Heart Center, Cardiology Division, Albertinen Hospital, Hamburg, Germany.
III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Perspect Med Educ. 2022 Oct;11(5):266-272. doi: 10.1007/s40037-022-00720-0. Epub 2022 Jul 21.
Interprofessional training wards (ITWs) are implemented to provide medical students with a holistic and authentic health care experience to improve their clinical competencies. Controlled outcome studies assessing students' competencies after ITW-training are uncommon. In this case-control study, we assessed final-year medical students who received ITW-training regarding entrustable professional activities (EPAs) and communicative as well as social competencies.
In March 2021, 32 final-year students, 16 with (ITW group) and 16 without (control group) a previous four-week placement on an ITW participated in a training simulating the first day of residency. The simulated patients assessed students' communication and interpersonal skills for history taking with the ComCare index after every consultation. Twelve prospective EPAs were assessed by three senior physicians after watching videos of the students' case presentations.
While baseline characteristics and ComCare index ratings were not significantly different between the two groups, the overall mean entrustment level for the 12 EPAs was significantly higher (p < 0.001) in the ITW group compared to the control group (median = 3.15 versus 2.22). The interrater reliability for all EPAs was high and entrustment in students from the ITW group was significantly higher in 10 out of 12 EPAs.
ITW training seems to prepare medical students well to practice competencies which are relevant for prospective entrustment decisions and can be deduced by senior physicians from case presentations. Further studies with larger student cohorts are needed to corroborate this finding and observable EPAs could also be defined to assess students' competencies after ITW training.
跨专业培训病房（ITW）的实施旨在为医学生提供全面而真实的医疗体验，以提高他们的临床能力。评估医学生在 ITW 培训后能力的对照结果研究并不常见。在这项病例对照研究中，我们评估了接受过 ITW 培训的最后一年医学生的可委托专业活动（EPA）以及沟通和社交能力。
在 2021 年 3 月，32 名最后一年的学生参加了一项培训，其中 16 名（ITW 组）有过为期四周的 ITW 实习，16 名（对照组）没有。培训模拟了住院医师的第一天。每位模拟患者在每次就诊后，都会使用 ComCare 指数评估学生的沟通和人际交往技能。三位资深医生在观看学生病例陈述的视频后，对 12 项预期 EPA 进行评估。
尽管两组的基线特征和 ComCare 指数评分没有显著差异，但在 12 项 EPA 中，总体委托水平在 ITW 组明显更高（p<0.001），对照组为 2.22，ITW 组为 3.15。所有 EPA 的内部评估者间信度均较高，且 ITW 组学生的委托水平在 10 项 EPA 中有 10 项显著高于对照组。
ITW 培训似乎很好地为医学生做好了准备，使他们能够实践与未来委托决策相关的能力，并且可以由资深医生从病例陈述中推断出来。需要进一步进行具有更大学生群体的研究来证实这一发现，并且可以定义可观察的 EPA 来评估医学生在 ITW 培训后的能力。
