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Didactic lecture versus instructional standardized patient interaction in the surgical clerkship.

Abstract：

BACKGROUND:Medical schools increasingly employ the standardized patient interaction (SPI) as a teaching and testing modality to prepare students for USMLE Step 2 Clinical Skills (Step 2 CS). However, little is known about the perceptions medical students have toward SPIs. We hypothesized that the SPI would increase the self-confidence of surgery students in their history and physical examination (H&P) skills as compared with the classic lecture format and that students would perceive the SPI as a valuable learning tool. METHODS:Students (n = 126) on the junior surgery clerkship were randomized into two groups. Group A (n = 61) received a didactic lecture on acute appendicitis. Group B (n = 65) participated in an SPI in which the portrayed patient had acute appendicitis. Student perceptions were surveyed by written questionnaire pre- and postencounter using a 5-point Likert scale, with 5 being the most favorable rating. Data (perceptions, performances on the SPI, clerkship grades) were compared using a Student t test followed by the Mann-Whitney rank sums test. RESULTS:Group A "enjoyed" the lecture format more than group B "enjoyed" the SPI format (3.4 +/- 0.1 versus 2.6 +/- 0.1, P <.001) and perceived the lecture as having more value to their overall education (3.5 +/- 0.1 versus 2.6 +/- 0.1, P <.001) than the SPI group. Surprisingly, student self-confidence in their H&P skills increased after the didactic lecture (from 3.6 +/- 0.1 to 4.1 +/- 0.1, P = .001) but not after the SPI (from 3.6 +/- 0.1 to 3.8 +/- 0.1, P = not significant). CONCLUSIONS:The didactic lecture format was not only enjoyed and valued more than the SPI, but our surgery students also perceived it as superior to the SPI in building confidence in history and physical examination skills. These findings suggest that surgical educators should develop ways to improve students' perceptions and attitudes surrounding the surgical SPI.

journal_name

Am J Surg

journal_title

American journal of surgery

authors

Carter MB,Wesley G,Larson GM

doi

10.1016/j.amjsurg.2004.09.013

subject

Has Abstract

pub_date

2005-02-01 00:00:00

pages

243-8

issue

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(04)00542-2

journal_volume

189

pub_type

临床试验,杂志文章,随机对照试验

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Didactic lecture versus instructional standardized patient interaction in the surgical clerkship.