The AaLplus near-peer teaching program in Family Medicine strengthens basic medical skills-A five-year retrospective study.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
18
10
2019
accepted:
08
05
2020
entrez:
30
5
2020
pubmed:
30
5
2020
medline:
10
9
2020
Statut:
epublish
Résumé
Basic medical skills such as history taking and physical examination are essential components of clinical work profiles, but nevertheless have been neglected by conventional preclinical curricula. The near-peer-teaching program AaLplus [living anatomy plus] teaches basic medical skills, especially history taking, physical examination, and venepuncture, to preclinical students. It is a highly popular compulsory course in the first four semesters (320 students/year, 9h/semester) at Heidelberg University and ends with a formative Objective Structured Clinical Examination (OSCE) during which students receive structured in-depth feedback on their performance. AaLplus is part of the Department of General Practice's longitudinal curriculum for Family Medicine. This study aims to assess whether the AaLplus program has positive effects on students' clinical skill development and subjective confidence in history taking, physical examination and venepuncture. From 2015 to 2019, we asked all AaLplus participants to rate the program and self-assess their medical skills on 5-point Likert scales (min 1, max 5). In 4-station OSCEs, trained tutors rated the students' performance in all taught skills using standardized checklists. From 2015 to 2019 n = 1534 questionnaires returned (response rate = 98.6%, 52.7% females). After course completion, students felt able to take a patient's history (mean 3.97, SD = 0.75) and perform physical examinations (means range 3.82-4.36, SDs range 0.74-0.89) as well as venepuncture (mean 4.12, SD = 0.88). A large majority of students claimed they acquired these skills in the AaLplus program. During OSCE, 81.9% passed anamnesis, 93.1% passed physical examination, and 95.4% passed venepuncture (of n = 1556). Students mostly rated the feedback they received during the OSCE as "helpful" or "very helpful" (means for different stations 4.69-4.76, SDs 0.50-0.70). AaLplus is a positive example of a peer teaching program in the preclinical stage of medical studies. It successfully trains junior students in essential medical abilities and increases their confidence in their skills. A high percentage of students pass the formative OSCE and evaluate it positively. Consistently high ratings indicate the program's routine viability. Further studies are needed to analyze if programs like AaLplus could have an impact on the number of graduates choosing career in Family Medicine.
Sections du résumé
BACKGROUND
Basic medical skills such as history taking and physical examination are essential components of clinical work profiles, but nevertheless have been neglected by conventional preclinical curricula. The near-peer-teaching program AaLplus [living anatomy plus] teaches basic medical skills, especially history taking, physical examination, and venepuncture, to preclinical students. It is a highly popular compulsory course in the first four semesters (320 students/year, 9h/semester) at Heidelberg University and ends with a formative Objective Structured Clinical Examination (OSCE) during which students receive structured in-depth feedback on their performance. AaLplus is part of the Department of General Practice's longitudinal curriculum for Family Medicine.
OBJECTIVES
This study aims to assess whether the AaLplus program has positive effects on students' clinical skill development and subjective confidence in history taking, physical examination and venepuncture.
METHODS
From 2015 to 2019, we asked all AaLplus participants to rate the program and self-assess their medical skills on 5-point Likert scales (min 1, max 5). In 4-station OSCEs, trained tutors rated the students' performance in all taught skills using standardized checklists.
RESULTS
From 2015 to 2019 n = 1534 questionnaires returned (response rate = 98.6%, 52.7% females). After course completion, students felt able to take a patient's history (mean 3.97, SD = 0.75) and perform physical examinations (means range 3.82-4.36, SDs range 0.74-0.89) as well as venepuncture (mean 4.12, SD = 0.88). A large majority of students claimed they acquired these skills in the AaLplus program. During OSCE, 81.9% passed anamnesis, 93.1% passed physical examination, and 95.4% passed venepuncture (of n = 1556). Students mostly rated the feedback they received during the OSCE as "helpful" or "very helpful" (means for different stations 4.69-4.76, SDs 0.50-0.70).
CONCLUSIONS
AaLplus is a positive example of a peer teaching program in the preclinical stage of medical studies. It successfully trains junior students in essential medical abilities and increases their confidence in their skills. A high percentage of students pass the formative OSCE and evaluate it positively. Consistently high ratings indicate the program's routine viability. Further studies are needed to analyze if programs like AaLplus could have an impact on the number of graduates choosing career in Family Medicine.
