of the third year. Objective structured clinical examinations (OSCEs) are carried out at the conclusion of both the preclinical module and the introductory clinical course. Our aim was to compare the scores at physical examination stations between the first and second matriculating classes of a newly reformed curriculum on preclinical second-year OSCEs and early clinical third-year OSCEs.
Analysis of routinely collected data.
One Polish medical school.
Complete OSCE records for 462 second-year students and 445 third-year students.
OSCE scores by matriculation year.
In comparison to the first class of the newly reformed curriculum, significantly higher (ie, better) OSCE scores were observed for those students who matriculated in 2013, a year after implementing the reformed curriculum. This finding was consistent for both second-year and third-year cohorts. Additionally, the magnitude of the improvement in median third-year OSCE scores was proportional to the corresponding advancement in preceding second-year preclinical OSCE scores for each of two different sets of physical examination tasks. In contrast, no significant difference was noted between the academic years in the ability to interpret laboratory data or ECG - tasks which had not been included in the second-year preclinical training.
Our results suggest the importance of preclinical training in a CS laboratory to improve students' competence in physical examination at the completion of introductory clinical clerkships during the first clinical year.
由于我校在2012年启动了课程改革，临床前培训从传统的3年缩短至2年，这为优化教学方法提供了额外动力。根据新课程，在学习的第二年进行为期一学期的临床技能（CS）实验室培训的临床前模块，而入门临床课程（即简短的入门实习）安排在第三年的秋季学期。在临床前模块和入门临床课程结束时进行客观结构化临床考试（OSCE）。我们的目的是比较新改革课程的第一和第二届入学班级在临床前第二年OSCE和临床第三年早期OSCE的体格检查站得分。
对常规收集的数据进行分析。
一所波兰医学院。
462名二年级学生和445名三年级学生的完整OSCE记录。
按入学年份划分的OSCE分数。
与新改革课程的第一届班级相比，在实施改革课程一年后的2013年入学的学生的OSCE分数显著更高（即更好）。这一发现对于二年级和三年级队列都是一致的。此外，对于两组不同的体格检查任务，三年级OSCE中位数分数的提高幅度与之前二年级临床前OSCE分数的相应提高成正比。相比之下，在解释实验室数据或心电图的能力方面，各学年之间没有显著差异，而这些任务未包括在二年级临床前培训中。
我们的结果表明，临床前在CS实验室进行培训对于提高学生在第一个临床年入门临床实习结束时的体格检查能力很重要。
