Use of Breast Simulators Compared with Standardized Patients in Teaching the Clinical Breast Examination to Medical Students
Use of Breast Simulators Compared with Standardized Patients in Teaching the Clinical Breast Examination to Medical Students
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DOI：
10.1016/j.jsurg.2011.10.005
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发表时间：
2012-05-01
影响因子：
2.9
通讯作者：
Kass, Rena B.
中科院分区：
文献类型：
--
作者：
Schubart, Jane R.;Erdahl, Lillian;Kass, Rena B.
目的：在医学生教学中，模拟器已经取代了一些标准化的病人，它们的使用似乎减少了与临床乳腺检查（CBE）相关的焦虑。我们比较了学习的CBE在乳房触诊模拟器上学习的标准化患者的技能收购和舒适度level.METHODS：在宾夕法尼亚州立大学医学院，类2008年（历史对照组，n = 113）学习的CBE在一个标准化的患者，而类2009年（实验组，n = 131）学习的乳房触诊模拟器。我们使用了过程测量（进行CBE）和结果测量（检查分数和异常发现的检测）。在第三年的外科实习期间，两组学生都完成了一份问卷，报告了CBE的数量和执行CBE的信心。然后，学生们在模拟器上进行了观察检查，并记录了检测到的阳性结果的数量。组间阳性结果的平均数进行了比较，并进行了经济分析carried.RESULTS：实验组有一个显着高于历史对照组的平均考试成绩。在亚组中，这种差异对于报告进行0-5次临床检查的患者具有显著性，但对于进行>6次检查的患者则无显著性。在个别项目上，实验组在颈部淋巴结检查、乳头内陷、皮肤变化和腋窝评估方面得分显著高于对照组。两组没有显着差异的平均数检测到的阳性结果或在评级的舒适度level.Conclusions：医学生谁学会了CBE乳房触诊模拟器执行以及或优于那些谁学会了标准化的患者，但是，亚组分析显示，受益仅限于学生较少的临床经验。（《外科学杂志》69：416-422）(C)2012年外科项目主任协会。爱思唯尔公司出版版权所有© 2016
OBJECTIVE: Simulators have replaced some standardized patients in medical student teaching, and their use seems to decrease anxiety related to the clinical breast examination (CBE). We compared learning the CBE on a breast palpation simulator with learning on a standardized patient with respect to skill acquisition and comfort level.METHODS: At Penn State College of Medicine, the class of 2008 (historical control group, n = 113) learned the CBE on a standardized patient, whereas the class of 2009 (experimental group, n = 131) learned on the breast palpation simulator. We used measures of the process (conducting the CBE) and measures of the outcome (examination scores and detection of abnormal findings). During their third-year surgical clerkship, students in both groups completed a questionnaire reporting the number of CBEs performed and confidence in performing the CBE. The students then performed an observed examination on the simulator, and the number of positive findings detected was recorded. The mean number of positive findings was compared between groups, and an economic analysis was conducted.RESULTS: The experimental group had a significantly higher mean examination score than the historical control. In subgroups, this difference was significant for those who reported performing 0-5 clinical examinations but for not those who had performed >6 examinations. On individual items, the experimental group scored significantly higher in examining for neck nodes, nipple retraction, skin changes, and axillary evaluation. The 2 groups did not differ significantly in the mean number of positive findings detected or in ratings of comfort level.CONCLUSIONS: Medical students who learned the CBE on breast palpation simulators performed as well or better than those who learned on standardized patients; however, a subgroup analysis revealed that the benefit was limited to students with less clinical experience. (J Surg 69:416-422. (C) 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)