Evaluación de las prácticas clínicas de Dermatología en el grado de Medicina

Dermatology teaching for undergraduate medical students in clinical routine - a structured four-week curriculum

BACKGROUND

Dermatology teaching is fundamental for the promotion of young colleagues in our specialty. However, traditional teaching methods are being scrutinized by students of the 'Generation Y and Z', which can pose new challenges for teaching institutions. We therefore aimed to assess the motivational impact and reception of a newly created four-week curriculum containing modernized teaching methods integrated into clinical routine.

METHODS

In this single-center study, 67 medical students completed this curriculum composed of weekly learning objectives including knowledge of morphological terms, 10 common dermatoses, communication and presentation skills. The participants provided information on their level of interest in dermatology each week as well as positive and negative aspects of the curriculum.

RESULTS

During the curriculum a significant median increase in interest in dermatology was reported with no differences between the genders. Low initial interest could be improved, high initial interest maintained. Participants with an interest in scientific work (20.9%) were more motivated during the curriculum. The variety, quality of teaching and structure were the main aspects rated positively. Suggestions for improvement included the need for more teaching by senior doctors, transfer of responsibility, and a working environment updated to the latest technology standards.

CONCLUSION

The presented curriculum was well received by the participants and allowed to better define learning preferences of new generations which can be helpful to modernize traditional teaching methods. Interest in scientific work could be a factor to identify students with a particularly strong interest in dermatology.

[Analysis on the correlation of auditory brain/stem response and 40 Hz auditory event related potential by pure tone audiometry in adult patients with sudden deafness]

Objective:To study the value of auditory brainstem response（ABR） and 40 Hz auditory evoked potential（40Hz AERP） in adult patients with sudden deafness. Methods:Pure tone audiometry, ABR and 40 Hz AERP were performed in 184 adult patients with sudden deafness before treatment. According to the frequency and severity of hearing loss revealed by pure tone audiometry, the patients were divided into low-frequency decline type（86 cases）, high-frequency decline type（60 cases）, flat type（32 cases） and total deafness type（6 cases, statistical analysis were not conducted in this group due to the incomplete elicitation of reaction threshold）. Data from 178 ears were collected for statistical results. After treatment, pure tone audiometry, ABR and 40 Hz AERP were performed. Results:As for ABR threshold, its correlation with 500 Hz threshold of subjective pure tone test was poor（r=0.233, P=0.706）, and was worse with 1000 Hz threshold（r=0.472, P=0.345）. ABR threshold was closely correlated with 2000 Hz threshold（r=0.878, P=0.021） and 4000 Hz threshold（r=0.800, P=0.010） of subjective pure tone test. As for 40 Hz AERP threshold, its correlation with 500 Hz threshold of subjective pure tone audiometry was good（r=0.992, P=0）, and was better with 1000 Hz threshold（r=0.912, P=0.110）. 40 Hz AERP threshold was poorly correlated with 2000 Hz threshold（r=0.210, P=0.690） and 4000 Hz threshold（r=0.370, P=0.945） of subjective pure tone audiometry. ABR and subjective pure tone audiometry have high correlation at high frequency, while 40 Hz AERP and subjective pure tone audiometry have high correlation at low frequency. Conclusion:ABR and 40 Hz AERP can comprehensively reflect the severity of hearing loss in adult patients with sudden deafness.

Objective Structured Clinical Examination as an Assessment Tool for Clinical Skills in Dermatology

BACKGROUND

Objective Structured Clinical Evaluation (OSCE) is an excellent method to evaluate student's abilities, but there are no previous reports implementing it in dermatology.

OBJECTIVES

To determine the feasibility of implementation of a dermatology OSCE in the medical school.

METHODS

Five stations with standardized patients and image-based assessment were designed. A specific checklist was elaborated in each station with different items which evaluated one competency and were classified into five groups (medical history, physical examination, technical skills, case management and prevention).

RESULTS

A total of 28 students were tested. Twenty-five of them (83.3%) passed the exam globally. Concerning each group of items tested: medical interrogation had a mean score of 71.0; physical examination had a mean score of 63.0; management had a mean score of 58.0; and prevention had a mean score of 58.0 points. The highest results were obtained in interpersonal skills items with 91.8 points.

LIMITATIONS

Testing a small sample of voluntary students may hinder generalization of our study.

CONCLUSIONS

OSCE is an useful tool for assessing clinical skills in dermatology and it is possible to carry it out. Our experience enhances that medical school curriculum needs to establish OSCE as an assessment tool in dermatology.

Do primary health centres and hospitals contribute equally towards achievement of the transversal clinical competencies of medical students? Performance on the Objective Structured Clinical Examination (OSCE) in competency acquisition

OBJECTIVES

The adaptation of the educational programmes of European faculties of medicine to the European Higher Education Area guidelines has focused curricula design on competence acquisition. Competencies are defined as the achievements of a predetermined level of efficacy in real-world scenarios. Our objective was to assess whether performance on a common competence evaluation test, the Objective Structured Clinical Examination (OSCE), resulted in different scores for second-year students after a practical medical training course took place in a primary health centre (PHC) or in a hospital.

DESIGN

A descriptive study was conducted during the 2010-2014 academic year of the OSCE test scores obtained by all second-year students.

LOCATION

Faculty of Medicine at the University of Lleida (Catalonia, Spain).

MAIN MEASUREMENTS

We performed a correlation analysis between students who completed their practical medical training at the PHC and hospitals utilising Student's t-test for comparison of means.

RESULTS

423 students who completed internships at the PHC and at hospitals obtained OSCE mean scores of 7.32 (SD; IC) (0.82; 7.18-7.47) points and 7.17 (0.83; 6.07-7.26) points, respectively (p=0.07).

CONCLUSIONS

Second-year medical students acquired similar competency levels in the two analysed training scenarios. The two areas both serve their teaching purpose.