Department of Family Medicine, West Virginia University-Health Sciences Campus, Morgantown, WV.
Department of Family Medicine, West Virginia University-Health Sciences Campus, Charleston, WV.
Fam Med. 2023 Oct;55(9):616-619. doi: 10.22454/FamMed.2023.410835. Epub 2023 Jul 24.
The COVID-19 pandemic necessitated rapid changes to medical education for student and patient protection. A dearth of published US studies examine resulting clinical education outcomes due to pandemic-induced curricula changes. We describe adaptations made to a family medicine clerkship to move it from traditional in-person delivery to virtual only, and then from virtual to hybrid; and compare educational outcomes of students across delivery types.
We stratified 386 medical students in their third year completing their 8-week family medicine clerkship by type of content delivery, including in person, virtual only, and hybrid instruction. We examined the impact of these changes on three clerkship learning outcomes: the midblock assessment score, the National Board of Medical Examiners (NBME) exam score, and the final numeric score (FNS).
In our sample, 164 (42.5%) received content in person, 36 (9.3%) received virtual only, and 186 (48.2%) received hybrid content. Students receiving virtual only (M=76.4, SD=9.1) had significantly higher midblock assessment scores (F=8.06, df=2, P=.0004) than students receiving hybrid (M=71.7, SD=8.8) and in-person training (M=74.5, SD=7.2). No significant differences existed in students' NBME exam scores or FNSs across delivery types.
Students receiving virtual-only or hybrid content performed at least as well on three clerkship-related educational outcomes as their pre-COVID peers participating in person. Further research is needed to understand how changes to medical education affected student learning and skill development.
COVID-19 大流行促使医疗教育必须迅速做出改变，以保障学生和患者的安全。由于大流行导致课程发生变化，目前缺乏已发表的美国研究来检验由此产生的临床教育成果。我们描述了将一门家庭医学实习课程从传统的面对面教学转变为完全在线教学，再转变为混合教学模式所做的调整，并比较了不同教学模式下学生的教育成果。
我们根据内容交付方式，将 386 名三年级医学生分为三类，包括面对面、仅在线和混合教学。我们考察了这些变化对三个实习学习成果的影响：中期评估成绩、美国医师执照考试委员会（NBME）考试成绩和最终数字成绩（FNS）。
在我们的样本中，164 名（42.5%）学生接受面对面教学，36 名（9.3%）学生接受仅在线教学，186 名（48.2%）学生接受混合教学。接受仅在线教学的学生（M=76.4，SD=9.1）中期评估成绩明显高于接受混合教学（M=71.7，SD=8.8）和接受面对面教学的学生（M=74.5，SD=7.2）（F=8.06，df=2，P=.0004）。在 NBME 考试成绩或 FNS 方面，不同教学方式的学生之间没有显著差异。
接受在线或混合教学的学生在三个与实习相关的教育成果方面的表现至少与参加面对面教学的 COVID-19 前学生一样好。需要进一步研究了解医学教育的变化如何影响学生的学习和技能发展。
