Application of Multidisciplinary Diagnosis and Treatment (MDT) Clinical Teaching Model in the Clinical Teaching of Some Undergraduates of Breast Diseases in Surgery

doi:10.21203/rs.3.rs-4020649/v1

Download PDF

Research Article

Application of Multidisciplinary Diagnosis and Treatment (MDT) Clinical Teaching Model in the Clinical Teaching of Some Undergraduates of Breast Diseases in Surgery

https://doi.org/10.21203/rs.3.rs-4020649/v1

This work is licensed under a CC BY 4.0 License

You are reading this latest preprint version

Background

Breast surgery, emerging as an independent discipline with a wealth of specialist cases and an extensive case resource library in medical history. Contemporary clinical teaching faces challenges with traditional methods unable to address students' theoretical strength and practical limitations. The COVID-19 pandemic further strained learning environments, limiting students' exposure to patient diagnosis and treatment. Conventional clinical teaching, organized by disciplines, often results in technical isolation and a narrow clinical perspective, impeding the development of well-rounded medical professionals. Multidisciplinary Comprehensive Diagnosis and Treatment (MDT) emerges as a patient-centric, collaborative approach involving various medical departments in clinical decision-making. Despite its success in clinical settings, the effectiveness of MDT in undergraduate medical education remains largely unexplored.

Methods

This study conducted at the Breast Department of the First Affiliated Hospital of Zhengzhou University, aimed to compare the learning outcomes of clinical interns under traditional and MDT teaching modes. In a randomized controlled trial with 140 participants, the MDT group received comprehensive training from diverse healthcare professionals, while the traditional group had standard teaching. Evaluation included pre-test and post-test assessments on knowledge acquisition, skill acquisition, and clinical decision-making. Longitudinal analysis and statistical tests, including t-tests and multiple regression, were employed.

Results

A total of 140 clinical medicine students participated, randomly assigned to MDT (n = 70) and Traditional Teaching Mode (n = 70) groups. Key baseline characteristics, such as age, gender, and completion rates, were comparable between groups. For each group’s pre- and post-test scores, MDT group means consistently surpassed Traditional Teaching Mode, with significant differences (p < 0.05).Correlation analysis showed that there were no significant variable correlations between individual performance characteristics and test scores. Post-training, significant score improvements were observed in both groups across all tests (p < 2.2e-16). Utilizing the Wilcoxon rank sum test, pre-test differences were not significant. However, post-test scores favored the MDT group significantly (p = 0.0016, 2.8e-09, 3.6e-07). For students pursuing a master's, no statistically significant differences in specialty choice were observed between groups, though a trend towards more MDT students choosing surgical specialties was noted.

Conclusion

This study pioneers the application of the MDT teaching method in breast cancer clinical education, comparing its efficacy against traditional teaching modes. Findings demonstrate that MDT-based breast cancer diagnosis and treatment education is more efficient and optimized, offering a transformative basis for clinical undergraduate education reform in China. The results advocate for the reconfiguration of multidisciplinary consultation clinical teaching and traditional methods, promising enhanced educational outcomes and heightened medical student knowledge.

Multidisciplinary comprehensive diagnosis and treatment

MDT

MDT teaching Mode

traditional teaching Mode

Breast surgery

Clinical Teaching

Breast surgery is a new discipline that belongs to surgery in history¹. After breast surgery became an independent discipline, although it diagnosed and treated fewer diseases, breast cancer (BC) is the malignant tumor with the highest incidence rate in the world². In other departments, breast surgery has more specialist cases and a richer case resource library³. At the same time, compared with other malignant tumors, breast cancer has a better prognosis, longer survival time, and more comprehensive follow-up data⁴. In recent years, the diagnosis and treatment methods of breast cancer have advanced rapidly, and various relevant clinical guidelines have been continuously updated⁵. The clinical manifestations, pathological classification and complex diagnosis and treatment process of breast cancer involve the knowledge of imaging, pathology, oncology, nutrition, endocrinology, gynecology and other disciplines, which is difficult for clinical undergraduates to learn and mastered diseases.

In recent years, clinical teaching has been paid more and more attention, and the training tasks and standards of clinical teaching have been raised to a new height⁶. Although the national opinions on teaching reform have been issued, there are still many problems in the teaching line of medical colleges. Using traditional teaching methods is difficult to change the current situation of students' strong theoretical learning ability and poor practical ability⁷. In addition, since the novel coronavirus epidemic swept the world in 2019, under the prevention and control measures to reduce population aggregation to prevent the spread of coronavirus, the learning environment may be more stressful. A clinical medical student often only has a limited understanding of patients' diagnosis and treatment methods, and it is difficult to personally participate in the diagnosis and treatment process and decision-making of patients. The traditional clinical teaching system based on various disciplines leads to technical isolation between different specialties, and the rotation learning mode of different departments even leads to the limitation and narrowness of clinical thinking of medical students, which seriously affects the training of medical talent echelon⁸.

