Kittisarapong Tanakorn, Blatt Benjamin, Lewis Karen, Owens Jennifer, Greenberg Larrie
Medical Student, George Washington University School of Medicine and Health Sciences.
Associate Professor of Medicine, George Washington University School of Medicine and Health Sciences.
MedEdPORTAL. 2016 Jun 10;12:10411. doi: 10.15766/mep_2374-8265.10411.
Traditionally, full-time faculty members have assumed major responsibility for teaching physical examination skills to first- and second-year medical students. Problems with faculty recruitment and adhering to a standardized way of teaching have challenged educators to seek alternatives to teaching the physical examination to novices. To address these problems, we created and implemented a novel curriculum that has standardized the teaching of physical examination skills to novice students by using standardized patient instructors (SPIs) and fourth-year medical students (MS-4s) working as an interdisciplinary team (known as a dyad).
This dyad training workshop occurs early in the school year, before first-year medical students begin their physical diagnosis course. Prior to the workshop, SPIs and MS-4s receive prereading on which they are quizzed both individually and as a preassigned dyad, during the session. The workshop requires a total of 100 minutes and includes several discussions on formative learning theory, roles, and teamwork.
In 2013, 16 SPIs (100%) and 44 MS-4s (77%) completed a 4-question questionnaire. The majority (> 80%) of respondents selected agree or strongly agree for all four questions.
While initial feedback from SPIs and MS-4s was enthusiastically positive, evidence showed the dyad could be strengthened by (1) providing time to learn the theoretical scaffolding underlying working together, (2) meeting and planning approaches to teaching efforts, and (3) enabling medical students and standardized patient instructors to apply the theoretical constructs as the foundation to reflect on their teaching roles in effectively instructing novices in physical exam skills.
传统上,全职教员主要负责向医学一、二年级学生传授体格检查技能。教员招聘问题以及坚持标准化教学方式给教育工作者带来了挑战,促使他们寻找向新手教授体格检查的替代方法。为了解决这些问题,我们创建并实施了一项新颖的课程,该课程通过使用标准化患者教员(SPI)和作为跨学科团队(称为二元组)工作的四年级医学生(MS-4),将体格检查技能的教学标准化,传授给新手学生。
这种二元组培训工作坊在学年早期进行,在一年级医学生开始他们的物理诊断课程之前。在工作坊之前,SPI和MS-4会收到预读材料,在课程期间他们会分别以及作为预先分配的二元组接受关于这些材料的测验。工作坊总共需要100分钟,包括几次关于形成性学习理论、角色和团队合作的讨论。
2013年,16名SPI(100%)和44名MS-4(77%)完成了一份4个问题的问卷。大多数(>80%)受访者对所有四个问题都选择了同意或强烈同意。
虽然SPI和MS-4的初步反馈非常积极,但有证据表明,通过以下方式可以加强二元组:(1)提供时间来学习共同工作背后的理论框架,(2)会面并规划教学工作的方法,以及(3)使医学生和标准化患者教员能够将理论结构作为基础,反思他们在有效指导新手体格检查技能方面的教学角色。