军医大学医学生死亡教育课程内容体系的构建研究

目的系统构建军医大学医学生死亡教育课程内容体系,进一步促进死亡教育课程教学的理论与实践研究。方法在前期文献查阅、学生半结构质性访谈的基础上,初步拟定出军医大学医学生死亡教育课程核心内容体系,遴选25名来自医疗、护理、教育、哲学等相关领域的专家作为函询对象,利用Delphi法对本课程内容体系展开专家函询,并通过统计学方法进行目标内容体系的修订和排除。结果 2轮专家函询的问卷回收率分别为100.0%、96.0%,专家权威性系数分别为0.825、0.832,专家肯德尔协调系数分别为0.187、0.327(均P0.01),最终确定一个由7个一级指标、39个二级指标构成的军校学生死亡教育课程内容体系。结论该死亡教育课程内容体系可为下一步的死亡教育课程标准的制定和学生生命关怀能力的提升提供借鉴和指导。     

Development and initial evaluation of a novel urology curriculum for medical students

PURPOSE: After the development and implementation of a novel urology curriculum for medical students we evaluated urological learning by medical students using a validated measure of learning in the 4 clinical areas of benign prostatic hyperplasia, erectile dysfunction, prostate cancer and prostate specific antigen screening. MATERIALS AND METHODS: Third year medical students completed an online validated pre-test and post-test immediately before and after the mandatory 1-week clinical rotation in urology. Online pre-surveys and post-surveys were also administered. Overall student participation was 90% (37 of 41) with 63% of students (26 of 41) completing all 4 tests and surveys. RESULTS: Student overall test scores improved significantly upon completion of the 1-week clinical rotation in urology (p <0.001). A trend toward increased learning by male students was identified (p = 0.07). Significant variation in exposure to outpatient clinics and in the performance of physical examination skills was observed among the different teaching sites. CONCLUSIONS: This study demonstrates significant learning by medical students during their 1-week clinical rotation in urology. Further data are needed to confirm the trend toward increased learning by males and elucidate its etiology. Scheduling changes have been implemented to address the inconsistencies across clinical sites.     

Development and evaluation of a digital education tool for medical students in wound care

The aim of this study was to develop and evaluate an interactive, video‐enhanced, and case‐based online course for medical students. We chose a case about wound care since this topic is still underrepresented in the medical curriculum. First, instructional videos were created to teach practical skills in wound care. These were implemented into a case‐based online course, using the online learning platform ILIAS. In a comparative initial and final survey, numbers of users were assessed, content and structure of the course, as well as the thematic interest of the students and self‐assessed gain of competence, were evaluated. Since the summer of 2019, 310 students have successfully completed the course. The survey data showed a high participation rate and a positive response regarding the content as well as the structural concept. Most of the students rated the content within the course as useful for their future medical work (86.1%) and the gain of knowledge superior to a traditional lecture (69.4%). Self‐assessments of video‐mediated skills showed a significant increase in subjectively perceived competence. The online course is an efficient way to reach many students by the small use of resources. It resembles an option to arouse growing interest in wound care in medical students.     

The Advanced Trauma Life Support course for senior medical students.

The authors conducted the Advanced Trauma Life Support (ATLS) Course for 90 students who were in their 4th year of medicine at the University of Manitoba. The impact of the course was evaluated through questionnaires completed by students, instructors and emergency-room physicians. The students' performances were also compared with those of 96 practising physicians who took the ATLS course in Manitoba. The failure rate for students (3.3%) was not statistically different from that for practising physicians (4.2%). Overall, the students' performances in the written test were better (55% of students scored over 90% on the test compared with 15% of practising physicians). The student-to-faculty ratio was 1.5:1 and included 21 physician-instructors. Ninety-five percent of the faculty and students suggested that this course should be mandatory in the 4th year curriculum of medicine and that the course improves trauma care provided by the students and interns by increasing their confidence and improving communication with specialist surgeons. However, 10% of the faculty suggested that more time should be allocated to the surgical-skills practicum. The authors' experience with this program suggests that the ATLS course should be uniformly incorporated in the Canadian undergraduate 4th year medical curriculum and that techniques used in this course should be considered in other areas of the undergraduate medical curriculum.     

