Hinojosa-Gonzalez David Eugenio, Farias Juan S, Tellez-Giron Valeria Cecilia, Aguirre-Villarreal David, Brenes-Castro David, Flores-Villalba Eduardo
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico.
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico; Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Nuevo Leon, Mexico.
J Surg Educ. 2021 Mar-Apr;78(2):485-491. doi: 10.1016/j.jsurg.2020.07.043. Epub 2020 Aug 14.
Clinical clerkships are a fundamental component of medical education where students' learning is aided by exposure to real patients in diverse practical settings. Countless programs use overnight call shifts as an essential part of their clerkships. There has been concerns about the negative effects these shifts have on students. The study aims to determine relations between call schedule, lecture attendance, and academic and clinical performance.
One hundred and eight medical students were followed during their surgery clerkship. Students on a Q3 schedule had an on-call shift once every 3 nights, while students on a Q4 schedule once every 4 nights. Their academic performance was evaluated using their exams grades, while their clinical performance was evaluated by their attending physicians. Burnout syndrome was measured using Maslach Inventory.
A total of 108 medical students attended their surgical clerkship. Sixty-nine students were under the Q3 call schedule while 39 students in the Q4 call schedule. Mean lecture attendance for students in Q3 was 82.7% (17.3%) compared to 90% (11.2%) (p = 0.020). Final exam grades were different between groups, with Q3 scoring a mean 71.55 (9.3) compared to Q4 85.07 (9.8) (p = 0.001). Clinical performance score means were similar between groups (p = 0.777). Q4 had 74% and Q3 had 49.3% of the students with >90% of attendance (p = 0.008). Q4 had 2.6% students with <70% attendance compared to Q3 with 23.2% (p = 0.008). Students with >90% attendance regardless of call schedule, scored higher in both midterms and final exams (p = 0.002; p = 0.001). Burnout prevalence was higher in students on the Q3 schedule with 28.6% compared to 4.7% of those on the Q4 schedule (p = 0.003).
Students with less call frequency were associated with an improvement in lecture attendance and academic performance, and a lower burnout syndrome rate, without impacting clinical performance. Students with higher attendance regardless of call schedules performed higher academically. Further studies should evaluate the impact on clinical performance and exposure more thoroughly.
临床实习是医学教育的基本组成部分，学生通过在不同实际环境中接触真实患者来辅助学习。无数项目将通宵值班轮班作为其实习的重要组成部分。人们一直担心这些轮班会对学生产生负面影响。本研究旨在确定值班安排、讲座出勤率与学业及临床成绩之间的关系。
在108名医学生进行外科实习期间对他们进行跟踪。按Q3排班的学生每3个晚上值一次班，而按Q4排班的学生每4个晚上值一次班。用考试成绩评估他们的学业成绩，由主治医生评估他们的临床成绩。使用马氏倦怠量表测量倦怠综合征。
共有108名医学生参加了外科实习。69名学生按Q3值班安排，39名学生按Q4值班安排。Q组学生的平均讲座出勤率为82.7%（17.3%），而Q4组为90%（11.2%）（p = 0.020）。两组的期末考试成绩不同，Q3组平均得分为71.55（9.3），而Q4组为85.07（9.8）（p = 0.001）。两组的临床成绩平均分相似（p = 0.777）。Q4组有74%的学生出勤率>90%，Q3组为49.3%（p = 0.008）。Q4组有2.6%的学生出勤率<70%，而Q3组为23.2%（p = 0.008）。无论值班安排如何，出勤率>90%的学生在期中考试和期末考试中的得分都更高（p = 0.002；p = 0.001）。Q3排班的学生倦怠患病率更高，为28.6%，而Q4排班的学生为4.7%（p = 0.003）。
值班频率较低的学生在讲座出勤率和学业成绩方面有所提高，倦怠综合征发生率较低，且不影响临床成绩。无论值班安排如何，出勤率较高的学生学业表现更好。进一步的研究应更全面地评估对临床成绩和接触机会的影响。
