Teh Jhia Jiat, Cheung Ka Yan, Patrick Yusuf, Panahi Mona, Boyle Robert, Tudor-Williams Gareth
Department of Medicine, Imperial College London, London, UK.
Department of Pediatrics, Imperial College London, London, UK.
Adv Med Educ Pract. 2020 Feb 24;11:163-169. doi: 10.2147/AMEP.S234856. eCollection 2020.
Pediatrics is a specialty reserved until later stages of the medical curriculum, with many students receiving early exposure via volunteering opportunities. Self-perceived confidence across the pediatric curriculum is crucial, due to limited clinical exposure before qualification. We aimed to assess the impact of a 7-week pediatric placement on medical students' self-perceived confidence and factors that influenced self-perceived confidence.
We conducted a prospective pilot survey on three cohorts of fifth-year students undertaking pediatric placements in 2018. A two-part questionnaire was distributed before and after the placement, evaluating the level of self-confidence in clinical skills using a 10-point scale.
Of 103 students, 62 (60%) students completed both questionnaires. Of these, 34 (55%) students reported previous professional experiences with children. There was a significant increase in self-reported confidence scores across ten questions before (mean 5.4 [IQR 4.1-6.1]) and after the placement (7.6 [6.6-8.5], <0.0001). Subgroup analyses between students with prior professional experience with children and those without revealed a significant difference in preplacement confidence in four pediatric practices: verbal communication, physical engagement, asking sensitive or probing questions, and explaining medical management (<0.05). There was no significant difference in postplacement confidence between these two groups.
Medical students with prior professional experience with children reported higher self-confidence in interacting with pediatric patients prior to placement. However, a large and consistent increase in confidence across the cohort was such that there were no measurable differences at exit. This study supports the value of undergraduate pediatric training in promoting student self-confidence in managing pediatric clinical issues.
儿科学是医学课程后期才设置的专业，许多学生通过志愿者活动获得早期接触。由于资格认证前临床接触有限，在整个儿科学课程中自我感知的信心至关重要。我们旨在评估为期7周的儿科实习对医学生自我感知信心的影响以及影响自我感知信心的因素。
我们对2018年进行儿科实习的三组五年级学生进行了一项前瞻性试点调查。在实习前后发放了一份两部分的问卷，使用10分制评估临床技能的自信程度。
103名学生中，62名（60%）学生完成了两份问卷。其中，34名（55%）学生报告此前有过与儿童相关的专业经历。在实习前，十个问题的自我报告信心得分均值为5.4（四分位间距4.1 - 6.1），实习后为7.6（6.6 - 8.5），差异有统计学意义（<0.0001）。有儿童相关专业经历的学生和没有此类经历的学生之间的亚组分析显示，在实习前，在四种儿科实践中的信心存在显著差异：言语沟通、身体互动、询问敏感或探究性问题以及解释医疗管理（<0.05）。两组在实习后的信心没有显著差异。
有儿童相关专业经历的医学生在实习前与儿科患者互动时报告的自信心更高。然而，整个队列的信心有大幅且持续的提升，以至于在实习结束时没有可测量的差异。本研究支持本科儿科培训在提升学生处理儿科临床问题自信心方面的价值。
