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Assessing Abdominal Examination Skills in a Surgery Clerkship Standardized Patient Encounter for Curriculum Improvement.

التفاصيل البيبلوغرافية
العنوان: Assessing Abdominal Examination Skills in a Surgery Clerkship Standardized Patient Encounter for Curriculum Improvement.
المؤلفون: Marshall H; Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA., Weingartner LA; Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA., Henry T; Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA., Smith J; Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA., Wright T; Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA., Bohnert CA; Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA., Shaw MA; Undergraduate Medical Education, University of Louisville School of Medicine, Louisville, KY, USA., Adamson DT; Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA.
المصدر: Journal of medical education and curricular development [J Med Educ Curric Dev] 2024 Aug 07; Vol. 11, pp. 23821205241272382. Date of Electronic Publication: 2024 Aug 07 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: SAGE Publications Country of Publication: United States NLM ID: 101690298 Publication Model: eCollection Cited Medium: Print ISSN: 2382-1205 (Print) Linking ISSN: 23821205 NLM ISO Abbreviation: J Med Educ Curric Dev Subsets: PubMed not MEDLINE
أسماء مطبوعة: Publication: <2016- > : Thousand Oaks, CA : SAGE Publications
Original Publication: Auckland, New Zealand : Libertas Academica Ltd., [2014]-
مستخلص: Introduction: Standardized patient (SP) encounters allow medical students to practice physical examination skills and clinical reasoning. SP cases are used for learning and assessment, but recorded encounters can also be valuable curriculum evaluation tools. We aimed to review SP encounters to improve abdominal examination skills and the broader physical examination curriculum.
Methods: We reviewed recorded SP encounters of third-year medical students on surgery clerkship rotation. Students examined a cisgender woman presenting with acute right lower abdominal pain. We observed abdominal examinations to determine which maneuvers were attempted and completed correctly. We then used these outcomes to develop targeted clerkship training for the subsequent student cohort. Our intervention targeted abdominal examination gaps by explaining how to integrate abdominal examination findings with a focused history for surgical patients. We evaluated the intervention's impact on abdominal examination skills with third-year medical students in comparison (2021-2022, n  = 119) and intervention (2022-2023, n  = 132) groups.
Results: In both the comparison and intervention groups, nearly all students attempted at least 1 general examination maneuver like auscultation, palpation, percussion, or rebound tenderness. Only 40% of students in the comparison group attempted an advanced maneuver like the Rovsing, Psoas, or Obturator sign. After the intervention, 75% of students in the intervention group attempted an advanced maneuver (χ 2 (1, 251) = 31.0, p  < .001). Cohorts did not gain skills over time through the clerkship. Rebound tenderness was frequently assessed incorrectly by students in both groups, with many avoiding the right lower quadrant entirely.
Conclusions: This project highlights how medical students struggle to utilize abdominal examination maneuvers and integrate findings. The results also showed that students did not consistently learn advanced examination skills either before or during clerkship rotation, which may be commonly assumed by clinical faculty. Finally, this work demonstrates how SP encounters can be used to evaluate and improve surgical education curriculum.
Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2024.)
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فهرسة مساهمة: Keywords: assessment; clinical reasoning; clinical skills; medical student; physical examination; simulation
تواريخ الأحداث: Date Created: 20240809 Latest Revision: 20240810
رمز التحديث: 20240812
مُعرف محوري في PubMed: PMC11307356
DOI: 10.1177/23821205241272382
PMID: 39119065
قاعدة البيانات: MEDLINE
الوصف
تدمد:2382-1205
DOI:10.1177/23821205241272382