Friedrich-Schiller University of Jena, Dean's office of Medical Faculty, Jena, Germany; Jena University Hospital, Paediatric Department, Jena, Germany.
Friedrich-Schiller University of Jena, Dean's office of Medical Faculty, Jena, Germany.
Z Evid Fortbild Qual Gesundhwes. 2021 Aug;164:70-78. doi: 10.1016/j.zefq.2021.05.009. Epub 2021 Jul 10.
Practical training on the patient is crucial in medical students' last year education - the so-called practical year (PJ) in Germany. Due to difficulties in combining student training with the everyday tasks on ward, it is often criticised as not sufficient for a good preparation for later practical work. The Medical Faculty of the University of Jena therefore designed a project called "PJplus". The project includes mentoring and workplace-based assessment by means of Mini-Clinical Evaluation Exercise (Mini-CEX) in combination with training workshops for supervisors. Three years after the first clinical departments started voluntary participation, the project was evaluated by comparing the experience and the self-assessed learning progress of students from departments participating in this project (PJplus group) with those non-participating (control group).
An online questionnaire was sent to all medical students registered at the University of Jena for PJ between March 2016 and April 2017. The students were invited to participate at the end of each section of their PJ within that period. The answers of the PJplus group were compared to the answers of the control group using descriptive and multivariable analysis.
201 students participated in the survey and filled out 257 questionnaires. PJplus was recommended by 80% of the students participating in the project. The PJplus group (n=92) was significantly more satisfied with their PJ and felt significantly better prepared for work than the control group (n=165). The project's elements mentoring and feedback could lead to a better improvement in practical medical skills. However, only 17% of the students managed to conduct the required amount of three Mini-CEX during their PJ rotation and 52% of the students seemed to have lost contact to their mentor or did not have one at all. These difficulties arose due to unfamiliarity with the project, shortage of time and staff on ward or due to lack of motivation among supervisors.
Adding mentoring and feedback to the PJ helps to better prepare students for their practical work after finishing studies. With the project presented, it is feasible to integrate these elements in a structured way. Nevertheless, a good control of the elements' implementation and consistent training of the supervising physicians is needed to ensure long-term success.
在医学生的最后一年教育中，即德国所谓的实习年（PJ），对患者进行实践培训至关重要。由于将学生培训与病房日常工作相结合存在困难，因此经常受到批评，认为这不足以为以后的实际工作做好充分准备。耶拿大学医学系因此设计了一个名为“PJplus”的项目。该项目包括通过迷你临床评估练习（Mini-CEX）进行指导和基于工作场所的评估，并结合培训研讨会为主管人员提供培训。在最初的三个临床科室自愿参与该项目三年后，通过比较参与该项目（PJplus 组）和未参与（对照组）的学生的经验和自我评估的学习进展来评估该项目。
2016 年 3 月至 2017 年 4 月期间，向耶拿大学所有注册实习年的医学生发送了一份在线问卷。在此期间，在他们实习的每一部分结束时邀请学生参加。使用描述性和多变量分析比较 PJplus 组和对照组的答案。
共有 201 名学生参加了调查，并填写了 257 份问卷。80%的参与项目的学生推荐 PJplus。PJplus 组（n=92）对他们的 PJ 满意度明显更高，并且对工作的准备感觉明显更好，而对照组（n=165）则不然。项目的指导和反馈等元素可以导致实践医学技能的更好提高。然而，只有 17%的学生在他们的实习轮转期间完成了规定数量的三个 Mini-CEX，而 52%的学生似乎与导师失去了联系，或者根本没有导师。这些困难是由于对项目不熟悉、病房短缺时间和人员以及主管人员缺乏动力造成的。
在 PJ 中增加指导和反馈有助于更好地为学生完成学业后的实际工作做好准备。通过提出的项目，可以以结构化的方式整合这些元素。然而，需要对这些元素的实施进行良好的控制，并对监督医生进行持续培训，以确保长期成功。
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