Cook County Health and Hospital Systems, Department of Emergency Medicine, Chicago, Illinois.
West J Emerg Med. 2020 Dec 19;22(1):15-19. doi: 10.5811/westjem.2020.12.48761.
Clinical rotations in emergency medicine (EM) can be challenging for medical students because of the lack of continuity with attending physicians. To overcome this challenge, institutions have started to match a student's schedule with that of a resident, referred to as "paired shifts." We sought to pilot and compare two schedule formats for fourth-year medical students (MS4) - a resident-paired shifts (RPS) and a traditional resident-unpaired shifts (RUS) schedule.
This prospective, crossover trial included MS4s rotating in the emergency department over four consecutive four-week blocks. Each MS4 was assigned two weeks using the RUS schedule and two weeks with the RPS schedule, alternating the format order each month. At the end of the rotation students were anonymously surveyed regarding the differences in learning experience, their ability to showcase their knowledge and clinical skills, and familiarity with the residency program with the two formats.
The response rate was 47 of 58 students (84%). Respondents indicated that RPS resulted in more teaching time (64.6% RPS vs 8.3% RUS), a better overall educational experience (68.8% RPS vs 8.3% RUS), and a greater ability to showcase their medical knowledge (52.1% RPS vs 6.3% RUS). Additionally, students felt that the program was better able to evaluate them (66.7% RPS vs 10.4% RUS) and they were better able to better evaluate the program (66.7% RPS vs 6.3% RUS) in the RPS format.
When compared to traditional RUS during an MS4 rotation, a RPS format provided students with the perception of an improved learning experience, ability to showcase knowledge, and familiarity with the residency program without sacrificing teaching from attending physicians.
由于与主治医生缺乏连续性,医学专业的学生在急诊医学(EM)临床轮转中可能会面临挑战。为了克服这一挑战,各机构开始将学生的日程安排与住院医师相匹配,称为“配对班次”。我们试图为四年级医学生(MS4)试用和比较两种日程安排模式 - 住院医师配对班次(RPS)和传统住院医师非配对班次(RUS)。
这项前瞻性、交叉试验包括在连续四个四周的块中在急诊科轮转的 MS4。每位 MS4 被分配两周的 RUS 日程安排和两周的 RPS 日程安排,每月交替安排格式顺序。在轮转结束时,学生匿名调查了两种格式在学习体验、展示知识和临床技能的能力以及对住院医师计划的熟悉程度方面的差异。
58 名学生中有 47 名(84%)做出了回应。受访者表示,RPS 导致了更多的教学时间(64.6%的 RPS 与 8.3%的 RUS)、更好的整体教育体验(68.8%的 RPS 与 8.3%的 RUS)和更好地展示他们的医学知识的能力(52.1%的 RPS 与 6.3%的 RUS)。此外,学生们认为该计划能够更好地评估他们(66.7%的 RPS 与 10.4%的 RUS),并且他们能够更好地评估该计划(66.7%的 RPS 与 6.3%的 RUS)。
与 MS4 轮转期间的传统 RUS 相比,RPS 格式为学生提供了更好的学习体验、展示知识的能力和对住院医师计划的熟悉程度,而不会牺牲主治医生的教学。