Effect Of Early Clinical Practice On Cognition Of Low - Grade Medical Students

PurposeEarly clinical practice is one trend of the medical education reform.This study aims to know the influence of early clinical practice to medical students about their knowledge, to know the evaluation of education experts, teachers and students to the early clinical practice plan.In addition,the study wants to fi nd out the problems existing in the early stage of the activity, to explore the implementation effect of the early clinical practice and provide useful informa tion for the medical education reform.MethodsThis study uses the way of experimental intervention about early clinical practice and questionnaire survey to understand the effect of early clinical prac tice to medical students about their related cognition.198medical students in7-year program from grade2011and2012in our medical school were selected.95seven-year program of clinical medical students (pediatrics) as the experim ental group,103seven-year program of clinical medical students as the control group, to carry out the early clinical practice in the experimental group.At the start of the study, all the junior medical students need to fill in the questionn aire about their knowledge; at the end of the study, all students fill in the sa me questionnaire again, and a questionnaire survey was conducted in the exper imental group students about their feeling of early clinical practice.Meanwhile,t o understand their views on the activities of this study,interview the experts,tea chers in school and hospital after the activity. ResultsBefore and after the early clinical practice, the comparison results of the related cognitive of experimental group shows that they have changed some v iews of the problems,and there are statistically significant between the differenc es.For example,before the activity,there were86.6%students thought they kn ew about the volunteer activities in hospital well,94.6%of the students thought it was necessary to carried out the early clinical practice in the lower grades; About the question of what kind of knowledge and skills is important in medi cal study,84.2%of the students select"communication skills",55.8%of the stude nts choose"understanding of the medical treatment condition and the psychologi cal of the patients",25.3%of students choose "understanding of the social vario us aspects";After the activity,there were96.8%students thought they knew abo ut the volunteer activities in hospital well,97.9%of the students thought it is necessary to carried out the early clinical practice in the lower grades;About t he question of what kind of knowledge and skills is more important in medica1study,94.8%of the students select "communication skills",75.3%of the studen ts choose "understanding of the medical treatment condition and the psychologi cal of the patients",44.3%of students choose "understanding of the social vario us aspects".After the early clinical practice, the comparison results shows that there are many changes about the related cognitive between the experimental group and the control group students. And the differences are statistically significant between the two group. For example:after the activity,100%of the experiment al group students choose that they know the hospital environment,92.2%of th e control group students choose that they know the hospital environment;67. 3%of the experimental group students think that they understand the status an d the psychological of the patients,51.0%of the control group students think that they understand the status and the psychological of the patients;88.2%of the experimental group students show that they will study medicine actively,78.6%of the control group students show that they will study medicine actively;98.0%of the experimental group students think the activities are helpful to th e learning of the clinical theoretical,89.1%of the control group students think the activities are helpful to the learning of the clinical theoretical; About the q uestion of what kind of knowledge and skills is important in medical study,94.7%of the experimental group students choose "clinical operational skills",79.4%in the control group students choose "clinical operational skills";84.2%of the experimental group students choose "communication skill","communication skill" is the choice for72.5%of the control group students;47.4%of the exp erimental group students choose "understanding of the hospital environment and hospital workflow",25.5%of the control group students choose "understandin g of the hospital environment and working process"; About the question of wh at is the main work for doctors,75.3%of the experimental group students cho ose "care for patients with psychological",57.4%of the control group students choose " care for patients with mental",60.2%of the experimental group st udents choose "good service attitude,"29.7%of the control group students cho ose "good service attitude".The understanding of medical humanities are different between the experi mental group and the control group students. Before the start of the activity, t he answer about medical humanities of the two groups of students mainly limi t in the aspect of macroscopic understanding;While after the activity, the exper imental group had more students made answer to this question, and their unde rstanding are deeper and more detailed than before and the understanding of th e control group students.According to the survey,98.9%of the students in the experimental group interest in the early clinical practice,think the activity is very meaningful,and they are pleased with the arrange of the content and the form of the active m ade by the clinical teacher;95.4%of the students think the activity are helpful for the future clinical theoretical study;95.4%of the students think the activity help to arouse the ent husiasm and the initiative of learning;98.9%of the students think the activity help them to develop communication skills;92%of the students think the acti vity help to deepen their understanding of medicine and doctor career. In the activity, students have the most profound impression of the hospital environme nt, the working attitude of the medical staff and the medical ethics, the next a re the communication skills and the workflow of hospital.But only31%of the students communicate with the patient and family actively, only36.8%of the students has recorded the activity.ConclusionEarly clinical practices have improved students’ who in the experimental g roup medical learning interest and initiative,made them understand the necessity of early clinical practice and recognize that the activities are advantageous to grasp the theoretical knowledge of medicine.Early clinical practices make stud ents have profound understanding of the hospital environment,the status and th e psychology of the patient, and have a more profound understanding of medi calhumanities education. At the same time,the activity has improved their under standing of the importance of learning in clinical medicine, preventive medicin e, clinical skills, communication skills. Most of the experts and teachers think that early clinical practices accord with the new requirement of medical education:"Early clinical, More clinical, R epeated clinical".It is good to cultivate the students’ occupation quality and val ue, conducive to promoting students’ autonomous learning and good to improve the interpersonal communication ability. Early clinical practice is suitable for t he implementation and promotion in the affiliated hospital.While,there are some problems needed to solve in the practice in the future.