University of Kansas, School of Medicine, Kansas City, Kansas; University of Kansas Medical Center, Department of Neurosurgery, Kansas City, Kansas.
University of Kansas, School of Medicine, Kansas City, Kansas.
J Surg Educ. 2024 Nov;81(11):1513-1521. doi: 10.1016/j.jsurg.2024.07.031. Epub 2024 Aug 31.
Negative stereotypes associated with surgery by medical students are well documented in literature. Many cite long hours, poor work-life balance, pessimism, mean personalities, and cynicism as pervasive among surgeons and operating room culture. If allowed to persist, these negative perceptions can deter otherwise interested students from pursuing surgical subspecialties.
Incorporation of peer-teaching in the third-year clerkship to not only illuminate the hidden curriculum in surgery but adequately prepare students to participate in the operating room is paramount to taking steps to improve student perception as well as success as clerkship students.
An academic medical center.
Pre-clinical medical students.
One-hundred and forty-three third year clerkship students were surveyed with pre- and postinstruments. Students who participated in these pre clerkship peer-teaching sessions reported significant improvements in their ability to identify surgical anatomy (p < 0.001), an increased confidence in answering questions from attendings about anatomy and function as well as in identifying anatomical abnormalities (all p < 0.001). Students also reported significantly improved perceptions about surgeons as teachers and their willingness to support students pursuing surgery.
This study demonstrates that the incorporation of an immersive orientation prior to the start of the surgery clerkship has significantly positive impacts on the learning experience and confidence of medical students. Increased efforts should be made to introduce students to surgeons, surgical careers, and the operating room prior to the surgery clerkship, being sure to incorporate aspects of the hidden curriculum, to address the negative perceptions that continue to exist regarding surgical fields.
学生对手术的负面刻板印象在文献中已有充分记载。许多人认为,长时间工作、工作与生活失衡、悲观、刻薄的性格和玩世不恭是外科医生和手术室文化中普遍存在的特征。如果这些负面看法任其存在,可能会阻止原本对外科感兴趣的学生选择外科专业。
在三年级实习中融入同伴教学,不仅可以阐明外科领域的隐性课程,还可以充分准备学生参与手术室,这对于采取措施改善学生的看法以及实习学生的成功至关重要。
学术医疗中心。
临床前医学生。
对 143 名三年级实习学生进行了预调查和后调查。参加这些预实习同伴教学课程的学生报告说,他们在识别外科解剖结构方面的能力有了显著提高(p < 0.001),他们在回答主治医生关于解剖结构和功能以及识别解剖异常方面的问题的信心也有所增强(所有 p < 0.001)。学生还报告说,他们对外科医生作为教师的看法以及支持学生从事外科工作的意愿有了显著改善。
这项研究表明,在开始外科实习之前,融入沉浸式定向学习对医学生的学习体验和信心有显著的积极影响。应该更加努力地让学生在外科实习前接触外科医生、外科职业和手术室,并确保纳入隐性课程的各个方面,以解决关于外科领域的持续存在的负面看法。