Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
J Surg Educ. 2023 Jul;80(7):957-964. doi: 10.1016/j.jsurg.2023.05.001. Epub 2023 Jun 3.
Numerous institutions have reduced preclinical didactic time to facilitate earlier clinical exposure during the second year of medical education. However, the effects that shortened preclinical education may have on performance in the surgery clerkship are unclear. This study aims to compare the clinical and examination performance of second- (MS2) and third-year (MS3) students synchronously completing an identical surgery clerkship.
All students completing the surgery clerkship (identical didactics, examinations, clinical rotations, etc.) were included. MS3s received 24 months of preclinical education, whereas MS2s received 14 months. Performance outcomes included weekly quizzes based on lectures, NBME Surgery Shelf Exam, numeric clinical evaluations, objective structured clinical examination (OSCE) scores, and overall clerkship grades.
University of Miami Miller School of Medicine.
All second- (MS2) and third-year (MS3) medical students completing the Surgery Clerkship over 1 year (n = 395).
There were 199 MS3 (50%) and 196 MS2 (50%) students. MS3s demonstrated higher median shelf exams (77% vs 72% MS2s), weekly quiz score averages (87% vs 80% MS2s), clinical evaluations (96% vs 95% MS2s), and overall clerkship grades (89% vs 87% MS2s), all p < 0.020. There was no difference in median OSCE performance (both 92%; p = 0.499). A greater proportion of MS3 students performed in the highest 50% of weekly quiz scores (57% vs 43% MS2), NBME shelf exams (59% vs 39% MS2), and overall clerkship grades (45% vs 37% MS2), all p < 0.010. No significant difference in the proportion of students placing in the top 50% of clinical parameters including the OSCE (48% MS3 vs 46% MS2; p = 0.106) and clinical evaluations (45% MS3 vs 38%; p = 0.185) was observed.
Although the duration of preclerkship education may correspond to examination scores, MS2s and MS3s perform similarly on clinical metrics. Future strategies to enhance available preclinical didactic time and preparation for examinations are needed.
许多机构已经减少了临床前的理论教学时间，以便在医学教育的第二年更早地接触临床。然而，缩短临床前教育对手术实习表现的影响尚不清楚。本研究旨在比较同步完成相同手术实习的二年级（MS2）和三年级（MS3）学生的临床和考试表现。
所有完成手术实习（相同的理论教学、考试、临床轮转等）的学生都包括在内。MS3 接受了 24 个月的临床前教育，而 MS2 接受了 14 个月。绩效结果包括基于讲座的每周测验、NBME 外科支架考试、数字临床评估、客观结构化临床考试（OSCE）分数和整体实习成绩。
迈阿密大学米勒医学院。
所有完成 1 年以上手术实习的二年级（MS2）和三年级（MS3）医学生（n=395）。
有 199 名 MS3（50%）和 196 名 MS2（50%）学生。MS3 的中位数支架考试成绩较高（77%对 72%的 MS2）、每周测验得分平均值较高（87%对 80%的 MS2）、临床评估较高（96%对 95%的 MS2）和整体实习成绩较高（89%对 87%的 MS2），所有 p<0.020。OSCE 表现的中位数无差异（均为 92%；p=0.499）。更多的 MS3 学生在每周测验成绩的最高 50%中表现出色（57%对 43%的 MS2）、NBME 支架考试成绩（59%对 39%的 MS2）和整体实习成绩（45%对 37%的 MS2），所有 p<0.010。在 OSCE（48%MS3 对 46%MS2；p=0.106）和临床评估（45%MS3 对 38%；p=0.185）等临床参数中，排名前 50%的学生比例没有显著差异。
尽管临床前教育的持续时间可能与考试成绩相对应，但 MS2 和 MS3 在临床指标上的表现相似。需要制定未来的策略来增加现有的临床前理论教学时间和为考试做准备。
