Garcia-Huidobro Diego, Fernandez Joaquín, Espinosa Pilar, Lustig Nicole, Perez Ignacio, Letelier Luz M
Pontificia Universidad Catolica de Chile, Vicuña Mackenna, Macul, Santiago, Chile.
University of Minnesota, Minneapolis, MN, 55455, USA.
BMC Med Educ. 2024 Dec 26;24(1):1533. doi: 10.1186/s12909-024-06421-y.
Therapy decision-making (TDM) is an essential medical skill. However, teaching therapeutic reasoning poses significant challenges. We present a comprehensive TDM course for medical students and report on student satisfaction with the educational strategies, their perceived importance of various TDM domains, and their self-efficacy in incorporating these elements into clinical decisions.
Three student cohorts participated in a 16-week TDM course, which included self-instruction modules, application assignments, faculty symposia, and application seminars as educational strategies. The course focused on TDM and emphasized how factors such as the patient's diagnosis, needs and preferences, treatment options, physicians' viewpoints, the patient-physician relationship, and contexts of medical practice impact TDM. After the course, students completed a before-and-after survey assessing their satisfaction with the educational strategies, their perceived importance of ten TDM domains, and their ability to incorporate these domains into patient management. Scores ranged from 1 to 10. Students from the first two cohorts completed a 1- and 2-year follow-ups.
A total of 387 students completed the course. All educational strategies were well-received, with self-instruction modules and faculty symposia yielding the highest satisfaction rates (94.8% and 88.6% respectively). Before-and-after evaluations indicated that students` perceived importance of the TDM domains increased from an average of 8.0 ± 2.4 at baseline to 9.9 ± 1.0 after the course. Additionally, their perceived ability to integrate TDM domains into practice rose from an average of 5.2 ± 3.2 to 9.4 ± 1.5 by the end of the course. Follow-up results showed a decrease in these outcomes over time.
This course serves as a successful model for systematically teaching TDM to medical students.
治疗决策（TDM）是一项重要的医学技能。然而，教授治疗推理面临重大挑战。我们为医学生开设了一门全面的TDM课程，并报告学生对教育策略的满意度、他们对TDM各个领域重要性的认知以及他们将这些要素纳入临床决策的自我效能感。
三个学生群体参加了为期16周的TDM课程，该课程采用自我指导模块、应用作业、教师研讨会和应用研讨会作为教育策略。该课程聚焦于TDM，并强调患者诊断、需求和偏好、治疗选择、医生观点、医患关系以及医疗实践背景等因素如何影响TDM。课程结束后，学生完成了一项前后调查，评估他们对教育策略的满意度、他们对十个TDM领域重要性的认知以及他们将这些领域纳入患者管理的能力。分数范围为1至10分。前两个群体的学生完成了1年和2年的随访。
共有387名学生完成了该课程。所有教育策略都受到好评，自我指导模块和教师研讨会的满意度最高（分别为94.8%和88.6%）。前后评估表明，学生对TDM领域重要性的认知从基线时的平均8.0±2.4提高到课程后的9.9±1.0。此外，他们将TDM领域整合到实践中的认知能力从平均5.2±3.2提高到课程结束时的9.4±1.5。随访结果显示，随着时间推移，这些结果有所下降。
本课程是向医学生系统教授TDM的成功范例。
