Dean Ryan, Morrow Dustin, Connelly Steven
Prisma Health-Upstate.
MedEdPublish (2016). 2021 May 3;10:109. doi: 10.15694/mep.2021.000109.1. eCollection 2021.
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Physicians frequently report poor confidence applying the physical exam for medical decision making. We developed a novel, multifaceted, resident-led curriculum to teach medical students the physical exam for clinical practice.
We created a two-week elective comprised of didactics, journal discussions, bedside ultrasound, and physical exam rounds for fourth year medical students at the University of South Carolina School of Medicine - Greenville. and by Steven McGee, MD, were used to develop content. The curriculum focused on cardiac, pulmonary, abdominal, endocrine, and neurologic exams. Faculty and residents facilitated all portions of the course. Chi-squared testing was used to calculate confidence intervals on pre- and post-course assessments.
Twenty-two fourth year medical students enrolled in the elective over the course of three years. Seventeen faculty, three chief residents, and 13 residents provided instruction. Residents provided roughly half of the total instruction hours. Students demonstrated statistically significant improvement on multiple choice pre-course and post-course assessments (56.8% vs 77.1%, p < 0.001). 95.5% of students reported feeling "confident" in their physical exam skills after the course.
After participating in the course, students demonstrated improved skill and comfort using the physical exam for clinical decision making.
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医生们经常表示在将体格检查应用于医疗决策时信心不足。我们开发了一种新颖的、多方面的、由住院医师主导的课程，以教授医学生临床实践中的体格检查。
我们为南卡罗来纳大学医学院格林维尔分校的四年级医学生创建了一个为期两周的选修课，包括讲座、期刊讨论、床边超声和体格检查查房。由医学博士史蒂文·麦吉撰写的[相关文献]被用于开发课程内容。该课程重点关注心脏、肺部、腹部、内分泌和神经系统检查。教员和住院医师负责课程的所有部分。使用卡方检验计算课程前后评估的置信区间。
在三年的时间里，有22名四年级医学生参加了该选修课。17名教员、3名总住院医师和13名住院医师提供了教学指导。住院医师提供了大约一半的总教学时长。学生在课程前和课程后的多项选择题评估中表现出统计学上的显著进步（56.8%对77.1%，p<0.001）。95.5%的学生在课程结束后表示对自己的体格检查技能“有信心”。
参加该课程后，学生在将体格检查用于临床决策方面表现出技能提升和舒适度提高。
