DeBehnke D, Shepherd D, Ma O J
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
Acad Emerg Med. 1995 Jun;2(6):519-22. doi: 10.1111/j.1553-2712.1995.tb03251.x.
To determine the effects of a case-based, core content-oriented emergency medicine (EM) curriculum on the basic EM knowledge of senior medical students.
All senior medical students rotating through the Milwaukee County EM elective during the 1992-1993 academic year were assigned specific chapter readings from a case-oriented EM textbook. A course curriculum consisting of goals and objectives for each chapter and two to three representative cases for the discussion topic also was distributed to each student. Interspersed with the cases was a series of questions directed at pathophysiology, diagnosis, management, and disposition. The EM faculty and residents conducted case discussions three times per week. All students completing the rotation were given a pretest at the beginning and a final examination at the end of the rotation. In addition, the students rated the textbook, coursebook, and lecture series at the end of the rotation using a five-point Likert scale.
Seventy-five students rotated through the elective. The students showed a significant improvement in their EM knowledge base as judged by improvement in final examination scores compared with pretest scores (pretest score 62.2 +/- 7.1%; final examination score 76.2 +/- 6.3%; p < 0.0001). The mean change in scores was 14.8%, with a range of -1.6% to 34%. The students also rated the textbook, coursebook, and lecture series as effective, as shown by high median scores on a Likert scale.
A case-based EM curriculum coupled with ED clinical experience improves basic EM diagnostic and management knowledge of senior medical students.
确定以病例为基础、以核心内容为导向的急诊医学（EM）课程对高年级医学生急诊医学基础知识的影响。
1992 - 1993学年所有轮转至密尔沃基县急诊医学选修课的高年级医学生，被指定阅读一本以病例为导向的急诊医学教材中的特定章节。还向每位学生分发了一份课程大纲，其中包括每章的目标以及针对讨论主题的两到三个代表性病例。穿插在病例中的是一系列针对病理生理学、诊断、管理和处置的问题。急诊医学教员和住院医师每周进行三次病例讨论。所有完成轮转的学生在轮转开始时进行一次预测试，结束时进行一次期末考试。此外，学生在轮转结束时使用五点李克特量表对教材、课程大纲和讲座系列进行评分。
75名学生完成了该选修课轮转。与预测试成绩相比，期末考试成绩有所提高，表明学生的急诊医学知识基础有显著改善（预测试成绩62.2 +/- 7.1%；期末考试成绩76.2 +/- 6.3%；p < 0.0001）。成绩的平均变化为14.8%，范围为 - 1.6%至34%。学生还将教材、课程大纲和讲座系列评为有效，李克特量表上的中位数得分较高即表明了这一点。
以病例为基础的急诊医学课程结合急诊室临床经验，可提高高年级医学生的急诊医学诊断和管理基础知识。
