Podraza Lindsay C, Starnes Lauren S, Starnes Joseph R, Patel Anuj, Apple Rachel K P
Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN USA.
Vanderbilt University Medical Center, Nashville, TN USA.
Med Sci Educ. 2024 Nov 13;35(1):343-350. doi: 10.1007/s40670-024-02191-w. eCollection 2025 Feb.
Medical students feel poorly prepared to examine pediatric patients during clerkship. Our institution's introduction to clinical skills course lacked practice with pediatrics physical examination skills. We developed a novel clinical skills curriculum to increase students' confidence in examining pediatric patients.
Ericsson's deliberate practice conceptual framework guided curriculum design. We utilized a flipped-classroom model to teach the newborn examination. Students watched a video, then practiced with manikins and patients. For the child examination, students attended a lecture and practiced with hospitalized children and facilitators. Students then participated in a Home, Education, Eating/Exercise, Activities/Employment, Drugs, Suicidality, Sexuality, Safety (HEEADSSS) didactic and role play activity. Before and after participation, students completed REDCap surveys ranking confidence in performing pediatric examinations and identifying normal examination findings on a Likert scale (1 = "Not at all confident," 4 = "Extremely confident"). We analyzed data using Wilcoxon rank sum tests.
A total of 97 students participated in the curriculum. Respectively, 56 (58%) and 32 (30%) students completed pre- and post-participation surveys. Post-participation, students reported increased confidence in identifying normal infant (median [interquartile range]; (2 [2,2] vs 4 [3,4]; < 0.001) and child (2 [2,2] vs 3 [3,4]; < 0.001) examination findings as well as HEEADSSS assessment components (2 [1.5,2] vs 4 [3,4]; < 0.001), and had significantly higher scores on confidence performing infant (2 [2,2.5] vs 4 [3,4]; p < 0.001), child (2 [2,2] vs 3 [3,4]; < 0.001), and HEEADSSS assessment (2 [2,3] vs 4 [3,4]; < 0.001).
This multi-modal curriculum emphasizing pediatric examination skills improved students' confidence in pediatric-specific knowledge and skills prior to clerkship.
The online version contains supplementary material available at 10.1007/s40670-024-02191-w.
医学生在临床实习期间感觉自己对儿科患者的检查准备不足。我们学校的临床技能入门课程缺乏儿科体格检查技能的实践。我们开发了一种新颖的临床技能课程,以增强学生检查儿科患者的信心。
爱立信的刻意练习概念框架指导课程设计。我们采用翻转课堂模式教授新生儿检查。学生观看视频,然后使用人体模型和患者进行练习。对于儿童检查,学生参加讲座并与住院儿童及指导教师一起练习。然后,学生参与家庭、教育、饮食/运动、活动/就业、药物、自杀倾向、性取向、安全(HEEADSSS)教学和角色扮演活动。参与前后,学生完成REDCap调查,用李克特量表(1 =“一点也不自信”,4 =“极其自信”)对进行儿科检查的信心以及识别正常检查结果进行排名。我们使用威尔科克森秩和检验分析数据。
共有97名学生参加了该课程。分别有56名(58%)和32名(30%)学生完成了参与前和参与后的调查。参与后,学生报告在识别正常婴儿(中位数[四分位间距];(2[2,2]对4[3,4];<0.001)和儿童(2[2,2]对3[3,4];<0.001)检查结果以及HEEADSSS评估组件(2[1.5,2]对4[3,4];<0.001)方面信心增强,并且在进行婴儿(2[2,2.5]对4[3,4];p<0.001)、儿童(2[2,2]对3[3,4];<0.001)和HEEADSSS评估(2[2,