教育研究：全球大流行期间美国神经病学临床实习的趋势
Education Research: Trends of Neurology Clerkships in the United States Amidst a Global Pandemic.
作者信息
VanHaerents Stephen, Kung Doris, Furr-Stimming Erin, Cutsforth-Gregory Jeremy K, Weaver Joshua, Cahill Carolyn M, Ostendorf Tasha, Keran Christopher M
机构信息
From the Department of Neurology Feinberg School of Medicine (S.V.), Northwestern University, Chicago, IL; Baylor College of Medicine (D.K.), Houston, TX; University of Texas Health Science Center at Houston (E.F.S.), McGovern Medical School; Mayo Clinic (J.K.C.-G.), Rochester, MN; Weill Cornell Medical College (J.W.), New York, NY; American Academy of Neurology (C.M.C., T.O., C.M.K.), Minneapolis, MN.
出版信息
Neurol Educ. 2024 Nov 6;3(4):e200169. doi: 10.1212/NE9.0000000000200169. eCollection 2024 Dec.
BACKGROUND AND OBJECTIVES
To report a 2022 survey of US medical school neurology clerkship directors (CDs) and to compare the results with those of similar surveys conducted in 2005, 2012, and 2017.
METHODS
An American Academy of Neurology (AAN) Consortium of Neurology Clerkship Directors (CNCD) workgroup developed the survey sent to all neurology CDs listed in the AAN CNCD database. Comparisons were made with 2005, 2012, and 2017 surveys.
RESULTS
The response rate was 72 (47%) of 152 CDs. The number of respondents reporting a required neurology clerkship has not significantly changed over the past 17 years (93%, 93%, 94%, and 96% for 2005, 2012, 2017, and 2022, respectively, = 0.848), but the timing of the clerkship has shifted. The proportion of clerkships that occur exclusively in students' third year has fluctuated around 50% since 2012 (56% in 2012, 51% in 2017, and 58% in 2022). Those taken only in the fourth year have decreased (from 45.6% in 2005, to 12% in 2012, 9% in 2017, and 3% in 2022 < 0.001). Three-fourths of respondents (n = 54 of 72) report a 4-week clerkship duration, the same as past years (75% in 2017 and 75% in 2012). During the initial stages of the coronavirus disease 2019 (COVID-19) pandemic (March 2020-July 2021), students in the neurology clerkship spent an average of 6 hours in online learning compared with 3 hours currently ( < 0.001). Respondents received an average of 27% of a full-time equivalent protected time. 87% indicated that they are very or somewhat satisfied in their role, but most (60%, n = 38/63) indicated that they have experienced burnout at some point within their career as a neurology CD.
DISCUSSION
Neurology clerkships remained resilient in the United States through the initial stages of the COVID-19 pandemic with demonstrated consistency in structure, curriculum, and administration. There has been a continued increase in the requirement of the clerkship as a 4-week clinical experience. The needs persist for more clerkship coordinator support and more protected time for neurology CDs. Despite high satisfaction, most of the respondents have experienced burnout for a variety of reasons, including lack of protected time and competing obligations.
背景与目的
报告2022年对美国医学院校神经病学实习主任（CDs）的一项调查，并将结果与2005年、2012年和2017年进行的类似调查结果进行比较。
方法
美国神经病学学会（AAN）神经病学实习主任联盟（CNCD）的一个工作组制定了该调查问卷，并发送给AAN CNCD数据库中列出的所有神经病学CDs。与2005年、2012年和2017年的调查进行了比较。
结果
152名CDs中有72名（47%）回复。报告有必修神经病学实习课程的受访者人数在过去17年中没有显著变化（2005年、2012年、2017年和2022年分别为93%、93%、94%和96%，P = 0.848），但实习时间有所变化。自2012年以来，仅在学生第三年进行的实习课程比例一直在50%左右波动（2012年为56%，2017年为51%，2022年为58%）。仅在第四年进行的实习课程有所减少（从2005年的45.6%降至2012年的12%，2017年的9%，2022年的3%，P < 0.001）。四分之三的受访者（72人中的54人）报告实习课程为期4周，与过去几年相同（2017年和2012年均为75%）。在2019冠状病毒病（COVID - 19）大流行的初始阶段（2020年3月至2021年7月），神经病学实习的学生平均花费6小时进行在线学习，而目前为3小时（P < 0.001）。受访者获得的相当于全职的受保护时间平均为27%。87%的人表示他们对自己的角色非常或有点满意，但大多数人（60%，n = 38/63）表示他们在作为神经病学CD的职业生涯中曾在某个时候经历过职业倦怠。
讨论
在美国，神经病学实习在COVID - 19大流行的初始阶段保持了韧性，在结构、课程和管理方面表现出一致性。作为为期4周临床经验的实习课程要求持续增加。对更多实习协调员支持和为神经病学CDs提供更多受保护时间的需求依然存在。尽管满意度很高，但大多数受访者由于各种原因经历过职业倦怠，包括缺乏受保护时间和相互竞争的职责。
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