■据报道,对患者遭遇的视频记录可改善医学生的临床表现。然而,缺乏关于具体补救策略或结果的证据。我们的目标是在医学生中实施基于视频记录的标准化患者接触补救,结合一对一反馈或同伴小组讨论,并使用客观结构化临床检查(OSCE)评估两种修复方法的有效性。
■在标准化的患者遭遇之后,根据视频审查的不同补救方法,将107名最后一年的医学生分为两组:(1)带有导师反馈的接受视频审查(N=55)和(2)私人视频审查以及随后在监督下的同行小组讨论(N=52)。在视频审查之前和之后,所有学生都接受了欧安组织的十二个站点。学生修复前和修复后的欧安组织成绩,患者遭遇的自我效能水平,对每种方法的教育满意度进行了评估,并在不同的基于视频的补救方法之间进行了比较,以评估其各自的效果。
■补救后,OSCE总分和分部分分,比如历史,体检,和病人-医生互动(PPI),在所有学生中显著增加。修复后的OSCE评分显示两种修复方法之间没有显着差异(受体模块,79.6±4.3vs.对等模块,OSCE总分79.4±3.8)。在两个模块中进行补救后,学生的自我效能水平都有所提高(两个p值<0.001),两个模块之间没有区别。然而,学生的满意度在导师模块中高于同伴模块(80.1±17.7与59.2±25.1,p值<0.001)。在OSCE基线表现不佳的学生中,在基于受体的模块中,PPI评分显著增加.
■基于视频的患者治疗,要么通过一对一反馈的导师审查,要么通过同行讨论的私人审查,在提高医学生的OSCE成绩和自我效能水平方面同样有效。表现不佳的学生可以从建立PPI的接受视频评论中受益。
UNASSIGNED: Video-recordings review of patient encounters is reported to improve the clinical performance of medical students. However, evidence on specific remediation strategies or outcomes are lacking. We aimed to implement videorecording-based remediation of standardized patient encounters among medical students, combined with
preceptor one-on-one feedback or peer group discussion, and evaluate the effectiveness of the two remediation methods using objective structured clinical examination (OSCE).
UNASSIGNED: Following standardized patient encounters, 107 final-year medical students were divided into two groups based on different remediation methods of video review: (1) precepted video review with
preceptor feedback (N = 55) and (2) private video review and subsequent peer group discussion under supervision (N = 52). All students underwent twelve-stations of OSCE both before and after the video review. Students\' pre- and post-remediation OSCE scores, self-efficacy level in patient encounters, and level of educational satisfaction with each method were assessed and compared between different video-based remediation methods to evaluate their respective effects.
UNASSIGNED: After remediation, the total and subcomponent OSCE scores, such as history taking, physical examination, and patient - physician interaction (PPI), among all students increased significantly. Post-remediation OSCE scores showed no significant difference between two remediation methods (
preceptor module, 79.6 ± 4.3 vs. peer module, 79.4 ± 3.8 in the total OSCE score). Students\' self-efficacy levels increased after remediation in both modules (both p-value <0.001), with no difference between the two modules. However, students\' satisfaction level was higher in the
preceptor module than in the peer module (80.1 ± 17.7 vs. 59.2 ± 25.1, p-value <0.001). Among students with poor baseline OSCE performance, a prominent increase in PPI scores was observed in the preceptor-based module.
UNASSIGNED: Video-based remediation of patient encounters, either through
preceptor review with one-on-one feedback or through private review with peer discussion, was equally effective in improving the OSCE scores and self-efficacy levels of medical students. Underperforming students can benefit from precepted video reviews for building PPI.