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临床实习医生是否精通基础科学?对三年级医学生在核心临床实习轮转前和结束时的基础科学知识进行评估。

Are Clerks Proficient in the Basic Sciences? Assessment of Third-Year Medical Students' Basic Science Knowledge Prior to and at the Completion of Core Clerkship Rotations.

作者信息

Norris Madeleine E, Cachia Mark A, Johnson Marjorie I, Martin Charys M, Rogers Kem A

机构信息

Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON Canada.

出版信息

Med Sci Educ. 2021 Mar 2;31(2):709-722. doi: 10.1007/s40670-021-01249-3. eCollection 2021 Apr.

Abstract

Basic sciences are a cornerstone of undergraduate medical education (UME), yet research indicates that students' basic science knowledge is not well retained. Many UME curricula are increasing the integration between the basic and clinical sciences with the goal of enhancing students' knowledge levels; however, the impact of clerkship training on students' basic science knowledge remains inconclusive. Thus, using clerkship directors' expectations as framework, we aimed to assess third-year medical students' basic science knowledge during clerkship training and evaluate the influence of clerkship training on their basic science knowledge. Using concepts deemed necessary by clerkship directors, we created a basic science assessment for each clerkship rotation. Assessments were distributed to third-year medical students as a pre- and post-test to assess their basic science knowledge prior to and at the completion of each rotation. On average, students retained ≥ 60% of relevant basic science knowledge from pre-clerkship, and neither clerkship rotation order, nor the basic science discipline being assessed, impacted students' basic science knowledge levels. Post-test data revealed that students, on average, reinforced fundamental concepts during clerkship. Interestingly, even though lower-performing students demonstrated the greatest post-test improvement, they still left each rotation with knowledge deficits compared with their highest-performing peers, suggesting that the clinical experience of clerkship appears to be particularly beneficial for lower-performing students, in regard to enhancing their basic science knowledge. Overall, results indicate that earlier exposure to clinical learning in UME, along with integration of basic science education into clerkship, could promote students' basic science knowledge acquisition and retention.

摘要

基础科学是本科医学教育(UME)的基石,但研究表明学生的基础科学知识掌握得并不牢固。许多UME课程正在加强基础科学与临床科学之间的整合,以期提高学生的知识水平;然而,临床实习培训对学生基础科学知识的影响仍不明确。因此,我们以临床实习主任的期望为框架,旨在评估三年级医学生在临床实习培训期间的基础科学知识,并评估临床实习培训对其基础科学知识的影响。利用临床实习主任认为必要的概念,我们为每个临床实习轮转创建了一项基础科学评估。评估作为预测试和后测试分发给三年级医学生,以评估他们在每次轮转之前和结束时的基础科学知识。平均而言,学生在临床实习前保留了≥60%的相关基础科学知识,临床实习轮转顺序和所评估的基础科学学科均未影响学生的基础科学知识水平。后测试数据显示,学生在临床实习期间平均强化了基本概念。有趣的是,尽管表现较差的学生在后测试中进步最大,但与表现最好的同龄人相比,他们在每次轮转结束时仍存在知识缺陷,这表明临床实习经历似乎对表现较差的学生在提高其基础科学知识方面特别有益。总体而言,结果表明,在UME中更早地接触临床学习,以及将基础科学教育融入临床实习,可以促进学生基础科学知识的获取和保留。

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