Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.
Department of Family Medicine, McMaster University, Hamilton, Canada.
Educ Prim Care. 2021 Sep;32(5):259-265. doi: 10.1080/14739879.2021.1901614. Epub 2021 Apr 7.
There is a paucity of literature that explores whether students use clinical skills learned during medical school in practice. The study aimed to report on the most clinically relevant examination skills to focus on and increase student preparedness for clinical practice. We disseminated a 10-minute online anonymised survey to residents and physicians using an open recruitment strategy with convenience and snowball sampling. This survey sought to determine the practical use of respiratory exam skills. We conducted basic quantitative and descriptive content analysis to evaluate results.From a total of 161 respondents, 148 completed the entire survey. The majority of respondents found all 12 inspection skills to be useful in practice. Tracheal deviation was the only palpation skill found useful (68.63% useful). Auscultating for breath sounds was found to be unanimously useful, while all other percussion and auscultation skills were not found useful. In qualitative analysis, the major theme was that skills should be taught despite minimal use as they help teach disease pathophysiology, help in limited resource settings, and have usefulness in particular situations (e.g. traumas or different specialities).There is a discrepancy between the clinical skills taught to students and the ones actually used in practice. Despite this, there is still utility in teaching these skills to medical students. Rather than removing skills from the curriculum, a better avenue would be to emphasise manoeuvres that are clinically important to help guide preparation for clinical settings.
目前,探讨医学生是否将在医学院习得的临床技能应用于实践的文献匮乏。本研究旨在报告最与临床相关的检查技能,以提高学生对临床实践的准备。我们采用开放式招募策略,通过便利抽样和滚雪球抽样,向住院医师和医生分发了一份 10 分钟的在线匿名调查。该调查旨在确定呼吸检查技能的实际应用。我们进行了基本的定量和描述性内容分析来评估结果。在总共 161 名受访者中,有 148 名完成了整个调查。大多数受访者发现所有 12 项检查技能在实践中都有用。气管偏移是唯一被发现有用的触诊技能(68.63%有用)。听诊呼吸音被一致认为是有用的,而其他所有叩诊和听诊技能都没有被发现有用。在定性分析中,主要主题是,尽管某些技能的使用频率较低,但仍应教授这些技能,因为它们有助于教授疾病病理生理学,在资源有限的情况下有所帮助,并且在特定情况下(例如创伤或不同的专业)具有实用性。学生所接受的临床技能与实际应用的技能之间存在差异。尽管如此,向医学生教授这些技能仍然具有实用性。与其从课程中删除技能,不如强调对临床重要的操作,以帮助指导为临床环境做准备。