Ende J, Pozen J T, Levinsky N G
J Gen Intern Med. 1986 Jul-Aug;1(4):232-7. doi: 10.1007/BF02596189.
Third-year clerkships, organized around clinical experiences, may provide students with an uneven or narrowly focused fund of clinical knowledge. This paper describes the results of a comparative trial in which a structured curriculum, based on learning objectives, was introduced into an internal medicine clerkship at one of three teaching hospitals of a single medical school; the other two hospitals, providing similar patient care experiences, were used for comparison purposes. Students who did their clerkship at the hospital using the structured curriculum scored significantly higher on the Medicine section of the National Board Part II examination when scores were adjusted for past academic performance. The structured curriculum was very well received and, according to student perceptions, achieved the goal of expanding their basic clinical knowledge beyond that derived from reading only in connection with patient care. These results support the use of curricular guidelines and objectives as a means of enhancing students' cognitive experience during clinical clerkships.
以临床经验为基础组织的三年级临床实习，可能会给学生提供不均衡或过于狭隘的临床知识储备。本文描述了一项对比试验的结果，在一所医学院三所教学医院之一的内科临床实习中引入了基于学习目标的结构化课程；另外两所提供类似患者护理体验的医院用作对照。在根据过去学业成绩进行分数调整后，在采用结构化课程的医院进行临床实习的学生在国家医师资格考试第二部分的医学科目中得分显著更高。结构化课程很受欢迎，并且根据学生的看法，实现了将他们的基础临床知识拓展到不仅仅源于与患者护理相关阅读的目标。这些结果支持将课程指南和目标用作增强学生临床实习期间认知体验的一种手段。
