Teaching pediatric otoscopy skills to the medical student in the clinical setting: preceptor perspectives and practice

BMC Medical Education

Alanna D. Higgins Joyce¹  Suzanne M. Schmidt¹  Corinne Lehmann²  Kari A. Simonsen³  Cynthia Christy⁴  Meg G. Keeley⁵  Caroline R. Paul⁶  Gary L. Beck Dallaghan⁷ 

[1] Department of Pediatrics, Northwestern University Feinberg School of Medicine;Department of Pediatrics, University of Cincinnati College of Medicine;Department of Pediatrics, University of Nebraska Medical Center;Department of Pediatrics, University of Rochester School of Medicine and Dentistry;Department of Pediatrics, University of Virginia School of Medicine;Department of Pediatrics, University of Wisconsin School of Medicine and Public Health;University of North Carolina School of Medicine, Office of Medical Education;

关键词: Pediatric otoscopy;    Ear exam;    Acute otitis media;    Faculty development;    Clinical educator;    Clinical teaching;   

DOI  :  10.1186/s12909-020-02307-x

来源: DOAJ

【 摘 要 】

Abstract Background Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. Methods A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. Results Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). Conclusions Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.

【 授权许可】

Unknown