Alrahmani Ahmad, Aldarsouni Fayez G, Alothman Ghada I, Alsubaie Norah M
Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, SAU.
Department of Trauma Surgery, King Saud Medical City, Riyadh, SAU.
Cureus. 2024 Feb 21;16(2):e54662. doi: 10.7759/cureus.54662. eCollection 2024 Feb.
Medical students' transition to internship has a discernible gap in structured preparation, particularly in practical skill application. We introduced the internship preparatory clinical course (IPCC) to address this gap. Methods: The course was conducted at the clinical skills and simulation center at King Saud University Medical City and included a total of eight skills distributed across four stations. It employs a timed-station methodology, inspired by the Observed Structured Clinical Examination, but innovatively adapted as a teaching method. Participants were exposed to various stations, such as suturing techniques, interactive mannequins for anatomical structure demonstration, real ultrasound machines on simulated patients, IV cannulation, and urinary catheterization. To facilitate active learning, participants received course materials a day prior, equipped with QR codes for quick reference. Instructors emphasized on-the-spot review, fostering an environment where learners actively engage. Toward the end of the course, after internship a follow-up survey was administered to obtain feedback, achieving a response rate of 83% (n=45/54).
Feedback from the course was overwhelmingly positive, with 91.1% (n=41/45) rating the course as 7 and above out of 10. Participants expressed a higher degree of confidence in providing wound care (Median: 8, IQR: 2) and inserting or removing a Foley catheter (Median: 8, IQR: 4). Lower confidence was observed in stoma examination and care (Median: 5, IQR: 4). During their internships, participants reported that 100% (n=45/45) utilized suturing skills, 48.9% (n=22/45) performed focused assessment with sonography in trauma (FAST) examinations, and 62.2% (n=28/45) attempted nasogastric tube insertions. Additionally, 88.9% (n=40/45) performed wound examinations, 77.8% (n=35/45) provided wound care and dressing, 37.8% (n=17/45) performed abscess drainage, 51.1% (n=23/45) removed and 37.8% (n=17/45) inserted a Foley catheter, and 20% (n=9/45) provided stoma care.
The IPCC effectively addresses the existing gap in medical education, bridging the theory-to-practice divide. The innovative use of the timed-station approach emphasizes the importance of active learning. Our results signify the importance of simulation training, as most interns acknowledge the positive impact of the course on their internship. We recommend preparing pre-interns for internships by giving special consideration to the procedural aspects as most associated with medical errors. The timed-station approach can improve cost-effectiveness and enhance responsibility-driven learning.
医学生向实习阶段的过渡在结构化准备方面存在明显差距，尤其是在实践技能应用方面。我们引入了实习预备临床课程（IPCC）来弥补这一差距。方法：该课程在沙特国王大学医学城的临床技能与模拟中心开展，总共包括分布在四个站点的八项技能。它采用限时站点方法，灵感来源于客观结构化临床考试，但创新性地作为一种教学方法进行了调整。参与者接触了各个站点，如缝合技术、用于解剖结构演示的交互式人体模型、模拟患者身上的真实超声机、静脉穿刺置管和导尿术。为促进主动学习，参与者在课程前一天收到配有二维码以便快速查阅的课程材料。教师强调现场复习，营造学习者积极参与的环境。课程结束后，在实习之后进行了一项后续调查以获取反馈，回复率为83%（n = 45/54）。
课程反馈总体积极，91.1%（n = 41/45）的参与者将该课程评为10分制中的7分及以上。参与者在提供伤口护理（中位数：8，四分位距：2）和插入或拔除Foley导尿管（中位数：8，四分位距：4）方面表现出更高的信心。在造口检查和护理方面信心较低（中位数：5，四分位距：4）。在实习期间，参与者报告称100%（n = 45/45）运用了缝合技能，48.9%（n = 22/45）在创伤重点超声评估（FAST）检查中进行了操作，62.2%（n = 28/45）尝试了鼻胃管插入。此外，88.9%（n = 40/45）进行了伤口检查，77.8%（n = 35/45）提供了伤口护理和换药，37.8%（n = 17/45）进行了脓肿引流，51.1%（n = 23/45）拔除且37.8%（n = 17/45）插入了Foley导尿管，20%（n = 9/45）提供了造口护理。
IPCC有效弥补了医学教育中现有的差距，弥合了理论与实践的鸿沟。限时站点方法的创新应用强调了主动学习的重要性。我们的结果表明了模拟培训的重要性，因为大多数实习生认可该课程对他们实习的积极影响。我们建议通过特别关注与医疗差错最相关的操作方面来为实习前的学生做好实习准备。限时站点方法可以提高成本效益并增强责任驱动型学习。
