Medical Programme Directorate, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Department of Surgery, The University of Auckland, Auckland, New Zealand.
Med Teach. 2023 Aug;45(8):877-884. doi: 10.1080/0142159X.2023.2186205. Epub 2023 Mar 11.
Progress tests (PTs) assess applied knowledge, promote knowledge integration, and facilitate retention. Clinical attachments catalyse learning through an appropriate learning context. The relationship between PT results and clinical attachment sequence and performance are under-explored. Aims: (1) Determine the effect of Year 4 general surgical attachment (GSA) completion and sequence on overall PT performance, and for surgically coded items; (2) Determine the association between PT results in the first 2 years and GSA assessment outcomes.
All students enrolled in the medical programme, who started Year 2 between January 2013 and January 2016, were included; with follow up until December 2018. A linear mixed model was applied to study the effect of undertaking a GSA on subsequent PT results. Logistic regressions were used to explore the effect of past PT performance on the likelihood of a student receiving a distinction grade in the GSA.
965 students were included, representing 2191 PT items (363 surgical items). Sequenced exposure to the GSA in Year 4 was associated with increased performance on surgically coded PT items, but not overall performance on the PT, with the difference decreasing over the year. PT performance in Years 2-3 was associated with an increased likelihood of being awarded a GSA distinction grade (OR 1.62, < 0.001), with overall PT performance a better predictor than performance on surgically coded items.
Exposure to a surgical attachment improves PT results in surgically coded PT items, although with a diminishing effect over time, implying clinical exposure may accelerate subject specific learning. Timing of the GSA did not influence end of year performance in the PT. There is some evidence that students who perform well on PTs in preclinical years are more likely to receive a distinction grade in a surgical attachment than those with lower PT scores.
进展测试（PT）评估应用知识，促进知识整合，并有助于保留。临床实习通过适当的学习环境促进学习。PT 结果与临床实习顺序和表现之间的关系尚未得到充分探索。目的：（1）确定四年级普通外科实习（GSA）完成和顺序对整体 PT 表现的影响，以及对手术编码项目的影响；（2）确定前 2 年 PT 结果与 GSA 评估结果之间的关系。
所有于 2013 年 1 月至 2016 年 1 月期间开始二年级学习的医学课程学生均被纳入研究；随访至 2018 年 12 月。线性混合模型用于研究进行 GSA 对随后 PT 结果的影响。逻辑回归用于探索过去 PT 表现对学生在 GSA 中获得优异成绩可能性的影响。
共纳入 965 名学生，共涉及 2191 项 PT 项目（363 项手术项目）。四年级有顺序地接触 GSA 与手术编码 PT 项目的表现提高有关，但与 PT 整体表现无关，且差异随时间的推移而减小。在 2-3 年级的 PT 表现与获得 GSA 优异成绩的可能性增加相关（OR 1.62，<0.001），整体 PT 表现比手术编码项目的表现更好地预测。
接触外科实习可提高手术编码 PT 项目的 PT 成绩，尽管随着时间的推移效果逐渐减弱，这表明临床接触可能加速特定学科的学习。GSA 的时间安排并不影响 PT 年终表现。有一些证据表明，在基础临床学年中 PT 表现良好的学生比 PT 成绩较低的学生更有可能在外科实习中获得优异成绩。
