Third-Year Resident, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt.
Hospital Medicine Fellow, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt.
MedEdPORTAL. 2024 Oct 4;20:11448. doi: 10.15766/mep_2374-8265.11448. eCollection 2024.
In busy clinical settings, there is limited time to teach physical examination (PE) and procedural skills, particularly when the traditional head-to-toe PE approach is time-consuming. Near-peer teaching of a more efficient approach, the hypothesis-driven PE (HDPE), increases students' learning opportunities. We developed a near-peer HDPE module to improve medical student confidence, knowledge, and skills for diagnosing and managing streptococcal pharyngitis.
During this 1-hour module, residents taught the diagnostic approach for a patient with sore throat and facilitated small groups for practicing PE and throat swab skills. We assessed students using pre- and postmodule surveys including Likert-scale confidence scores (1 = , 5= ), multiple-choice knowledge questions, and a skills rubric. A control group was surveyed at clerkship conclusion.
Of the 71 pediatric clerkship students who participated, 69 (97%) completed premodule surveys and 65 (91%) completed skills assessments. Twenty-eight (39%) completed postmodule surveys and skill assessments. After participation, students' survey responses and rubrics indicated significant increase in confidence ( = 2 [IQR = 1,2], = 4 [IQR = 4,5]; < .001), knowledge ( = 40%, = 77%; < .001), and skills ( = 5.3, = 7.5; < .01). Participating students also had significantly higher confidence ( < .005) and knowledge ( < 0.01) compared to the control group.
This near-peer HDPE module improved students' knowledge, confidence, and skills related to streptococcal pharyngitis diagnosis and management and achieved compliance for a required clerkship skill.
在繁忙的临床环境中，教授体检（PE）和操作技能的时间有限，尤其是当传统的从头到脚的 PE 方法耗时较长时。以同伴教学的方式教授更有效的方法，即基于假设的体检（HDPE），可以增加学生的学习机会。我们开发了一种基于同伴的 HDPE 模块，以提高医学生对诊断和管理链球菌性咽炎的信心、知识和技能。
在这个 1 小时的模块中，住院医师教授了咽痛患者的诊断方法，并为小组练习 PE 和咽喉拭子技能提供了便利。我们使用模块前后的调查评估学生，包括李克特量表的信心评分（1= 非常低，5= 非常高）、多项选择题知识问题和技能评分表。对照组在实习结束时进行调查。
在参与的 71 名儿科实习学生中，69 名（97%）完成了模块前的调查，65 名（91%）完成了技能评估。28 名（39%）完成了模块后的调查和技能评估。参与后，学生的调查回复和评分表显示出在信心（ = 2 [IQR = 1,2]， = 4 [IQR = 4,5]； <.001）、知识（ = 40%， = 77%； <.001）和技能（ = 5.3， = 7.5； <.01）方面有显著提高。与对照组相比，参与的学生在信心（ <.005）和知识（ < 0.01）方面也有显著提高。
这种基于同伴的 HDPE 模块提高了学生与链球菌性咽炎诊断和管理相关的知识、信心和技能，并达到了实习所需技能的合规性。
