Yu Jihye, Lee Sukyung, Lee Janghoon, Park Inwhee
Department of Medical Education, Ajou University School of Medicine, Suwon, Korea.
Ajou Center for Clinical Excellence, Ajou University School of Medicine, Suwon, Korea.
Korean J Med Educ. 2025 Jun;37(2):143-152. doi: 10.3946/kjme.2025.331. Epub 2025 May 29.
The COVID-19 (coronavirus disease 2019) pandemic led to significant changes in clinical clerkships, including reduced ward rounds. We aimed to determine how the pandemic-induced changes in the clinical practice environment affect the clinical performance of medical students.
We analyzed objective structured clinical examination scores of third- and fourth-year medical students from 2019-2020 and 2020-2021 across six stations by the Seoul-Gyeonggi Consortium. Clinical, communication, and ability scores were measured and analyzed using repeated-measures multivariate analysis of variance.
The interaction between clinical practice progress and pandemic-induced changes significantly affected physical examination and medical history scores, though the differences were not substantial. Patient-physician interaction significance varied by measurement period. Clinical communication ability also showed significant differences based on the measurement period and practical experience.
During the pandemic, alternative learning methods, including self-learning, simulation/practice, and peer role-play, helped improve medical competency in areas such as history-taking and physical examination. However, these were less effective in improving patient-physician interactions or clinical communication efficacy. Alternative learning methods have limitations, and they cannot replace direct patient encounters in clinical practice.
2019年冠状病毒病（COVID-19）大流行导致临床实习发生重大变化，包括查房次数减少。我们旨在确定大流行引起的临床实践环境变化如何影响医学生的临床能力。
我们分析了首尔-京畿道联盟在2019 - 2020年和2020 - 2021年期间对三、四年级医学生在六个站点进行的客观结构化临床考试成绩。使用重复测量多变量方差分析对临床、沟通和能力得分进行测量和分析。
临床实践进展与大流行引起的变化之间的相互作用对体格检查和病史得分有显著影响，尽管差异不大。医患互动的重要性因测量时期而异。临床沟通能力也因测量时期和实践经验而存在显著差异。
在大流行期间，包括自主学习、模拟/实践和同伴角色扮演在内的替代学习方法有助于提高医学生在病史采集和体格检查等方面的能力。然而，这些方法在改善医患互动或临床沟通效果方面效果较差。替代学习方法存在局限性，无法替代临床实践中与患者的直接接触。
