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妇产科实习轮转前多维技术技能培训课程对表现和接触机会的影响

Impact of a Multidimensional Technical Skills Training Session Before Obstetrics and Gynaecology Clerkship Rotation on Performance and Exposure.

作者信息

Mitric Cristina, Chow Kammie, Krishnamurthy Srinivasan, Zeng Xing Ziggy, Leung Annie

机构信息

Department of Obstetrics and Gynecology, McGill University, Montréal, QC.

Department of Obstetrics and Gynecology, Memorial University, Saint John's, NL.

出版信息

J Obstet Gynaecol Can. 2018 Oct;40(10):1315-1323. doi: 10.1016/j.jogc.2018.01.008.

Abstract

OBJECTIVE

This study sought to assess the impact of an obstetrics and gynaecology (OBGYN) multidimensional technical skills training session on medical student self-perceived confidence, objective performance, clinical exposure, and interest in OBGYN.

METHODS

OBGYN clerkship students were divided into control (i.e., traditional curriculum) and intervention (i.e., additional pre-rotation simulation training in vaginal delivery, suturing and knot tying, speculum and bimanual examinations, and intrapartum cervical examination) groups. Both groups underwent an objective structured clinical examination (OSCE) after the rotation and completed pre- and post-rotation questionnaires to assess confidence, clinical exposure, and interest in OBGYN. The primary outcomes were self-reported confidence and OSCE scores, and the secondary outcomes were clinical exposure and interest in OBGYN.

RESULTS

A total of 148 students participated. Both groups reported least confidence with vaginal delivery and cervical examinations before the rotation. There was improved self-confidence across all skills after the rotation, with the intervention group demonstrating greater improvement for vaginal delivery (3.36 vs. 3.10; P < 0.05) and cervical examination (3.14 vs. 2.86; P < 0.05). The intervention group also demonstrated a trend towards higher OSCE scores for all skills, but only speculum and bimanual examinations reached statistical significance. The intervention increased exposure from "0 to 5" to "6 to 10" for vaginal delivery and suturing. There was no difference in interest in OBGYN between the two groups.

CONCLUSION

A technical skills training session before OBGYN clerkship is feasible and has the potential to increase students' confidence, OSCE performance, and hands-on procedural exposure. The optimal combination of skills to be included still needs to be defined.

摘要

目的

本研究旨在评估妇产科多维度技术技能培训课程对医学生自我感知的信心、客观表现、临床接触以及对妇产科的兴趣的影响。

方法

妇产科实习学生被分为对照组(即传统课程)和干预组(即在阴道分娩、缝合打结、阴道窥器和双合诊检查以及产时宫颈检查方面进行额外的轮转前模拟培训)。两组在轮转后均接受了客观结构化临床考试(OSCE),并完成了轮转前后的问卷,以评估对妇产科的信心、临床接触和兴趣。主要结局是自我报告的信心和OSCE分数,次要结局是临床接触和对妇产科的兴趣。

结果

共有148名学生参与。两组在轮转前均表示对阴道分娩和宫颈检查最缺乏信心。轮转后所有技能的自信心均有所提高,干预组在阴道分娩(3.36对3.10;P<0.05)和宫颈检查(3.14对2.86;P<0.05)方面的改善更大。干预组在所有技能的OSCE分数上也呈现出更高的趋势,但只有阴道窥器和双合诊检查达到统计学意义。干预使阴道分娩和缝合的接触从“0至5次”增加到“6至10次”。两组对妇产科的兴趣没有差异。

结论

妇产科实习前的技术技能培训课程是可行的,并且有可能提高学生的信心、OSCE表现和实践操作接触。仍需确定要纳入的最佳技能组合。

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