Abstracts
Abstract
Introduction: The progression from preclinical medical training to clerkship is a pivotal yet steep transition for medical students. Effective feedback on clinical skills during preclinical training can better equip students for clerkship and allows time for them to address difficulties promptly. The goal of this study was to explore whether and how narrative comments at this stage were being leveraged to achieve this transition.
Methods: We conducted a content analysis to categorize narrative comments on the clinical skills of two cohorts of third-year preclinical students at one academic institution.
Results: Teachers made narrative comments for 272 students. Each comment was divided into analysis units (n = 1,314 units). Comments were either general (n = 187) or focused on attitude (n = 628), knowledge and cognitive processes (n = 357), or clinical reasoning (n = 142). They were abundantly positive (n = 1,190) and marginally negative (n = 39). Few (6%) contained suggestions for improvement.
Discussion: In this study, narrative comments on clinical skills before clerkship seemed minimally helpful, as they were overwhelmingly positive and seldom offered suggestions. This could suggest missed opportunities for early interventions. Pre-clerkship narrative comments could potentially be optimized by increasing emphasis on clinical reasoning, addressing challenges early and providing actionable steps for improvement.
Résumé
Introduction : Le passage de la formation médicale préclinique à l'externat est une transition cruciale mais abrupte pour les étudiants en médecine. Une rétroaction efficace sur les compétences cliniques au cours de la formation préclinique peut mieux préparer les étudiants à l'externat et leur donner le temps de remédier rapidement aux difficultés rencontrées. L'objectif de cette étude était d'explorer si et comment les commentaires narratifs à ce stade étaient mis à profit pour réaliser cette transition.
Méthodes : Nous avons effectué une analyse de contenu pour catégoriser les commentaires narratifs sur les compétences cliniques de deux cohortes d'étudiants précliniques de troisième année dans un établissement universitaire.
Résultats : Les enseignants ont fait des commentaires narratifs pour 272 étudiants. Chaque commentaire a été divisé en unités d'analyse (n = 1 314 unités). Les commentaires étaient soit généraux (n = 187), soit axés sur l'attitude (n = 628), les connaissances et les processus cognitifs (n = 357), ou le raisonnement clinique (n = 142). Ils étaient en général positifs (n = 1 190) et rarement négatifs (n = 39). Peu d'entre eux (6 %) contenaient des suggestions d'amélioration.
Discussion : Dans cette étude, les commentaires narratifs sur les compétences cliniques avant l'externat ont semblé peu utiles, car ils étaient en grande majorité positifs et offraient rarement des suggestions. Cela donne à penser que des occasions d’intervention précoce ont pu être perdues. Les commentaires narratifs avant l'externat pourraient être optimisés en mettant davantage l'accent sur le raisonnement clinique, en abordant rapidement les défis rencontrés et en proposant des mesures d'amélioration réalisables.
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