Identifiants
pubmed: 32470972
doi: 10.1371/journal.pone.0233748
pii: PONE-D-19-29135
pmc: PMC7259978
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0233748Déclaration de conflit d'intérêts
The authors of this study have read the journal's policy and have the following competing interests: All authors are involved in the AaLplus program. There are no patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Références
GMS J Med Educ. 2016 Aug 15;33(4):Doc54
pubmed: 27579354
Psychol Rev. 1977 Mar;84(2):191-215
pubmed: 847061
BMC Med Educ. 2018 Mar 20;18(1):43
pubmed: 29558914
Med Teach. 2016 Aug;38(8):829-37
pubmed: 26613398
Ann Intern Med. 1979 Dec;91(6):898-902
pubmed: 517891
JAMA. 2006 Sep 6;296(9):1094-102
pubmed: 16954489
Med Teach. 2015 Apr;37(4):312-22
pubmed: 25319403
Med Educ. 2005 Oct;39(10):1015-20
pubmed: 16178828
Nurse Educ Today. 2017 Mar;50:42-50
pubmed: 28012361
Med Teach. 2004 May;26(3):239-43
pubmed: 15203501
BMC Med Educ. 2019 Jun 4;19(1):187
pubmed: 31164127
Med Educ. 2001 Feb;35(2):121-8
pubmed: 11169083
Med Educ. 1989 Mar;23(2):189-95
pubmed: 2716558
Med Teach. 2008;30(2):124-45
pubmed: 18464136
BMJ Open. 2017 Sep 25;7(9):e016294
pubmed: 28951408
Lancet. 2001 Mar 3;357(9257):699-703
pubmed: 11247568
Plast Reconstr Surg. 2013 May;131(5):1194-201
pubmed: 23629100
BMC Res Notes. 2017 Nov 29;10(1):650
pubmed: 29187258
Ann Fam Med. 2018 Mar;16(2):149-154
pubmed: 29531107
Adv Med Educ Pract. 2017 May 19;8:337-345
pubmed: 28579871
Med Educ. 2009 Feb;43(2):113-20
pubmed: 19161480
Acad Med. 2015 Feb;90(2):246-56
pubmed: 25374041
Aust Fam Physician. 2014 Mar;43(3):156-8
pubmed: 24600681
Med Educ. 2007 Nov;41(11):1032-8
pubmed: 17973763
BMC Med Educ. 2014 Jun 09;14:115
pubmed: 24912500
Nurse Educ Today. 2018 Nov;70:60-68
pubmed: 30145536
J Gen Intern Med. 1997 Apr;12 Suppl 2:S34-40
pubmed: 9127242
Med Educ Online. 2010 Aug 06;15:
pubmed: 20711483
J Gen Intern Med. 1994 Apr;9(4):213-8
pubmed: 8014727
Med Teach. 2007 Sep;29(6):546-52
pubmed: 17978967
BMC Med Educ. 2019 Apr 2;19(1):95
pubmed: 30940106
Z Evid Fortbild Qual Gesundhwes. 2017 May;122:54-60
pubmed: 28359724
Int J Chron Obstruct Pulmon Dis. 2013;8:369-77
pubmed: 23983462
BMC Med Educ. 2020 Jan 16;20(1):17
pubmed: 31948425
GMS J Med Educ. 2016 Aug 15;33(4):Doc64
pubmed: 27579364
Med Educ. 2007 Apr;41(4):411-8
pubmed: 17430287
Med Teach. 2002 May;24(3):280-5
pubmed: 12098414
Qual Saf Health Care. 2009 Feb;18(1):63-8
pubmed: 19204135
Med Educ. 2000 Jun;34(6):460-4
pubmed: 10792687
Med Teach. 2013;35(1):58-62
pubmed: 23102164
Med Teach. 2009 Feb;31(2):e32-5
pubmed: 19330661
BMJ. 2005 Aug 13;331(7513):387-91
pubmed: 16096306
Clin Teach. 2020 Feb 20;:
pubmed: 32080969
J R Soc Med. 2014 Mar;107(3):99-102
pubmed: 24526462
Med Educ. 2002 Jul;36(7):628-34
pubmed: 12109984
Med Teach. 2009 Dec;31(12):1047-55
pubmed: 19995166