Chen Xiangyu, Gong Matthew F, Wu Song, He Jinshen
Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China.
Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Front Surg. 2023 Feb 13;10:1113267. doi: 10.3389/fsurg.2023.1113267. eCollection 2023.
Despite the clerkship being crucial in the training of a future doctor, no widely accepted education model has been proposed. This study devised a new model for clinical clerkship rotations, titled "LEARN" for Lecture, English-video, Advisor, Real-case and Notion, and evaluated whether the LEARN model is appropriate for medical education in China.
A cross-sectional study was performed among 101 fourth-year students from the Xiangya School of Medicine during an Orthopaedic Surgery clerkship rotation in the Third Xiangya Hospital. They were divided into seven groups and took clerkship based on the LEARN model. A questionnaire was collected at the conclusion to measure learning outcomes.
The LEARN model was highly accepted with the acceptance of five sessions being 95.92% (94/98), 93.88% (92/98), 96.98% (97/98), 100% (98/98) and 96.94% (95/98). The outcomes of two genders were comparable, whereas a difference was observed in the test score among groups (group 3 scored 93.93 ± 5.20, higher than others). Quantitative analysis showed that positive correlations existed in participation in the Notion (Notion means students' case discussion) section with leadership ( = 0.84, 95% CI: 0.72-0.94, < 0.001), participation in the Real-case section with leadership ( = 0.66, 95% CI: 0.50-0.80, < 0.001), participation in the Real-case section with mastery of inquiring skills ( = 0.57, 95% CI: 0.40-0.71, < 0.001) and participation in the Notion section with mastery of physical examination skills ( = 0.56, 95% CI: 0.40-0.69, < 0.001). Further qualitative analysis demonstrated that high-level participation in the English-video section indicated better outcomes in mastery of inquiring ( < 0.01), physical examination ( < 0.001), film reading ( < 0.01) and clinical reasoning ( < 0.01) skills.
Our results support the LEARN model is a promising method for medical clerkship in China. Further research involving more participants and more meticulous design is planned to test its efficacy. For refinement, educators may try to promote students' participation in the English-video session.
尽管临床实习对未来医生的培训至关重要,但尚未提出被广泛接受的教育模式。本研究设计了一种新的临床实习轮转模式,名为“LEARN”,即讲座(Lecture)、英语视频(English-video)、导师指导(Advisor)、真实病例(Real-case)和病例讨论(Notion),并评估LEARN模式是否适用于中国的医学教育。
在湘雅三医院进行骨科临床实习轮转期间,对来自湘雅医学院的101名四年级学生进行了一项横断面研究。他们被分为七组,并按照LEARN模式进行临床实习。在实习结束时收集问卷以衡量学习成果。
LEARN模式得到了高度认可,五节课的认可率分别为95.92%(94/98)、93.88%(92/98)、96.98%(97/98)、100%(98/98)和96.94%(95/98)。两组性别学生的学习成果相当,但各小组之间的测试成绩存在差异(第3组得分为93.93±5.20,高于其他组)。定量分析表明,参与病例讨论(病例讨论是指学生的病例讨论)部分与领导力呈正相关(r = 0.84,95%CI:0.72 - 0.94,P < 0.001),参与真实病例部分与领导力呈正相关(r = 0.66,95%CI:0.50 - 0.80,P < 0.001),参与真实病例部分与问诊技能掌握呈正相关(r = 0.57,95%CI:0.40 - 0.71,P < 0.001),参与病例讨论部分与体格检查技能掌握呈正相关(r = 0.56,95%CI:0.