Prislin M D, Fitzpatrick C F, Radecki S
Department of Family Medicine, University of California, Irvine, USA.
Fam Med. 1998 Apr;30(4):279-82.
Family medicine clerkships are frequently conducted in decentralized settings. Concerns have been raised regarding the educational consistency of such rotations. In this study, we assess learning across multiple training sites, as reflected by measures of student performance.
The study population was 77 students assigned to six clusters of family medicine clerkship training sites during the 1993-1994 academic year. Learning, as measured by faculty evaluations, objective structured clinical examination (OSCE) performance, and Society of Teachers of Family Medicine (STFM) predoctoral examination performance, was compared for student cohorts assigned to each of the teaching site clusters using analysis of variance.
No differences in OSCE or STFM examination performance were found across the teaching site clusters. Greater variation in faculty evaluation across sites was apparent, and when the academic and private practice teaching sites were compared with the HMO and community clinics teaching sites, this variation achieved statistical significance.
As measured by OSCE and STFM examination performance, student learning did not vary across multiple training sites. However, greater variability was found in faculty evaluations of student performance. Sources of this variation might include differing levels of student-faculty interactions across sites or subjectivity inherent to the faculty evaluation process.
家庭医学实习通常在分散的环境中进行。人们对这种轮转实习的教育一致性提出了担忧。在本研究中，我们通过学生表现的测量指标来评估多个培训地点的学习情况。
研究对象为1993 - 1994学年被分配到六个家庭医学实习培训地点集群的77名学生。使用方差分析比较了分配到每个教学地点集群的学生群体在教师评价、客观结构化临床考试（OSCE）表现以及家庭医学教师协会（STFM）博士前考试表现方面所衡量的学习情况。
各教学地点集群之间在OSCE或STFM考试表现上未发现差异。各地点教师评价的差异更为明显，当将学术和私人执业教学地点与健康维护组织（HMO）和社区诊所教学地点进行比较时，这种差异具有统计学意义。
通过OSCE和STFM考试表现衡量，学生学习情况在多个培训地点之间没有差异。然而，在教师对学生表现的评价中发现了更大的变异性。这种变异的来源可能包括各地点师生互动水平的差异或教师评价过程中固有的主观性。
