Early and prolonged opportunities to practice suturing increases medical student comfort with suturing during clerkships: Suturing during cadaver dissection.
Early and prolonged opportunities to practice suturing increases medical student comfort with suturing during clerkships: Suturing during cadaver dissection.
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DOI：
10.1002/ase.1785
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发表时间：
2018-11
影响因子：
7.3
通讯作者：
Downie SA
中科院分区：
文献类型：
--
作者：
Manning EP;Mishall PL;Weidmann MD;Flax H;Lan S;Erlich M;Burton WB;Olson TR;Downie SA
医学院的学生在第三年的实习期间，预计将执行常见的程序，如对病人的治疗。然而，这些经验往往被医学生视为压力源，而不是学习的机会。这种压力的来源是在被要求观察或对患者进行手术之前缺乏关于常见手术的指导。第一次暴露于压力环境中的程序可能会导致医学生的信心下降，并降低他们在未来执行这些程序的频率。作者试图通过以下方式改变这种模式：（1）在解剖解剖实验室的背景下，向一年级医学生介绍一个学习模块;（2）测量其对学生在第三年实习期间遇到患者时的态度和行为的影响。作者发现，早期和长期的介绍与学生的信心增加相对于patient。参与了神经外科模块与学生在识别神经外科器械（P < 0.001）和神经外科患者（P = 0.013）方面的信心增加有关。此外，它积极影响了他们的行为，表现为从学生接触到学习模块的学习事件的性能增加。（P < 0.001）这项研究表明，早期和长期的机会，实践程序技能在低压力环境中增加学生的信心，在病人的互动和改变学生的行为。
Medical students are expected to perform common procedures such as suturing on patients during their third-year clerkships. However, these experiences are often viewed by medical students as stressors rather than opportunities for learning. The source of this stress is the lack of instruction on common procedures prior to being asked to observe or perform the procedure on a patient. First-time exposures to procedures in stressful environments may result in decreased confidence in medical students and decrease the frequency with which they perform these procedures in the future. The authors sought to change this paradigm by: (1) introducing a suturing module to first-year medical students in the context of the anatomy dissection laboratory; and (2) measuring its effects on student attitudes and behavior over the course of their third-year clerkships when they encounter patients. The authors found that early and prolonged introduction to suturing was associated with increased student confidence relative to suturing a patient. Participation in the suturing module was associated with increased student confidence in identifying suturing instruments (P < 0.001) and suturing patients (P = 0.013). Further it positively affected their behavior as demonstrated by increased performance of suturing events from students exposed to the suturing module. (P < 0.001) This study demonstrates that early and prolonged opportunities to practice a procedural skill in a low-stress environment increases student confidence during patient interactions and alters student behavior.
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