Keim Sarah A, Harmon Derek J, Martindale James R, Lopez Elisabeth N, Sanky Charles, Brooks William S, Cotter Meghan M, Davies David L, Doroudi Majid, Fahl Jeffrey C, Farias Anna, Granite Guinevere, Harrell Kelly M, Kar Rekha, Kramer Kenneth L, Jackson Jon, Jones Shiloh, Lackey-Cornelison Wendy, Laitman Jeffrey T, Latacha Kimberly, Lewis Steven R, Lovejoy Mork Amy, Marzban Hassan, McNary Thomas G, McWhorter David L, Merchant Aftab, Mussell Jason C, Quinn Melissa M, Reidenberg Joy S, Royer Danielle, Sakaguchi Alan, Sawyer F Kip, Topping Daniel B, Wainman Bruce, Wineski Lawrence E, Zumwalt Ann C, Hankin Mark H
Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Anat Sci Educ. 2023 Sep-Oct;16(5):943-957. doi: 10.1002/ase.2272. Epub 2023 Apr 11.
Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as essential or more important. Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.
临床实习对医学生来说是具有决定性意义的经历，在此期间，学生们在各种临床环境中积累诊断和治疗患者的经验时，将基础科学知识与临床信息相结合。在基础科学中，人们普遍认为解剖学是医学实践的基础。不幸的是，长期以来一直有人担心学生的解剖学知识低于临床实习主任和临床教师的期望。大多数全科医学医学院要求进行八门“核心”临床实习：内科（IM）、儿科（PD）、普通外科（GS）、妇产科（OB）、精神病学（PS）、家庭医学（FM）、神经病学（NU）和急诊医学（EM）。基于在这些临床实习中授课的临床医生的视角，进行了一项针对性需求评估，以确定对每门核心临床实习而言重要的解剖学知识。在美国24所全科医学医学院对总共525名临床教师进行了调查。参与者对全身各个区域的97个解剖结构组按照1 - 4李克特量表进行评分（1 = 不重要，4 = 必不可少）。非参数方差分析确定各临床实习之间是否存在差异。综合所有回复，91%的解剖结构组被归类为必不可少或更重要。家庭医学、急诊医学和普通外科的临床医生对大多数身体区域的解剖结构评分显著高于至少一门其他临床实习（p = 0.006）。本研究提供了一个解剖学内容的证据基础，这些内容应被视为对每门核心临床实习很重要，并且可能有助于开发和/或修订临床前课程，以支持医学生的临床培训。
