Abali Emine Ercikan, Rashid Hanin, Copeland H Liesel, Calt Melissa, DeMaio Richard, Patel Jashvin, Schild Sam, Phadtare Sangita, Chai Louis, Ullo Michael
Rutgers Robert Wood Johnson Medical School, Piscataway, NJ 08854 USA.
CUNY School of Medicine, Harris Hall 301-B, 160 Convent Avenue, New York, NY 10031 USA.
Med Sci Educ. 2020 Apr 6;30(2):791-800. doi: 10.1007/s40670-020-00951-y. eCollection 2020 Jun.
Integrating basic science into clinical teaching has been a struggle for medical schools. However, early exposure to clinical experience has been associated with an increased understanding of the importance of basic science, positive attitudes, and developing clinical skills faster. Furthermore, early clinical exposure can help students reconnect with what drove them into medicine in the first place, especially when they are starting to feel burned out by the volume of lecture material. As a result, increasing patient experience during the first year has become a goal of many medical schools.
At Rutgers Robert Wood Johnson Medical School, interprofessional case discussions (ICDs) begin with a lecture that explicitly integrates basic science with a disease, followed by a discussion with a patient, their family, the healthcare team, and first-year students. Our objective is to explore whether ICDs enhanced the learning experience of basic science.
ICD satisfaction was assessed using evaluations from two different courses (2013-2016). Responses were analyzed quantitatively using descriptive statistics and qualitatively using a grounded-theory-content analysis. Study 2: A follow-up measure with current third- and fourth-year students on long-term retention of basic science was analyzed using a Wilcoxon signed rank test. Relative rankings of three different case-based teaching modalities were assessed using chi-square.
Students reported significantly higher satisfaction with ICDs (93%) for reinforcing concepts and integrating materials compared to Flipped Classrooms (66%) and Jigsaws (65%), = 120.9, < .001. Student comments fit into five categories: enjoyment, learning/retention, the clinical usefulness of basic science, affirming passion to be in medicine, and others. The follow-up measure indicated significantly greater retention of the biochemical basis of diseases covered during ICDs.
While other teaching modalities integrate basic science into a clinical context, ICDs go further by displaying interprofessional care and the manifestation of the disease on the patient and the lives of their family. As a result, ICDs lead to a positive learning environment in which students feel comfortable, have a sense of rapport with the patients and health care providers, and feel motivated to learn basic science.
将基础科学融入临床教学一直是医学院校面临的难题。然而，早期接触临床经验与增强对基础科学重要性的理解、形成积极态度以及更快地培养临床技能有关。此外，早期临床接触有助于学生重新找回最初促使他们投身医学的动力，尤其是当他们开始因大量的讲座材料而感到倦怠时。因此，在第一年增加患者体验已成为许多医学院校的目标。
在罗格斯大学罗伯特·伍德·约翰逊医学院，跨专业病例讨论（ICD）始于一场将基础科学与一种疾病明确整合的讲座，随后是与患者、其家属、医疗团队以及一年级学生进行的讨论。我们的目标是探究跨专业病例讨论是否提升了基础科学的学习体验。
使用来自两门不同课程（2013 - 2016年）的评估来评估跨专业病例讨论的满意度。使用描述性统计对回复进行定量分析，并使用扎根理论内容分析法进行定性分析。研究2：对当前三年级和四年级学生关于基础科学长期记忆的后续测量结果使用威尔科克森符号秩检验进行分析。使用卡方检验评估三种不同基于病例的教学模式的相对排名。
与翻转课堂（66%）和拼图教学法（65%）相比，学生对跨专业病例讨论在强化概念和整合材料方面的满意度显著更高（93%），χ² = 120.9，P <.001。学生的评论可分为五类：享受、学习/记忆、基础科学的临床实用性、确认投身医学的热情以及其他。后续测量表明，对跨专业病例讨论中所涵盖疾病的生化基础的记忆明显更好。
虽然其他教学模式将基础科学融入临床情境，但跨专业病例讨论更进一步，展示了跨专业护理以及疾病在患者及其家人生活中的表现。因此，跨专业病例讨论营造了一个积极的学习环境，在这个环境中，学生感到舒适，与患者和医疗服务提供者建立起融洽的关系，并激发了学习基础科学的动力。
