III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
III. Medizinische Klinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany.
BMC Med Educ. 2019 Jan 7;19(1):9. doi: 10.1186/s12909-018-1438-1.
Important competences of physicians regarding patient safety include communication, leadership, stress resistance, adherence to procedures, awareness, and teamwork. Similarly, while selected, prospective flight school applicants are tested for the same set of skills. The aim of our study was to assess these core competences in advanced undergraduate medical students from different medical schools.
In 2017, 67 medical students (year 5 and 6) from the universities of Hamburg, Oldenburg, and TU Munich, Germany, participated in the verified Group Assessment Performance (GAP)-Test at the German Aerospace Center (DLR) in Hamburg. All participants were rated by DLR assessment observers with a set of empirically derived behavioural checklists. This lists consisted of 6-point rating scales (1: very low occurrence to 6: very high occurrence) and included the competences leadership, teamwork, stress resistance, communication, awareness, and adherence to procedures. Medical students' scores were compared with the results of 117 admitted flight school applicants.
Medical students showed significantly higher scores than admitted flight school applicants for adherence to procedures (p < .001, d = .63) and communication (p < .01, d = .62). They reached significantly lower ratings for teamwork (p < .001, d = .77), stress resistance (p < 0.001, d = .70), and awareness (p < .001, d = 1.31). Students in semester 10 showed significantly (p < .02, d = .58) higher scores in domain awareness compared to the final year students. On average, flight school entrance level was not reached by either group for this domain.
Advanced medical students' low results for awareness are alarming as awareness is essential and integrative for clinical reasoning and patient safety. Further studies should elucidate and discuss whether awareness needs to be included in medical student selection or integrated into the curriculum in training units.
医生在患者安全方面的重要能力包括沟通、领导力、抗压能力、遵守程序、意识和团队合作。同样，在选择有前途的飞行学校申请人时，也会对他们进行同样技能的测试。我们的研究目的是评估来自不同医学院的高年级医学生的这些核心能力。
2017 年，来自德国汉堡、奥尔登堡和慕尼黑工业大学的 67 名医学生（五年级和六年级）参加了在德国航空航天中心（DLR）汉堡举行的经核实的团体评估表现（GAP）测试。所有参与者均由 DLR 评估观察员使用一套经验衍生的行为检查表进行评分。该清单由 6 点评分量表（1：非常低的发生到 6：非常高的发生）组成，包括领导力、团队合作、抗压能力、沟通、意识和遵守程序等能力。将医学生的分数与 117 名被录取的飞行学校申请人的结果进行比较。
医学生在遵守程序（p<0.001，d=0.63）和沟通（p<0.01，d=0.62）方面的得分明显高于被录取的飞行学校申请人。他们在团队合作（p<0.001，d=0.77）、抗压能力（p<0.001，d=0.70）和意识（p<0.001，d=1.31）方面的评分明显较低。第 10 学期的学生在意识领域的得分明显（p<0.02，d=0.58）高于最后一年的学生。平均而言，两组在该领域的飞行学校入学水平均未达到。
高年级医学生的意识水平较低令人担忧，因为意识对于临床推理和患者安全至关重要。进一步的研究应该阐明和讨论是否需要将意识纳入医学生的选拔中，或者将其纳入培训单位的课程中。
