背景:长案用于评估医学生执行临床任务的熟练程度。作为形成性评估,目的是提供绩效反馈,旨在加强和加快临床学习。在低资源环境中,长病例是临床医师的主要形成性评估方法之一,但在文献中很少受到关注。
目的:探索医学生和教职员工在资源匮乏的三级护理教学医院中使用长案例研究作为形成性评估方法的经验。
方法:采用定性研究设计。这项研究是在马凯雷雷大学进行的,低资源设置。研究参与者是三年级和五年级的医学生以及讲师。目的抽样用于招募参与者。数据收集包括与学生的六次焦点小组讨论和与讲师的五次关键线人访谈。定性数据采用归纳专题分析法进行分析。
结果:研究中出现了三个主题:病房安置,案例介绍,以及案例评估和反馈。调查结果显示,学生在分配给整个职员的特定病房/单位的患者床边进行长期病例。有效监督,反馈,和分数被强调为对学习过程产生积极影响的关键实践。然而,挑战,例如对长期案件的定位不足,医院病房的超专业化,寻找标记的压力,并确定了不充分的反馈做法。
结论:长期案例为学生提供了在临床环境中接触真实患者的机会。然而,在三级护理教学医院,这是至关重要的,以确保适当的设计和实施这一做法,使学生接触到各种情况。充分有效的监督和反馈为每个学习者提供提供宝贵的机会并接受纠正。
BACKGROUND: The long case is used to assess medical students\' proficiency in performing clinical tasks. As a formative assessment, the purpose is to offer feedback on performance, aiming to enhance and expedite clinical learning. The long case stands out as one of the primary formative assessment methods for clinical clerkship in low-resource settings but has received little attention in the literature.
OBJECTIVE: To explore the experiences of medical students and faculty regarding the use of the Long Case Study as a formative assessment method at a tertiary care teaching hospital in a low-resource setting.
METHODS: A qualitative study design was used. The study was conducted at Makerere University, a low-resource setting. The study participants were third- and fifth-year medical students as well as lecturers. Purposive sampling was utilized to recruit participants. Data collection comprised six Focus Group Discussions with students and five Key Informant Interviews with lecturers. The qualitative data were analyzed by inductive thematic analysis.
RESULTS: Three themes emerged from the study: ward placement, case presentation, and case assessment and feedback. The findings revealed that students conduct their long cases at patients\' bedside within specific wards/units assigned for the entire clerkship. Effective supervision, feedback, and marks were highlighted as crucial practices that positively impact the learning process. However, challenges such as insufficient orientation to the long case, the super-specialization of the hospital wards, pressure to hunt for marks, and inadequate feedback practices were identified.
CONCLUSIONS: The long case offers students exposure to real patients in a clinical setting. However, in tertiary care teaching hospitals, it\'s crucial to ensure proper design and implementation of this practice to enable students\' exposure to a variety of cases. Adequate and effective supervision and feedback create valuable opportunities for each learner to present cases and receive corrections.