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一种跨专业教学方法,用于医学和物理治疗专业的学生学习下脊柱和臀部的功能解剖和临床检查。

An interprofessional teaching approach for medical and physical therapy students to learn functional anatomy and clinical examination of the lower spine and hip.

机构信息

Institute for Anatomy and Cell Biology, Department of Molecular Embryology, Faculty of Medicine, University of Freiburg, Albertstraße 17, 79104 Freiburg, Germany; Furtwangen University, Faculty of Health, Safety and Society, Konrad-Goldmann-Straße 7, 79100 Freiburg, Germany; Gesundheitsschulen Südwest GmbH, Parkweg 18, 79312 Emmendingen, Germany.

Furtwangen University, Faculty of Health, Safety and Society, Konrad-Goldmann-Straße 7, 79100 Freiburg, Germany.

出版信息

Ann Anat. 2020 Sep;231:151534. doi: 10.1016/j.aanat.2020.151534. Epub 2020 May 23.

DOI:10.1016/j.aanat.2020.151534
PMID:32450130
Abstract

INTRODUCTION

Pain of the lower back is a frequent symptom and is treated by different health professions. Anatomical as well as clinical knowledge is utmost important for all professions involved in this field. Here, we present a model that brings together an interprofessional team of experts to teach functional and clinical anatomy of the lower spine and hip area to medical and physical therapy students.

METHODS

Two groups of medical students (n=60) and physical therapy students (n=77) were designated to two interprofessional clusters, with each cluster of students participating in three workshops, each lasting 40min. Workshops were guided by university anatomists, an orthopedic physician and physical therapists, and each provided specialized training, such as the conduction of clinical, orthopedic functional tests, the identification and palpation of anatomical structures and demonstrations of human anatomical joint prosections. A questionnaire, consisting of 18 questions regarding subjective anatomical and clinical knowledge and application of clinical assessment techniques was used as the evaluation tool before and after participation in the course. Furthermore, the amount of knowledge gained from peer group participants from the other profession versus the knowledge gained from the instructors was assessed. Descriptive statistics of data as well as quantitative data analysis was carried out for pre-post analysis.

RESULTS

A total of 148 students participated in the pre-course evaluation and self-assessment and 113 students completed the post-course evaluation and self-assessment. 11 of the students, who completed the pre-course evaluation, and five students who completed the post-course evaluation failed to reveal their affiliation and these were only included in the general and corresponding cluster analysis. A final 132 pre-questionnaire and 97 post-questionnaire results were included in the analyses due to a likely group response bias. Scores for all combined groups showed an increase in the pre-post evaluation of 11.7% (P<.001). Cluster 1 and 2 (pre-post) score comparisons showed an increase of 13.7% (P<.001) and 8.8% (P<.001) respectively. A subgroup pre-post-questionnaire analysis demonstrated that medical students from both clusters had the highest increase in scores (17.6% and 19.9%) in comparison to their physical therapy counterparts (9.1% and 5.8%) (P<.001). Specifically, medical students profited highly from the anatomy in vivo (palpation) as well as clinical, orthopedic assessment exercises. Sub-question analyses showed that students learned from each other as well as from an interprofessional team of guiding experts/instructors, though mostly from the latter.

CONCLUSIONS

This course offers an appropriate and effective model that brings together an interprofessional team of experts to teach functional and clinical anatomy to medical and physical therapy students. Study results demonstrated an increase in subject-specific competencies in functional and clinical anatomy of the lower spine and hip. Medical students demonstrated the highest increase in subjective knowledge, especially in regard to clinical examination and assessment, which highlights the usefulness of this course early in the medical education. All students learned from the exchange with interprofessional group members as well as the instructors.

摘要

简介

下背部疼痛是一种常见的症状,由不同的健康专业人员进行治疗。所有涉及该领域的专业人员都需要具备解剖学和临床知识。在这里,我们提出了一个模型,该模型汇集了一个跨专业团队的专家,为医学生和物理治疗学生教授下脊柱和臀部区域的功能和临床解剖学。

方法

将两组医学生(n=60)和物理治疗学生(n=77)分配到两个跨专业小组中,每个小组的学生参加三个研讨会,每个研讨会持续 40 分钟。研讨会由大学解剖学家、骨科医生和物理治疗师指导,每个研讨会都提供专门的培训,例如进行临床、骨科功能测试、识别和触诊解剖结构以及展示人体关节切片。在参与课程之前和之后,使用包含 18 个问题的问卷,评估关于主观解剖学和临床知识以及临床评估技术应用的知识。此外,还评估了来自另一专业的同组参与者与讲师相比获得的知识量。对数据进行描述性统计和定量数据分析,进行前后分析。

结果

共有 148 名学生参加了课前评估和自我评估,113 名学生完成了课后评估和自我评估。11 名完成课前评估的学生和 5 名完成课后评估的学生未能透露其所属专业,这些学生仅被纳入一般和相应的聚类分析。由于可能存在组内反应偏差,最终包括了 132 份课前问卷和 97 份课后问卷的结果。所有综合组的分数在前-后评估中均增加了 11.7%(P<.001)。聚类 1 和 2(前-后)的分数比较显示,增加了 13.7%(P<.001)和 8.8%(P<.001)。一个亚组的课前-课后问卷分析表明,与他们的物理治疗同行相比,来自两个组的医学生的分数都有最高的增加(17.6%和 19.9%)(P<.001)。具体来说,医学生从体内解剖学(触诊)以及临床、骨科评估练习中受益匪浅。分项分析表明,学生从跨专业团队的指导专家/教师以及彼此那里学习,尽管主要是从后者那里学习。

结论

本课程提供了一个合适且有效的模型,该模型汇集了一个跨专业团队的专家,为医学生和物理治疗学生教授下脊柱和臀部的功能和临床解剖学。研究结果表明,学生在下脊柱和臀部的功能和临床解剖学方面的特定学科能力有所提高。医学生表现出主观知识的最高增长,尤其是在临床检查和评估方面,这凸显了该课程在医学教育早期的实用性。所有学生都从与跨专业团队成员以及讲师的交流中受益。

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