Fernandes Lalita, Mesquita Anthony Menezes
Department of Pulmonary Medicine, Goa Medical College, Bardez, Goa, India.
J Educ Health Promot. 2018 Jun 12;7:82. doi: 10.4103/jehp.jehp_75_16. eCollection 2018.
Respiratory diseases are a major cause of mortality and morbidity worldwide. A sound knowledge of management of respiratory diseases is thus very vital. The clinical exposure of undergraduate medical students is limited to 2 weeks in pulmonary medicine. We hypothesized that the short duration of posting can be best utilized by developing need-based modules for bedside teaching.
This study aimed to determine gain in knowledge and skills of final-year medical students in diagnosis and management of common pulmonary diseases and assess students' perception of the module.
A one-group pretest-posttest quasi-experimental study design enrolled a convenience sample of 48 final-year medical students. Twenty-four students were posted at a given time for the bedside clinical posting in pulmonary medicine between August 2013 and November 2013. These students were divided randomly into two groups of 12 students each. All students consented to be part of the study. Two trained faculty taught in rotation. The bedside teaching module was prepared by Delphi technique and curriculum was based on Kern's six-step approach. History taking, physical examination, tuberculosis, chronic obstructive pulmonary disease, asthma, lung cancer, chest X-rays, and spirometry were taught. Students were administered pre- and post-test questionnaires to assess knowledge, while Objective Structured Clinical Examination assessed skills. Students' feedback questionnaire evaluated the teaching module. A two-tailed paired sample -test assessed mean gain in knowledge and skills. Effect size was calculated by Cohen's d, while Cronbach's alpha estimated the reliability testing of perception questionnaire. Statistical analysis was performed using statistical software package IBM SPSS version 23.
Mean pre- and posttest knowledge scores were 12.46 (8.09) and 43.17 (10.7), respectively, = 0.001. Mean pre- and posttest skills scores were 7.00 (4.76) and 24.79 (3.31), respectively, = 0.001, and Cohen's d showed large effect size. Most students stated that the module enhanced their clinical skills, helped to understand difficult material, and promoted inquiry and thinking. Cronbach's alpha for perception questionnaire was 0.854.
Structured bedside teaching module in pulmonary medicine improved the knowledge and skills of undergraduate medical students. The contents and various teaching methodologies were evaluated positively.
呼吸系统疾病是全球死亡和发病的主要原因。因此，扎实掌握呼吸系统疾病的管理知识至关重要。本科医学生在肺医学方面的临床实习时间限制为两周。我们假设通过开发基于需求的床边教学模块，可以充分利用这段短暂的实习时间。
本研究旨在确定医学专业最后一年学生在常见肺部疾病诊断和管理方面知识和技能的提升情况，并评估学生对该模块的看法。
采用单组前后测准实验研究设计，选取了48名医学专业最后一年学生作为便利样本。2013年8月至2013年11月期间，24名学生在特定时间被安排到肺医学床边临床实习。这些学生被随机分为两组，每组12名学生。所有学生均同意参与本研究。两名经过培训的教员轮流授课。床边教学模块采用德尔菲技术编制，课程基于克恩的六步法。讲授了病史采集、体格检查、结核病、慢性阻塞性肺疾病、哮喘、肺癌、胸部X线检查和肺活量测定。通过前后测问卷评估学生的知识，同时通过客观结构化临床考试评估技能。学生反馈问卷对教学模块进行评价。采用双尾配对样本t检验评估知识和技能的平均提升情况。效应量通过科恩d值计算，而克朗巴哈α系数估计感知问卷的信度检验。使用统计软件包IBM SPSS 23版进行统计分析。
前后测知识平均得分分别为12.46（8.09）和43.17（10.7），P = 0.001。前后测技能平均得分分别为7.00（4.76）和24.79（3.31），P = 0.001，科恩d值显示出较大的效应量。大多数学生表示该模块提高了他们的临床技能，有助于理解难懂的内容，并促进了探究和思考。感知问卷的克朗巴哈α系数为0.854。
肺医学结构化床边教学模块提高了本科医学生的知识和技能。其内容和各种教学方法得到了积极评价。
