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熟能生巧并不适用:临床经验与三年级医学生的能力并不相关。

Practice Doesn't Make Perfect: Clinical Experience With Procedures Does Not Correlate Well With Competence in Third-Year Medical Students.

机构信息

University of Kentucky College of Medicine, Lexington, Kentucky.

University of Kentucky College of Medicine, Lexington, Kentucky.

出版信息

J Surg Educ. 2022 Nov-Dec;79(6):1441-1446. doi: 10.1016/j.jsurg.2022.07.017. Epub 2022 Aug 4.

Abstract

OBJECTIVE

There is limited data available about factors which promote competence with procedures in medical students. Specifically, the relationship between procedural clinical experience and performance on an assessment is unclear. We sought to determine whether a correlation exists between the amount and type of clinical experience with a procedure and student performance on a standardized assessment of that procedure.

DESIGN

Faculty performed standardized assessments of third-year medical students on ten procedures using simulation. We prospectively surveyed students about 3 types of experience (performed, observed, and simulated) with these procedures during their clerkships. We then analyzed whether a correlation exists between student experience and their competency assessment scores using Pearson's correlation.

SETTING/PARTICIPANTS: Third-year medical students at the University of Kentucky College of Medicine.

RESULTS

In 2018 to 2019, 131 students were assessed on procedural competency with 10 failures. One hundred and twenty students (91.6%) completed the clinical experience survey. Correlations between types of experience and competency scores were small to moderate, with only 5 of 40 being significant. We found no correlation between experience having performed a procedure and competency score.

CONCLUSIONS

Overall, we did not find convincing evidence of a correlation between experience with procedures during clerkships and performance on a competency assessment. This suggests other factors may be contributing to procedural competence, which has implications for how educators should develop procedural competence in students.

摘要

目的

关于促进医学生掌握程序技能的因素,目前的数据有限。具体来说,程序临床经验与评估表现之间的关系尚不清楚。我们试图确定在程序方面,临床经验的数量和类型与学生在标准化评估中的表现之间是否存在相关性。

设计

教师使用模拟对三年级医学生进行了十项程序的标准化评估。我们前瞻性地调查了学生在实习期间对这些程序的三种经验(执行、观察和模拟)的情况。然后,我们使用 Pearson 相关分析来分析学生经验与其能力评估分数之间是否存在相关性。

地点/参与者:肯塔基大学医学院的三年级医学生。

结果

在 2018 年至 2019 年期间,有 131 名学生接受了 10 项程序能力评估,其中有 1 人失败。120 名学生(91.6%)完成了临床经验调查。经验类型与能力评分之间的相关性较小,只有 40 个中的 5 个具有统计学意义。我们没有发现执行程序的经验与能力评分之间存在相关性。

结论

总体而言,我们没有发现实习期间程序经验与能力评估表现之间存在相关性的令人信服的证据。这表明其他因素可能对程序能力有贡献,这对教育者如何在学生中培养程序能力具有启示意义。

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