Approaches to Teaching the Physical Exam to Preclerkship Medical Students: Results of a National Survey
Approaches to Teaching the Physical Exam to Preclerkship Medical Students: Results of a National Survey
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DOI：
10.1097/acm.0000000000002433
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发表时间：
2019-01-01
影响因子：
7.4
通讯作者：
Silvestri, Ronald C.
中科院分区：
文献类型：
--
作者：
Uchida, Toshiko;Park, Yoon Soo;Silvestri, Ronald C.
PurposeTo评估目前的方法来教物理考试preclerkship学生在美国医学schools.MethodThe临床技能课程的董事制定了一个49个问题的调查解决的方法，教学方法，和评估方法preclerkship物理考试课程。该调查于2015年10月对所有141所经医学教育联络委员会认证的美国医学院进行了调查。结果汇总跨学校，调查权重被用来调整响应率和学校size.Results106医学院（75%）作出回应。79%的学校（84所）在医学院的头两个月内开始教授体检。五十六%的学校（59所）采用了“从头到脚”的综合方法和临床推理方法。百分之二十三（24）教一部分的体检跨专业。视频，在线模块和模拟器被广泛使用，39%的学校（41所）使用床旁超声检查。学校报告了4个形成性评估和3个总结性评估的中位数，16%的学校（17所）使用基于标准的标准制定方法进行物理考试评估。结果并没有显着不同的学校size.ConclusionsThere是在医学院如何教物理考试preclerkship学生的变化很大。常见的教学方法包括早期启动体检教学，使用技术，以及支持临床推理和基于能力的医学教育的方法。少数学校使用的方法包括跨专业教育、超声波和基于标准的标准制定评估方法。研究物理考试教学的最佳方法的机会比比皆是。
PurposeTo assess current approaches to teaching the physical exam to preclerkship students at U.S. medical schools.MethodThe Directors of Clinical Skills Courses developed a 49-question survey addressing the approach, pedagogical methods, and assessment methods of preclerkship physical exam curricula. The survey was administered to all 141 Liaison Committee on Medical Education-accredited U.S. medical schools in October 2015. Results were aggregated across schools, and survey weights were used to adjust for response rate and school size.ResultsOne hundred six medical schools (75%) responded. Seventy-nine percent of schools (84) began teaching the physical exam within the first two months of medical school. Fifty-six percent of schools (59) employed both a "head-to-toe" comprehensive approach and a clinical reasoning approach. Twenty-three percent (24) taught a portion of the physical exam interprofessionally. Videos, online modules, and simulators were used widely, and 39% of schools (41) used bedside ultrasonography. Schools reported a median of 4 formative assessments and 3 summative assessments, with 16% of schools (17) using criterion-based standard-setting methods for physical exam assessments. Results did not vary significantly by school size.ConclusionsThere was wide variation in how medical schools taught the physical exam to preclerkship students. Common pedagogical approaches included early initiation of physical exam instruction, use of technology, and methods that support clinical reasoning and competency-based medical education. Approaches used by a minority of schools included interprofessional education, ultrasound, and criterion-based standard-setting methods for assessments. Opportunities abound for research into the optimal methods for teaching the physical exam.