Malik-Tabassum Khalid, Lamb Jonathan N, Chambers Alastair, West Robert, Pandit Hemant, Aderinto Joseph
Specialty Registrar Trauma and Orthopaedics, Conquest Hospital, East Sussex Healthcare NHS Trust, Hastings, United Kingdom.
Specialty Registrar Trauma and Orthopaedics, Clinical Research Fellow, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom.
J Surg Educ. 2020 Jul-Aug;77(4):817-829. doi: 10.1016/j.jsurg.2020.02.015. Epub 2020 Mar 24.
To assess the quality and duration of trauma and orthopedics (T&O) training in medical schools in United Kingdom (UK), and to evaluate final-year students' self-perceived level of competence in essential T&O skills.
This was a survey-based study of final-year medical students that attended 1-day undergraduate T&O courses held between Feb'17 and Feb'19. Outcome measures were duration and perceived quality of undergraduate T&O placements, students' self-rated competence in essential T&O skills, and impact of teaching methods on their subjective future competence.
Four courses held at education centers in 3 different locations in UK (London, Nottingham, and Leeds) PARTICIPANTS: All 414 course attendees from 13 UK medical schools completed the questionnaire.
19.3% of students had not experienced a placement in T&O. Mean duration of T&O placements was 2.5 weeks. 37.4% described their training as "poor". Majority of students attended 1-5 sessions of: lectures (50.5%), small group teaching (58.7%), trauma meetings (58.7%), clinics (65.7%), and theatres (72.5%). Lowest competency scores were reported in management of T&O emergencies, fracture management, and interpretation of T&O radiographs. Self-rated competence in essential T&O skills was significantly higher in students with previous experience of a T&O placement (p < 0.05). There was a strongly positive correlation between small group teaching attendance and perceived competence in management of T&O patients in different clinical settings (p < 0.001).
Medical schools in UK are currently failing to adequately train medical graduates to manage T&O patients, with students reporting low competency scores in all basic T&O skills. To mitigate the current situation, a minimum duration of a T&O placement for all students must be implemented nationally. Educational boards and medical schools must work in collaboration to improve the delivery of undergraduate T&O curriculum, the structure of the clinical T&O placement, and efficacy of the commonly encountered learning environments.
评估英国医学院校创伤与骨科（T&O）培训的质量和时长，并评估即将毕业的学生对基本T&O技能的自我认知能力水平。
这是一项基于调查的研究，对象为参加了2017年2月至2019年2月期间为期1天的本科T&O课程的即将毕业的医学生。结果指标包括本科T&O实习的时长和感知质量、学生对基本T&O技能的自我评分能力，以及教学方法对他们主观未来能力的影响。
在英国3个不同地点（伦敦、诺丁汉和利兹）的教育中心举办的4次课程
来自13所英国医学院校的所有414名课程参与者均完成了问卷。
19.3%的学生没有经历过T&O实习。T&O实习的平均时长为2.5周。37.4%的学生将他们的培训描述为“差”。大多数学生参加了1 - 5次以下课程：讲座（50.5%）、小组教学（58.7%）、创伤会议（58.7%）、诊所实习（65.7%）和手术室实习（72.5%）。在T&O急诊处理、骨折处理和T&OX光片解读方面，能力得分最低。有过T&O实习经历的学生在基本T&O技能方面的自我评分能力显著更高（p < 0.05）。小组教学的参与度与在不同临床环境中对T&O患者管理的感知能力之间存在强正相关（p < 0.001）。
英国医学院校目前未能充分培训医学毕业生管理T&O患者，学生在所有基本T&O技能方面的能力得分较低。为缓解当前状况，必须在全国范围内为所有学生实施T&O实习的最短时长。教育委员会和医学院校必须合作，以改善本科T&O课程的授课、临床T&O实习的结构以及常见学习环境的效果。
