Bissonette R, Routé C
Department of Family Medicine, Erie County Medical Center, Buffalo, NY.
Fam Med. 1994 Apr;26(4):226-31.
Rotations by American medical students in foreign countries have been common in US medical schools for nearly half a century. Although anecdotal literature makes claims for the significant educational value of these foreign rotations, neither the nature and educational consequences of these experiences, nor the students' impressions, have been thoroughly documented.
To document the educational impact of clinical rotations in developing countries, all 30 students at the University of Buffalo who participated in such rotations during a period of 7 years were given a questionnaire to complete. Completed questionnaires (n = 28) were analyzed using content analysis.
Students reported increased skill and confidence in the use of knowledge, personal history, and physical as the primary means of diagnosis; students also reported that the rotations contributed to outcomes such as enhanced sensitivity to cost issues, heightened awareness of the importance of public health and preventive medicine, greater appreciation for the role of the family and culture in health and disease, and decreased reliance on technology.
Students who completed clinical rotations in Third World countries reported gaining knowledge and skills in areas which, while important in all medical fields, are of particular concern to the family physician. While no causative relationship can be adduced from this study, the fact that 70% of the students who completed these rotations entered primary care careers suggests at least a reinforcing effect.
近半个世纪以来,美国医学院的学生到国外轮转实习在美国医学院校中一直很常见。尽管坊间文献宣称这些国外轮转实习具有重大教育价值,但这些经历的性质和教育结果,以及学生的感受,均未得到充分记录。
为记录在发展中国家临床轮转实习的教育影响,向布法罗大学在7年期间参加此类轮转实习的所有30名学生发放问卷以填写。使用内容分析法对填写完整的问卷(n = 28)进行分析。
学生报告称,在运用知识、个人病史和体格检查作为主要诊断手段方面,技能和信心有所提高;学生还报告称,轮转实习带来了一些成果,如对成本问题的敏感度提高、对公共卫生和预防医学重要性的认识增强、对家庭和文化在健康与疾病中作用的更深理解,以及对技术依赖的减少。
在第三世界国家完成临床轮转实习的学生报告称,他们在一些领域获得了知识和技能,这些领域虽然在所有医学领域都很重要,但对家庭医生尤为重要。虽然本研究无法得出因果关系,但完成这些轮转实习的学生中有70%进入初级保健行业这一事实表明至少有强化作用。