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住院医师指导:提高医学生年终超声检查表现

Resident Instruction: Improving End-of-Year Medical Student Ultrasound Performance.

作者信息

Taylor Michael J, Gittens Ayesha, Beaubian Drew, Grady James, Herbst Meghan Kelly

机构信息

School of Medicine, University of Connecticut, Farmington, CT.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA.

出版信息

Fam Med. 2024 Oct 14;56(10):668-71. doi: 10.22454/FamMed.2024.326354.

Abstract

BACKGROUND AND OBJECTIVES

Having a limited number of trained faculty is a barrier to successful incorporation of ultrasound into undergraduate medical education. We evaluated the effectiveness of a resident-led extended focused assessment with sonography in trauma (eFAST) session administered to fourth-year medical students during their emergency medicine clerkship by measuring students' end-of-year eFAST performance and confidence.

METHODS

This was a single-site cross-sectional study of all graduating medical students enrolled in fourth-year clerkships between May 1, 2022 and April 30, 2023. A 60-minute, team-based eFAST session (intervention), taught by emergency medicine residents, was added to students' fourth-year emergency medicine clerkship in September 2022. All students were assigned to review an eFAST video (control). End-of-year performance and self-reported confidence assessments used a 20-point objective structured clinical examination (OSCE) and a 5-point Likert scale, respectively. The mean OSCE and confidence scores for control and intervention groups were compared using two-sample t tests and repeated after removing students exposed to additional US experiences.

RESULTS

Of 113 eligible students, 103 students participated: 48 in the control group, 55 in the intervention group. The intervention group scored higher on the OSCE than the control group (11.9 ±4.6 vs 9.9 ±5.1, P=.04) and reported similar confidence (3.2 ±1.0 vs 2.8 ±1.2; P=.09). After removing the 28 students with additional US experiences, the intervention group scored higher (10.8 ± 4.4 vs 8.2 ± 4.0; P=.01) and reported higher confidence (3.0 ±1.0 vs. 2.3 ±1.0, P=.01).

CONCLUSIONS

Resident-taught eFAST instruction during emergency medicine clerkships led to improved end-of-year fourth-year medical student eFAST performance and confidence.

摘要

背景与目的

训练有素的教员数量有限是阻碍超声成功融入本科医学教育的一个因素。我们通过评估四年级医学生在急诊医学实习期末的创伤超声重点评估扩展版(eFAST)表现和信心,来评价由住院医师主导的eFAST课程对四年级医学生的有效性。

方法

这是一项单中心横断面研究,研究对象为2022年5月1日至2023年4月30日期间参加四年级实习的所有即将毕业的医学生。2022年9月,由急诊医学住院医师授课的60分钟基于团队的eFAST课程(干预措施)被添加到学生的四年级急诊医学实习中。所有学生都被安排观看一段eFAST视频(对照)。实习期末表现和自我报告的信心评估分别采用20分的客观结构化临床考试(OSCE)和5分的李克特量表。使用两样本t检验比较对照组和干预组的平均OSCE得分和信心得分,并在剔除有额外超声检查经历的学生后重复进行比较。

结果

113名符合条件的学生中,103名学生参与:对照组48名,干预组55名。干预组在OSCE上的得分高于对照组(11.9±4.6对9.9±5.1,P=0.04),且报告的信心相似(3.2±1.0对2.8±1.2;P=0.09)。剔除28名有额外超声检查经历的学生后,干预组得分更高(10.8±4.4对8.2±4.0;P=0.01),且报告的信心更高(3.0±1.0对2.3±1.0,P=0.01)。

结论

在急诊医学实习期间由住院医师授课的eFAST教学可提高四年级医学生在实习期末的eFAST表现和信心。

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The 2022 Model of the Clinical Practice of Emergency Medicine.《2022年急诊医学临床实践模式》
J Emerg Med. 2023 Jun;64(6):659-695. doi: 10.1016/j.jemermed.2023.02.016. Epub 2023 Mar 28.
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The benefits of being a near-peer teacher.成为准同龄人教师的好处。
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