Background:

Medical undergraduates should be prepared to recognize life threating critical conditions. Undergraduate medical curriculum development to incorporate more critical care education is an essential requirement. Problem Based Learning curriculum has a potential advantage in providing more focused critical care education to medical undergraduate.

Objectives:

We aimed to evaluate the final year medical students’ knowledge and confidence in key critical care concepts in Problem Based Learning (PBL) curriculum compared to those in Traditional (Lecture) Based Learning curriculum. We also aimed to evaluate undergraduate’s level of satisfaction with the exposure to critical care education during medical education and training.

Materials and methods:

This is a cross-sectional anonymous self-administered survey questionnaire completed by two groups of final-year medical students (PBL and TBL) from three Saudi medical schools to assess the degree of undergraduate exposure to critical care and their knowledge of key critical care assessment parameters.

Results:

The responses of 279 final year medical students was analyzed (70% response rate). The majority (53%) was male and the mean age 23.9 ± 1.4 years. Only 13% of students felt confident to manage hypovolemic shock and 15% could recognize the signs of a threatened airway. One third of the students (29%) correctly identified the critical level of lactic acid in shock and less than 2% of the sample responded correctly to all the questions related to the formal assessment of critically ill patients. Lectures were the main source of information in acute care. More than two-thirds (46%) of the sample indicated that they received tuition in critical care, however the total duration spent in a critical care rotation or teaching was 1 day or less. The medical students, who completed their training with a Problem-Based Learning curriculum, had a higher knowledge base and were more confident in many critical care concepts. Only 6.5% choose critical care as their likely future career.

Conclusion:

Medical undergraduates in PBL have an overall better knowledge on key concepts and assessment tools applicable to evaluating and managing critically ill patients compared to students in TBL. However the gap in knowledge and confidence in assessing ill patients in both groups is evident. Critical care was not chosen as a preferred future career in all surveyed students. There is a need for institutional support and endorsement of undergraduate critical care exposure and education in Saudi Universities both to better prepare medical students for their imminent post-graduates exposure to ill patients and to help in closing the gap in critical care physicians through promoting the specialty.

中文翻译：

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最后一年的医学生对重症监护核心概念的知识和信心，基于问题的学习与传统课程的比较

背景：

医学本科生应该准备好认识到威胁生命的危急情况。本科医学课程开发以纳入更多重症监护教育是一项基本要求。基于问题的学习课程在为医学本科生提供更集中的重症监护教育方面具有潜在优势。

目标：

我们旨在评估最后一年医学生在基于问题的学习 (PBL) 课程中与基于传统（讲座）的学习课程中的关键重症监护概念的知识和信心。我们还旨在评估本科生在医学教育和培训期间对重症监护教育的满意度。

材料和方法：

这是一份横断面匿名自我管理调查问卷，由来自沙特三所医学院的两组最后一年的医学生（PBL 和 TBL）完成，旨在评估本科生接触重症监护的程度及其对重症监护评估的知识参数。

结果：

分析了 279 名最后一年医学生的反应（反应率为 70%）。大多数 (53%) 为男性，平均年龄为 23.9 ± 1.4 岁。只有 13% 的学生有信心应对低血容量性休克，15% 的学生能够识别出气道受到威胁的迹象。三分之一（29%）的学生正确识别了休克中乳酸的临界水平，只有不到2%的样本正确回答了与危重患者正式评估相关的所有问题。讲座是急症护理的主要信息来源。超过三分之二 (46%) 的样本表示他们接受了重症监护的学费，但在重症监护轮换或教学中花费的总时间为 1 天或更短。通过基于问题的学习课程完成培训的医学生，拥有更高的知识基础，并且对许多重症监护概念更有信心。只有 6.5% 的人选择重症监护作为他们未来可能的职业。

结论：

与 TBL 的学生相比，PBL 的医学本科生对适用于评估和管理危重病人的关键概念和评估工具有更好的了解。然而，两组在评估患病患者方面的知识和信心差距是显而易见的。在所有接受调查的学生中，重症监护并未被选为未来的首选职业。沙特大学需要机构支持和认可本科重症监护接触和教育，以更好地为医学生为即将到来的研究生接触患病患者做好准备，并通过促进专业帮助缩小重症监护医生的差距.