新冠肺炎疫情对医学生临床技能实践及自我感知熟练程度的影响

Leanne Hall, Sophie Binks, Clare Heal
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摘要

背景:2019冠状病毒病(COVID-19)大流行对医学教育产生了重大影响。本研究旨在确定COVID-19如何影响学生在专业轮转期间实践核心临床技能的机会,以及他们对执行这些技能的自我认知熟练程度。方法:对2016 - 2021年医五年级学生医学培训经历和认知情况进行常规调查分析。比较新冠肺炎前(2016-2019年)和新冠肺炎期间(2020-2021年)核心临床技能的执行次数和各项技能的自我感知熟练程度。结果:219项调查的数据显示,在covid期间,进行“子宫颈筛查”(p<0.001)、“精神健康评估”(p=0.006)、“自杀风险评估”(p=0.004)和“膀胱导尿”(p=0.007)的机会减少了。在“心理健康评估”(p=0.026)和“心电图”(p=0.035)的表现方面,自我报告的技能熟练程度也较低。结论:COVID-19对心理健康技能的影响最大,可能是由于向远程医疗服务的转变以及由此导致的学生参与咨询的能力下降。在医疗保健领域可能发生长期变化的时期,必须确保在医疗培训期间有足够的机会实践所有核心临床技能。将远程保健尽早纳入课程可能有利于学生的信心。
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The effect of COVID-19 on medical student clinical skill practice and self-perceived proficiency
Background: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted medical education. This study aimed to determine how COVID-19 affected students’ opportunity to practice core clinical skills across specialty rotations and their self-perceived proficiency at performing these. Methods: Routinely administered surveys of fifth year medical student’ experiences and perceptions of medical training from 2016 to 2021 were analysed. Number of times core clinical skills were performed and self-perceived proficiency of each skill were compared pre- (years 2016-2019) and during-COVID (years 2020-2021). Results: Data from 219 surveys showed a reduction in the opportunity to perform “a cervical screen test” (p<0.001), “a mental health assessment” (p=0.006), “assess the risk of suicide” (p=0.004) and “bladder catheterisation” (p=0.007) during-COVID. Self-reported skill proficiency was also less during-COVID for performance of: “a mental health assessment” (p=0.026) and “an ECG” (p=0.035). Conclusions: The impact of COVID-19 on mental health skills was greatest, potentially due to a shift toward telehealth services and consequent reduced ability for students to engage in consultations. In a time of potential long-term change in the healthcare landscape, it is imperative to ensure adequate opportunity to practice all core clinical skills during medical training. Inclusion of telehealth earlier into the curriculum may benefit student confidence.
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