Multidisciplinary comprehensive diagnosis and treatment (MDT) refers to the patient-centered, multi-department cooperation in diagnosis and treatment of patients and clinical decision-making, so as to formulate the best diagnosis and treatment plan^9,10. Treatment of cancer has evolved toward a MDT approach.¹¹ MDT meetings may substantially reduce the time of patients consultation, and improve the efficiency of diagnosis and treatment¹². MDT emphasizes teamwork, communication, and collaboration, and has been shown to improve patients’ outcomes and healthcare quality in various clinical settings. The MDT clinical teaching method is an interdisciplinary approach to clinical education that involves a team of healthcare professionals from different disciplines working together to provide comprehensive patient care. However, the effectiveness of the MDT teaching method in clinical education has not been fully explored, especially in the context of undergraduate medical education¹³.

In this study, the MDT teaching method was applied to the clinical teaching of breast cancer, and its teaching effect was compared with the traditional teaching mode. We found that the teaching of breast cancer diagnosis and treatment based on the MDT platform is more efficient and optimized, that provided a basis for the reform and implementation of education for clinical undergraduates in China. Our results promoted the optimization and transformation of the multidisciplinary consultation clinical teaching mode and the traditional teaching mode, and will finally achieve better teaching effects and improve the knowledge level of medical students.

2.1 Objectives

The main objective of this study is to compare the learning outcomes of clinical interns in the traditional teaching mode and the MDT teaching mode in the Breast Department of the First Affiliated Hospital of Zhengzhou University. Specifically, the objectives are:

To assess the knowledge acquisition of clinical interns in the traditional teaching mode and the MDT teaching mode.

To evaluate the skill acquisition of clinical interns in the traditional teaching mode and the MDT teaching mode.

To measure the clinical decision-making abilities of clinical interns in the traditional teaching mode and the MDT teaching mode.

To determine if there is a significant difference in the learning outcomes between the traditional teaching mode and the MDT teaching mode.

2.2 Participants

This study used a randomized controlled trial design to compare the learning outcomes of clinical interns in the traditional teaching mode and the MDT teaching mode. The study was conducted in the Breast Department of the First Affiliated Hospital of Zhengzhou University over a period of one year. Participants in the experiment were selected from students majoring in clinical medicine who had a one-month clinical internship at the Breast Surgery Department of the First Affiliated Hospital of Zhengzhou University with no prior experience in the management of breast diseases from January to December 2020. Clinical interns with experience in breast disease management and clinical interns with any physical or psychological condition that might affect their learning outcomes were excluded. Finally, a total of 140 students were recruited for this project, and they were randomly divided into the MDT teaching model group (experimental group) (n = 70) and the traditional teaching model group (control group) (n = 70).

2.3 Interventions

Participants were recruited and randomly assigned to either the traditional teaching mode group (control group) or the MDT teaching mode group (experimental group). The traditional teaching mode group received the standard teaching that is currently used in the department. The MDT teaching mode group received comprehensive and multidisciplinary training from a team of healthcare professionals from different disciplines, including surgeons, radiologists, pathologists, and oncologists. Both groups had participated in group discussions, case presentations, and team-based problem-solving exercises.

The standard teaching mode is: according to the requirements of the teaching syllabus, only the teachers of the breast department will participate in the teaching process, and the theoretical content related to the case will be made into a PPT, and the clinical manifestations, diagnostic methods and treatment principles of breast diseases will be completed in combination with blackboard writing and clinical case observation. lecture. The whole explanation mainly involves the field of breast diseases, and the knowledge of other professional fields is only mentioned, without specific explanation. After the teaching teacher explains and demonstrates the relevant skill operation content of the mammary gland department, the students understand it according to the operation specification, and conduct operation training with a simulated human.

The MDT teaching mode in this study is: the teaching teacher selects the existing breast cancer cases, guides the students to consult the materials (textbooks, guidelines, expert consensus, etc.), and proposes how to make a diagnosis and differential diagnosis for the case, and how to carry out comprehensive treatment and follow-up principles and other issues, and form a picture or text file. According to the specific conditions of typical cases, key disciplines related to the disease were invited to discuss MDT with a multi-disciplinary expert group through the live broadcast platform (Houshan Network School used by Zhengzhou University). On the basis of clinical evidence, physicians of various specialties cooperate with each other to rationally analyze the treatment plan and discuss the results of disease analysis and treatment opinions. The teaching teacher explained the key points and difficulties of typical cases according to the teaching syllabus, and summarized the discussion content.

2.4 Ethics approval and informed consent

Ethical considerations had been taken into account in the design and implementation of this study. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki, and had been approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University. Informed consents were obtained from all participants prior to their inclusion in the study, and the data collected was kept confidential and anonymized. Digital files were stored on a secured laptop and access to the data was only granted to the project team.

