新冠疫情对台湾医学生学习成果的影响：一项关于客观结构化临床考试表现的两年前瞻性队列研究
The Impact of COVID-19 Pandemic on the Learning Outcomes of Medical Students in Taiwan: A Two-Year Prospective Cohort Study of OSCE Performance.
作者信息
Tzeng Tzyy-Yurn, Hsu Chia-An, Yang Ying-Ying, Yuan Eunice J, Chang Ya-Ting, Li Tzu-Hao, Li Chung-Pin, Liang Jen-Feng, Lirng Jiing-Feng, Chen Tzeng-Ji, Huang Chia-Chang, Hou Ming-Chih, Chen Chen-Huan, Sheu Wayne Huey-Herng
机构信息
Department of Medical Education, Medical Innovation and Research Office, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
College of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan.
出版信息
Int J Environ Res Public Health. 2021 Dec 25;19(1):208. doi: 10.3390/ijerph19010208.
BACKGROUND/AIMS: To avoid the negative impacts of the COVID-19 pandemic on clinical clerkship, supplemental teachings such as digital materials in the scenario-based distal simulations were implemented. This study utilized the OSCE (objective-structured clinical examination) to evaluate the impact of COVID-19 pandemic on the learning outcome of medical students from the regular group (class of 2020) and pandemic-impacted group (class of 2021).
METHODS
All medical students serially took, firstly, the mock-OSCE, secondly, the mock-OSCE, and the national OSCE. Then, the serial OSCE scores were compared between groups.
RESULTS
Although with similar scores in the first mock OSCE, the regular group ( = 78) had a higher average score in the national OSCE than the pandemic-impacted group ( = 80) (872.18 vs. 834.96, = 0.003). In terms of improvement, the performances of the regular group were also better than the pandemic-impacted group between the second mock OSCE and the national OSCE (79.10 vs. 38.14, = 0.014), and between the second mock OSCE and the national OSCE (125.11 vs. 77.52, = 0.003). While separating distinct genres, the regular group had more of a score increment in standardized patient-based stations between the second mock OSCE and the national OSCE (regular vs. pandemic-impacted: 57.03 vs. 18.95, = 0.003), as well as between the first mock OSCE and the national OSCE (75.97 vs. 26.36, < 0.001), but there was no significant difference among the skill-based stations. In particular, the scores of the emergency medicine associated station in the national OSCE of the pandemic-impacted group was lower.
CONCLUSIONS
Our study implies that the pandemic significantly hampered the learning outcomes of final year medical students in their clinical participation. Especially facing the COVID-19 pandemic, more supplemental teachings are needed to compensate the decreasing emergency medicine exposure.
背景/目的：为避免新冠疫情对临床实习产生负面影响，实施了基于情景的远程模拟等补充教学方式，如数字材料。本研究利用客观结构化临床考试（OSCE）评估新冠疫情对常规组（2020级）和受疫情影响组（2021级）医学生学习成果的影响。
方法
所有医学生先后参加了第一次模拟OSCE、第二次模拟OSCE和国家OSCE。然后，比较两组的系列OSCE成绩。
结果
尽管在第一次模拟OSCE中成绩相似，但常规组（n = 78）在国家OSCE中的平均成绩高于受疫情影响组（n = 80）（872.18对834.96，P = 0.003）。在提高方面，常规组在第二次模拟OSCE和国家OSCE之间的表现也优于受疫情影响组（79.10对38.14，P = 0.014），以及在第一次模拟OSCE和国家OSCE之间（125.11对77.52，P = 0.003）。在区分不同类型时，常规组在第二次模拟OSCE和国家OSCE之间以及第一次模拟OSCE和国家OSCE之间基于标准化患者的站点得分增量更多（常规组对受疫情影响组：57.03对18.95，P = 0.003），以及（75.97对26.36，P < 0.001），但在基于技能的站点之间没有显著差异。特别是，受疫情影响组在国家OSCE中与急诊医学相关站点的得分较低。
结论
我们的研究表明，疫情显著阻碍了最后一年医学生临床参与的学习成果。特别是面对新冠疫情，需要更多的补充教学来弥补急诊医学接触减少的情况。
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