Early assessment of a new integrated preclinical musculoskeletal curriculum at a medical school

Increased incidence of musculoskeletal conditions and medical students' deficiencies in musculoskeletal knowledge have been a cause for concern for educators in this field. Findings from a 2005 study conducted at our institution revealed that medical students, despite acknowledging the importance of musculoskeletal education, have inadequate knowledge and skill in this system. In response to these findings, additions to the preclinical musculoskeletal curriculum were designed and instituted. Medical students were assessed at the end of the new curriculum, using the same evaluation tools that had been administered before the curricular changes, and responses from the second-year students who completed the entire new preclinical curriculum were compared with those of students who had completed the old curriculum. Results showed that students reported significantly higher levels of clinical confidence in performing physical examinations of several anatomical regions of the musculoskeletal system. A notable proportion of students cited weaknesses in other fields, such as anatomy, as a prominent contributor to their lack of confidence in the musculoskeletal system.     

Teaching effectiveness of the trauma evaluation and management module for senior medical students

BACKGROUND: The Trauma Evaluation and Management (TEAM) module was devised by the American College of Surgeons for teaching senior medical students trauma management principles. This article reports on the teaching effectiveness of this module. METHOD: Cognitive skills (by 20 item multiple-choice question examination on trauma topics) and clinical trauma management skills performance, using the Objective Structured Clinical Examination, were compared between two groups of 16 randomly selected final year medical students who had completed the standard curriculum including trauma topics. One group had the TEAM (TEAM group) and the other did not (no-TEAM group). Objective Structured Clinical Examination score (percentage), Priority score (range, 1-7), Organized Approach score (range, 1-5), and Global Pass status were assigned at each station. The students also completed a five-part questionnaire. RESULTS: Results of the questionnaire showed that on a scale of 1 to 5, with 5 being excellent, 96.8% assigned a score of 4 or greater, indicating the objectives were met, 83.8% that trauma knowledge was improved, 51.6% that clinical skills were improved, 90.3% that the module should be mandatory, and 83.9% overall satisfaction with the program. CONCLUSION: The TEAM module is very effective in teaching trauma management principles to senior medical students, by whom the program was very well received. Consideration should be given to adopting this program more widely in our medical undergraduate curriculum.     

Development and validation of an index of musculoskeletal functional limitations

Background  

While musculoskeletal problems are leading sources of disability, there has been little research on measuring the number of functionally limiting musculoskeletal problems for use as predictor of outcome in studies of chronic disease. This paper reports on the development and preliminary validation of a self administered musculoskeletal functional limitations index.     

Effective retention of primary survey skills by medical students after participation in an expanded Trauma Evaluation and Management course

BACKGROUND: The Trauma Evaluation and Management (TEAM) module orients medical students to the initial assessment of an injured patient. At the Medical College of Wisconsin, a course based on expanded TEAM (eTEAM) was developed for junior medical students. This study determined whether eTEAM improved the ability to perform and retain primary survey skills. METHODS: Objective Structured Clinical Examination methodology was used to compare 2 groups of senior medical students 1 year after receiving either a 2-hour lecture or eTEAM. RESULTS: Students receiving eTEAM performed the primary survey much better than those receiving lecture alone. The overall Objective Structured Clinical Examination scores did not differ between groups. CONCLUSIONS: Medical students participating in eTEAM retained the ability to perform a primary survey in proper sequence 1 year later better than students receiving the information in lecture format only.     

A surgical residency preparatory course for senior medical students leads to earlier independence in ACGME competencies

Background

It is unknown whether surgery residency preparatory courses lead to earlier independent practice.

Development and evaluation of the advanced trauma operative management course

BACKGROUND: The Advanced Trauma Operative Management (ATOM) course was developed as a model for teaching operative trauma techniques to surgical residents, fellows, and attending surgeons as the number of these cases decreases. METHODS: The ATOM course consists of lectures and a porcine operative experience. Comprehensive evaluation of ATOM was designed to assess participant learning in the cognitive, affective, and psychomotor domains. Data on the first 50 participants were prospectively collected and analyzed. RESULTS: Participants included 20 expert traumatologists, 9 general surgeons, 9 trauma fellows, 8 general surgery fifth-year residents, and 4 general surgery fourth-year residents. All groups showed improvement in knowledge, with results in the expert and fellow groups reaching statistical significance. Self-efficacy (self-confidence) also improved, with all groups reaching statistical significance. CONCLUSION: This course creates life-like situations in a standardized fashion that, along with didactic instruction, improves knowledge and operative confidence for practicing surgeons and surgeons-in-training.