Greer T, Schneeweiss R, Baldwin L M
Department of Family Medicine, University of Washington, Seattle.
Fam Med. 1993 May;25(5):322-6.
In our required family medicine clerkship, we used data from student logbook records of clinical experience to compare the learning experiences of students in community practices and residency-based clinics.
Sixty-eight University of Washington students collected data on patients seen during the final two weeks of their family medicine clerkships. We compared patient demographics, location of patient encounters, and clinical problems seen at nine residency and eight community locations in a four-state area. National Ambulatory Medical Care Survey data were used to compare student experiences to national practices.
Log data documented that both community practices and residency sites met the course curriculum goals. Some variations occurred between the two types of clerkship sites, however. Students at community practices saw a higher mean number of patients and did more procedures than students at residency sites. Students at residencies were more likely to see patients for health maintenance and pregnancy care and less likely to see lacerations, sprains or strains, and some chronic diseases.
Episodic log data were successfully used to monitor the objective educational strategies for residency- and community-based student clerkship sites. Although all students met clerkship objectives, there were significant differences in certain aspects of students' clinical experiences at the two types of clerkship sites.
在我们要求的家庭医学实习中，我们使用学生临床经验日志记录中的数据，比较学生在社区诊所和住院医师培训诊所的学习经历。
68名华盛顿大学的学生收集了他们家庭医学实习最后两周期间诊治患者的数据。我们比较了四个州地区九个住院医师培训地点和八个社区地点的患者人口统计学特征、患者就诊地点以及所诊治的临床问题。使用国家门诊医疗调查数据将学生的经历与全国实践进行比较。
日志数据表明社区诊所和住院医师培训地点均达到了课程目标。然而，两种类型的实习地点之间存在一些差异。社区诊所的学生平均诊治的患者数量更多，进行的操作也比住院医师培训地点的学生更多。住院医师培训地点的学生更有可能诊治进行健康维护和孕期护理的患者，而诊治撕裂伤、扭伤或拉伤以及某些慢性病患者的可能性较小。
阶段性日志数据成功用于监测基于住院医师培训和社区的学生实习地点的客观教育策略。尽管所有学生都达到了实习目标，但在这两种类型的实习地点，学生临床经历的某些方面存在显著差异。
