日本医学生临床实习前对医疗实践态度的调查。
Survey on Medical Students' Attitudes Toward Medical Practice Just Before Clinical Clerkship in Japan.
作者信息
Komasawa Nobuyasu, Yokohira Masanao
机构信息
Community Medicine Education Promotion Office, Faculty of Medicine, Kagawa University, Takamatsu, JPN.
Department of Medical Education, Faculty of Medicine, Kagawa University, Takamatsu, JPN.
出版信息
Cureus. 2024 Jan 25;16(1):e52899. doi: 10.7759/cureus.52899. eCollection 2024 Jan.
INTRODUCTION
The present study examined the confidence in essential medical practices during clinical clerkship (CC) and performance in preparing education for medical students who are just starting CC at our university.
METHODS
We conducted a survey using questionnaires with 105 fourth-year medical students just before starting CC. This questionnaire analysis consists of the confidence in objective structured clinical examination (OSCE) and computer-based testing (CBT) performance toward essential medical practice recommended in the "Report on Medical Practice during Clinical Clerkship" by the Japanese Ministry of Health, Labor, and Welfare and medical safety for CC.
RESULTS
The response rate was 67.6% (71/105). As for the performance in each OSCE theme, the confidence in basic clinical technique was significantly smaller compared to chest or abdominal examination, medical interview, and emergency response (p<0.05 each). Medical interviews showed stronger confidence compared to gynecological, breast, or rectal examinations and prostate palpitation among medical examinations (p<0.05 each). In the basic technique during CC, skin disinfection showed stronger confidence compared to other techniques (p<0.05 each). On surgical technique during CC, surgical hand washing and gown technique significantly showed stronger confidence compared to skin suture, suture removal, bleeding control, and surgical assistant (p<0.05 each).
CONCLUSION
Our results suggest that medical students just before CC have less confidence in invasive medical practice during CC. As medical practice by student doctors becomes public, further systematic basic skill training both before and during CC is warranted.
引言
本研究调查了临床实习(CC)期间对基本医疗实践的信心,以及为我校刚开始CC的医学生准备教育时的表现。
方法
我们在105名四年级医学生刚开始CC之前,使用问卷进行了一项调查。该问卷调查分析包括对日本厚生劳动省《临床实习期间医疗实践报告》中推荐的基本医疗实践的客观结构化临床考试(OSCE)和基于计算机测试(CBT)表现的信心,以及CC的医疗安全。
结果
回复率为67.6%(71/105)。至于每个OSCE主题的表现,与胸部或腹部检查、医学问诊和应急反应相比,对基本临床技能的信心明显较小(各p<0.05)。在医学检查中,与妇科、乳房或直肠检查以及前列腺触诊相比,医学问诊表现出更强的信心(各p<0.05)。在CC期间的基本技能方面,与其他技能相比,皮肤消毒表现出更强的信心(各p<0.05)。在CC期间的手术技能方面,与皮肤缝合、拆线、出血控制和手术助手相比,外科洗手和穿手术衣技能明显表现出更强的信心(各p<0.05)。
结论
我们的结果表明,刚开始CC的医学生对CC期间的侵入性医疗实践信心较低。随着实习医生的医疗实践变得公开化,在CC之前和期间进行进一步系统的基本技能培训是必要的。