一门关于功能性医学疾病的医学生课程。

A Medical Student Curriculum on Functional Medical Disorders.

作者信息

Butt Mohsin F, Scotto Daniele, Gilmartin Christopher G S, Dhali Arkadeep, Gonem Sherif, Singhal Sumeet, Monaghan Tanya M, Frain John, Corsetti Maura

机构信息

NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.

Nottingham Digestive Diseases Centre, Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, UK.

出版信息

Clin Teach. 2025 Aug;22(4):e70117. doi: 10.1111/tct.70117.

DOI:10.1111/tct.70117

PMID:40571293

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12202073/

Abstract

BACKGROUND

Functional medical disorders (FMDs) refer to persistent physical symptoms that cause impairment or disability, but which cannot be explained by routine medical testing. Negative perceptions towards FMDs exist amongst a variety of healthcare professionals, including medical students. The aim of this study was to develop and evaluate a course addressing FMDs for medical students in their first year of clinical training, which was integrated within the formal medical school curriculum.

APPROACH

A multidisciplinary team of eight healthcare professionals delivered seven teaching sessions, each two hours in length, over six weeks. The curriculum was delivered via a combination of didactic teaching, small group tutorials and sessions with simulated patients. Pre- and post-course validated questionnaires assessed knowledge of, attitudes towards and confidence around irritable bowel syndrome (IBS). Students undertook a two-station objective structured clinical examination (OSCE), which assessed their ability to take a clinical history from and communicate a diagnosis to simulated patients with IBS and fibromyalgia.

EVALUATION

Twenty-seven students completed the pre- and post-course surveys, which demonstrated an increase in knowledge of FMDs at course conclusion (88.89% vs. 57.50%, p < 0.001). Students' confidence ratings increased in all (100%) domains relating to FMDs: pathophysiology, symptoms, investigations for diagnosis and communicating a diagnosis (p < 0.001, all analyses). There was a statistically significant improvement in attitude ratings towards FMDs in 11 of 12 (91.7%) questions. All (100%) students passed the OSCE.

IMPLICATIONS

A course integrated within the formal medical school curriculum may be a helpful way to improve knowledge and reduce stigma around FMDs.

摘要

背景

功能性医学疾病（FMDs）是指导致功能损害或残疾的持续性身体症状，但常规医学检查无法解释这些症状。包括医学生在内的各类医疗保健专业人员对FMDs存在负面看法。本研究的目的是开发并评估一门针对临床培训第一年医学生的FMDs课程，该课程融入了正规医学院课程体系。

方法

一个由八名医疗保健专业人员组成的多学科团队在六周内进行了七次教学课程，每次课程时长两小时。课程通过理论教学、小组辅导和与模拟患者互动相结合的方式进行。课程前后使用经过验证的问卷评估学生对肠易激综合征（IBS）的知识、态度和信心。学生进行了一个两站式客观结构化临床考试（OSCE），评估他们从患有IBS和纤维肌痛的模拟患者那里获取临床病史并向其传达诊断的能力。

评估

27名学生完成了课程前后的调查，结果显示课程结束时学生对FMDs的知识有所增加（88.89%对57.50%，p<0.001）。学生在与FMDs相关的所有（100%）领域的信心评分都有所提高：病理生理学、症状、诊断检查和传达诊断（p<0.001，所有分析）。在12个问题中的11个（91.7%）问题上，学生对FMDs的态度评分有统计学上的显著改善。所有（100%）学生通过了OSCE。