Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Internal Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Clin Teach. 2022 Oct;19(5):e13520. doi: 10.1111/tct.13520. Epub 2022 Aug 6.
Near the beginning of the COVID-19 pandemic in the United States, medical students were pulled out of all in-person patient care activities. This resulted in massive disruption to the required clinical rotations (clerkships), necessitating creative curricular solutions to ensure continued education for medical students.
In response to the lockout, our school adopted a "flipped" clinical rotations model that assigned students to remote learning activities prior to in-person patient care activities. This approach allowed students to continue their clinical education virtually with a focus on knowledge for practice while awaiting return to the shortened in-person portions of their rotation. In planning the modified clinical curriculum, educational leaders adhered to several guiding principles including ensuring flexible remote curricular components that would engage students in active learning, designating that no rotation would be completely virtual, and completing virtual educational activities and standardised exams before students returned to in-person experiences.
End of rotation evaluations and standardised exam scores were analysed to determine the effectiveness of this model. Despite the disruption associated with the pandemic and the rapid implementation of the "flipped" rotations, students continued to rate the overall experiences as highly as traditional clinical rotations. Students also performed similarly on standardised exams when compared to cohorts from other classes at the same experience level.
While borne out of necessity during a pandemic, the lessons learned from our implementation of a "flipped" rotations model can be applied to address problems of capacity and clinical preparedness in the clinical setting.
在美国 COVID-19 大流行初期，医学生被全部撤出了所有的面对面病人护理活动。这导致必需的临床轮转（实习）受到了巨大干扰，需要创造性的课程解决方案来确保医学生的持续教育。
为应对封锁，我们学校采用了“翻转”临床轮转模式，在面对面病人护理活动之前为学生分配远程学习活动。这种方法允许学生在等待返回轮转的缩短面对面部分的同时，通过专注于实践知识的虚拟方式继续他们的临床教育。在规划修改后的临床课程时，教育领导者遵循了几个指导原则，包括确保灵活的远程课程部分，使学生能够积极参与学习，指定没有轮转将完全是虚拟的，并在学生返回面对面体验之前完成虚拟教育活动和标准化考试。
对轮转结束评估和标准化考试成绩进行了分析，以确定该模式的有效性。尽管受到疫情的干扰和“翻转”轮转的快速实施，学生们继续给予这种模式与传统临床轮转一样高的整体体验评价。与同一经验水平的其他班级的学生相比，学生在标准化考试中的表现也相似。
虽然在大流行期间是出于必要而实施的，但我们实施“翻转”轮转模式所吸取的经验教训可以应用于解决临床环境中的能力和临床准备问题。
