通过智能手机应用程序进行教学脚本可以促进住院医师主导的医学生教学。

Teaching scripts via smartphone app facilitate resident-led teaching of medical students.

机构信息

Department of Pediatrics, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 152, Chicago, IL, 60611, USA.

Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA.

出版信息

BMC Med Educ. 2021 Jun 8;21(1):331. doi: 10.1186/s12909-021-02782-w.

DOI:10.1186/s12909-021-02782-w

PMID:34103029

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8185492/

Abstract

BACKGROUND

Previous studies have suggested that resident physicians are the most meaningful teachers during the clinical clerkships of third-year medical students (MS3s). Unfortunately, residents often feel unprepared for this crucial role. The pediatrics clerkship at our institution identified a paucity in the frequency of resident-led teaching with MS3s. Lack of confidence, suboptimal teaching space, and insufficient time were cited as the most significant barriers. To enhance resident-led teaching of MS3s, we created teaching scripts of general pediatrics topics accessible via a smartphone application (app).

METHODS

Prior to the implementation of the app, MS3s and pediatric residents were surveyed on clerkship teaching practices. From May 2017 through July 2018, pediatric residents working with MS3s were introduced to the app, with both groups queried on resident teaching habits afterward. We compared pre-intervention and post-intervention data of time spent teaching, teaching frequency, and a ranking of pediatric resident teaching performance compared to residents of other MS3 core clerkships.

RESULTS

44 out of 90 residents (49%) responded to a pre-intervention survey on baseline teaching habits. 49 out of 61 residents (80%) completed our post-intervention survey. Pre-intervention, 75% (33/44) of residents reported spending less than 5 min per teaching session on average. Post-intervention, 67% (33/49) reported spending more than 5 min (p < 0.01). 25% (11/44) of residents reported teaching at least once per day pre-intervention, versus 55% (27/49, p = 0.12) post-intervention. Post-intervention data demonstrated a statistically significant correlation between app use and increased frequency of teaching (p < 0.01). The MS3 average ranking of pediatric resident teaching increased from 2.4 to 3.4 out of 6 (p < 0.05) after this intervention.

CONCLUSIONS

Residency programs looking to reform resident-led teaching, particularly of residents early in their training, should consider our novel approach. In addition to addressing barriers to teaching and creating a platform for near-peer teaching, it is adaptable to any specialty or learner level. Future direction includes developing objective measures for teaching performance and content proficiency to better assess our intervention as an educational curriculum, as well as further investigation of the intervention as a controlled trial.

摘要

背景

先前的研究表明，住院医师是三年级医学生（MS3）临床实习中最重要的教师。不幸的是，住院医师往往对此关键角色准备不足。我们机构的儿科学实习发现，住院医师与 MS3 之间的主导教学频率很少。缺乏信心、教学空间不佳和时间不足被认为是最大的障碍。为了加强住院医师对 MS3 的主导教学，我们创建了一个可通过智能手机应用程序（app）访问的一般儿科学主题教学脚本。

方法

在实施应用程序之前，对 MS3 和儿科住院医师的实习教学实践进行了调查。从 2017 年 5 月到 2018 年 7 月，与 MS3 一起工作的儿科住院医师开始使用该应用程序，之后两组都对住院医师的教学习惯进行了查询。我们比较了干预前和干预后用于教学的时间、教学频率以及与其他 MS3 核心实习相比儿科住院医师教学表现的排名。

结果

在基线教学习惯的预干预调查中，90 名住院医师中有 44 名（49%）做出了回应。在干预后调查中，有 61 名住院医师中的 49 名（80%）完成了调查。在干预前，75%（33/44）的住院医师报告平均每次教学课程花费不到 5 分钟。干预后，67%（33/49）的住院医师报告花费超过 5 分钟（p<0.01）。在干预前，25%（11/44）的住院医师报告每天至少教学一次，而在干预后，这一比例为 55%（27/49，p=0.12）。干预后数据显示，应用程序的使用与教学频率的增加之间存在统计学上的显著相关性（p<0.01）。在这项干预之后，MS3 对儿科住院医师教学的平均排名从 6 分中的 2.4 分提高到了 3.4 分（p<0.05）。

结论

希望改革住院医师主导教学的住院医师项目，特别是那些早期培训的住院医师，应考虑我们的新方法。除了解决教学障碍和为近同行教学创建平台外，它还适用于任何专业或学习者水平。未来的方向包括开发教学表现和内容熟练程度的客观衡量标准，以更好地评估我们的干预措施作为教育课程，以及进一步将干预措施作为对照试验进行调查。