临床医学(八年制)专业医学生甲状腺癌认知情况调查

Investigation on Cognition of Thyroid Carcinoma Among Medical Students

目的调查临床医学(八年制)专业医学生甲状腺癌相关知识及甲状腺自查方法的掌握情况,为临床前医学教育和临床教学提供借鉴和指导。方法2020年3月,采用便利抽样法选取北京协和医学院临床医学(八年制)专业三至六年级医学生为调查对象。将三、四年级医学生定义为临床前阶段医学生(preclinical medical students,PMS),将五、六年级医学生定义为临床阶段医学生(clinical medical students,CMS),采用自行设计的问卷对此两类医学生开展网络调查。结果共发放问卷337份,回收有效问卷274份(PMS 129份,CMS 145份)。CMS在甲状腺癌预后(97.2%比64.5%,P<0.001)、诊断方式(95.6%比33.1%,P<0.001)及手术治疗指征(82.1%比58.1%,P=0.001)方面的认知水平高于PMS;在甲状腺癌危险因素方面,二者的认知水平接近。相较于PMS,更高比率的CMS认为甲状腺结节出现恶变的概率在5%及以下(45.5%比6.5%,P<0.001),且更高比率的CMS支持无症状及结节时也应进行甲状腺癌筛查(62.1%比41.9%,P<0.001)。CMS进行甲状腺自查的比率高于PMS(55.9%比12.1%,P<0.001),但进行规律自查的比率较低(19.8%,16/81)。结论临床教学可显著提高医学生的甲状腺癌认知水平,但CMS对甲状腺结节持更加乐观态度,轻视自查,且对甲状腺超声筛查缺乏正确的成本-效益认识。建议今后应重视医学生的临床前通识教育,丰富临床阶段的实践内容,充分发挥其社会科普宣传效应。

Objective To investigate how well medical students master knowledge about thyroid carcinoma(TC)and thyroid self-examination,and to provide guidance for pre-clinical education and clinical teaching.Methods The survey was based on the eight-year program of clinical medicine in Peking Union Medical College Medical College.Students of the third and fourth grade were defined as preclinical medical students(PMS),and students of the fifth and sixth grade were clinical medical students(CMS).The survey was conducted in March 2020 through online questionnaires.Results A total of 337 questionnaires were distributed and 274 valid responses were collected with 129 from PMS and 145 from CMS.Generally,CMS had better comprehension of TC,including prognosis(97.2%vs.64.5%,P<0.001),diagnosis(95.6%vs.33.1%,P<0.001)and surgery indications(82.1%vs.58.1%,P=0.001).There was no significant difference between PMS and CMS on the acquaintance of the risk factors.However,more CMS stated that≤5%of thyroid nodules might turn malignant(45.5%vs.6.5%,P<0.001),and more CMS suggested that people without nodules should receive TC screening tests(62.1%vs.41.9%,P=0.001).The percentage of thyroid self-examination in CMS was higher than that of PMS(55.8%vs.11.6%,P<0.001),but the rate of regular self-examination was lower(19.8%,16/81).Conclusions Medical education on TC is effective,but CMS tend to be over optimistic about TC,ignore the importance of self-examination,and lack proper awareness of cost-effectiveness in thyroid screening.It is suggested that medical schools should focus more on education of preclinical general health and clinical practices in the future to engage medical students in popularization of health science.