Wyte C D, Adams S L, Cabel J A, Pearlman K, Yarnold P R, Morkin M, Hott K A, Mathews J J
Division of Emergency Medicine, Northwestern University Medical School, Chicago, IL, USA.
Acad Emerg Med. 1996 Jan;3(1):72-6. doi: 10.1111/j.1553-2712.1996.tb03307.x.
To determine whether either bedside teaching alone (group A) or bedside teaching with written course materials (group B) improved written examination scores, satisfaction with the rotation, or clinical grades of rotating PGY1 residents.
A prospective, controlled educational trial was conducted. Sixty-five PGY1 residents from diverse specialties rotated in the ED for one month over a ten-month study period, and were included in the study. The PGY1 residents were assigned to group by month of rotation. All the PGY1 residents received unstructured bedside teaching by emergency medicine (EM) residents and faculty. In addition, group B received written course materials on day 1.
Mean posttest scores were higher than mean pretest scores for the interns considered as a whole (p < 0.0001), but mean pretest, posttest, and clinical grades were comparable across instructional groups. Mean satisfaction ratings were higher for group A than for group B (p < 0.015). The interns specializing in EM achieved higher mean test scores (p < 0.013) and clinical grades (p < 0.003) than did the interns specializing in another medical specialty.
Both instructional methods were associated with improved written test performance. Written course materials did not augment bedside teaching in terms of test scores, clinical grades, or satisfaction with the rotation. At a university-based, high-volume ED, bedside teaching offers educational benefit to rotating PGY1 residents that may not be augmented by written course materials.
确定单纯床边教学（A组）或床边教学结合书面课程材料（B组）是否能提高轮转的PGY1住院医师的笔试成绩、对轮转的满意度或临床成绩。
进行了一项前瞻性对照教育试验。在为期10个月的研究期间，65名来自不同专业的PGY1住院医师在急诊科轮转1个月，并纳入研究。PGY1住院医师按轮转月份分组。所有PGY1住院医师均接受急诊医学（EM）住院医师和教员的非结构化床边教学。此外，B组在第1天收到书面课程材料。
作为一个整体，实习生的平均后测成绩高于平均前测成绩（p < 0.0001），但各教学组的平均前测、后测和临床成绩相当。A组的平均满意度评分高于B组（p < 0.015）。与其他医学专业的实习生相比，急诊医学专业的实习生平均考试成绩更高（p < 0.013），临床成绩更高（p < 0.003）。
两种教学方法都与笔试成绩的提高有关。就考试成绩、临床成绩或对轮转的满意度而言，书面课程材料并未增强床边教学效果。在一所大学附属的高流量急诊科，床边教学对轮转的PGY1住院医师具有教育益处，书面课程材料可能无法增强这种益处。
