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
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.
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).
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.
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.
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。
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。
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。
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。
