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一门为医学生儿科实习做准备的新型儿科临床技能课程。

A Novel Pediatric Clinical Skills Curriculum to Prepare Medical Students for Pediatrics Clerkship.

作者信息

Podraza Lindsay C, Starnes Lauren S, Starnes Joseph R, Patel Anuj, Apple Rachel K P

机构信息

Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN USA.

Vanderbilt University Medical Center, Nashville, TN USA.

出版信息

Med Sci Educ. 2024 Nov 13;35(1):343-350. doi: 10.1007/s40670-024-02191-w. eCollection 2025 Feb.

Abstract

INTRODUCTION

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.

METHODS

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.

RESULTS

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).

DISCUSSION

This multi-modal curriculum emphasizing pediatric examination skills improved students' confidence in pediatric-specific knowledge and skills prior to clerkship.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-024-02191-w.

摘要

引言

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。

方法

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。

结果

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,

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d52/11933490/3fa24c584621/40670_2024_2191_Fig1_HTML.jpg

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