2.5 Teaching content

Teaching content was the same for both groups and included: Introduction to Breast Anatomy and Physiology, Breast Disease Diagnostic Techniques (including imaging techniques such as mammography and ultrasound), Breast Biopsy Technique and Interpretation of Biopsy Results, Breast Disease Multidisciplinary Treatment planning methods, surgical techniques for breast disease, chemotherapy and radiation therapy for breast cancer, management of treatment complications and side effects of treatment.

2.6 Observation Indicators

The assessment content of the two groups was the same, and the assessment items arranged three observation indicators: knowledge acquisition tests, skill acquisition assessments, and clinical decision-making evaluations. The learning outcomes of both groups were measured by a pre-test and post-test. The knowledge acquisition tests covered topics related to breast diseases and their diagnosis and treatment. The tests consisted of multiple-choice questions and short answer questions. The score of knowledge acquisition tests counted for 30 percent of the total score.

The skill acquisition assessments involved the performance of clinical procedures related to breast diseases, such as breast examination, ultrasound-guided biopsy, and breast surgery. The assessments were conducted by experienced faculty members who were blinded to the group assignments of the clinical interns. The score of skill acquisition assessments counted for 35 percent of the total score.

The clinical decision-making evaluations involved the analysis of clinical cases related to breast diseases. The evaluations were conducted by experienced faculty members who were blinded to the group assignments of the clinical interns. The score of clinical decision-making evaluations counted for 35 percent of the total score.

2.7 Long term analysis

To analyze the follow-up results, we conducted a longitudinal study to assess the impact of the MDT teaching mode on student performance over time. The students in the two groups were followed up continuously to analyze whether the MDT teaching in breast surgery had any impact on their subsequent learning (learning methods, whether to continue studying for a master's degree, professional choice for studying for a master's degree/work, etc.). The plot was generated using R software (v.4.2.2) package ggplot2 (v.3.3.6) ¹⁴ through Hiplot Pro (https://hiplot.com.cn/), a comprehensive web service for biomedical data analysis and visualization.

2.8 Statistical Analysis

The IBM SPSS statistical software 27.0 was used to compare and analyze the results of the study. Descriptive statistics was used to describe the characteristics of the study population, and independent sample t-tests was used to compare the learning outcomes between the two groups. The level of significance was set at p < 0.05. Multiple regression analysis was used to test the effect of background variables on the results. The level of statistical significance was set at p < 0.05.

3.1 Descriptive statistics

A total of 140 students majoring in clinical medicine who had a one-month clinical practice in breast surgery of The First Affiliated Hospital of Zhengzhou University were recruited and randomly assigned to either the MDT teaching mode group (experimental group)(n = 70) or the traditional teaching mode group༈control group༉ (n = 70). The age of experimental group was (23.71 ± 0.127) years and that of the control group was (23.6 ± 0.14). There were 33 males and 37 females in the experimental group and 37 males and 33 females in the control group. The number of students in the experimental group and the control group who actually completed all course plans was 92.9% (65/70) respectively. The total absence time of students in the experimental group and the control group was 8 hours respectively. The comparison between the other factors of the experimental group and the control group students (height, weight, place of birth, whether glasses are worn, previous GPA, and whether there are clinical workers in the immediate family) is shown in Fig. 1. Among the baseline factors of the enrolled students in the experimental and control groups, only height and weight were correlated. The correlation coefficient (Corr) between height and weight in the experimental group was 0.812, while the Corr between height and weight in the control group was 0.830, all of which were highly correlated (Corr > 0.8).

First, for the scores of the two groups of students on the knowledge acquisition pre-test, skill acquisition assessment pre-test, clinical decision-making assessment pre-test, knowledge acquisition post-test, skill acquisition assessment post-test and clinical decision-making assessment post-test, we used the mean, standard deviation, median and other measurement indicators to perform descriptive statistics on the data to understand the distribution of the data and identify outliers. As shown in Supplementary Table 1, the descriptive statistics of all variables in the data set (gender, age, height, weight, native/non-native and wearing glasses/not wearing glasses) of the experimental group and the control group are shown respectively.

For the experimental group, the average scores of the knowledge acquisition pre-test, skill acquisition evaluation pre-test, clinical decision evaluation pre-test, knowledge acquisition post-test, skill acquisition evaluation post-test, and clinical decision evaluation post-test are 18.09, 17.09, 14.05, 28.31, 23.54, and 23.54, respectively. The standard deviations of these scores are 0.73, 0.74, 0.83, 0.67, 1.28, and 1.91, respectively. The median scores of these six tests are 18.15, 17.15, 13.95, 28.30, 23.60, and 23.35, respectively. The score ranges are 14.6–19.8, 13.7–18.5, 12.1–16.3, 26.6–30.0, 20.3–26.8, and 19.9–29.1, respectively. For the control group, the mean scores for the knowledge acquisition pre-test, skill acquisition assessment pre-test, clinical decision assessment pre-test, knowledge acquisition post-test, skill acquisition assessment post-test, and clinical decision assessment post-test are 17.86, 16.80, 14.16, 27.80, 22.33, and 22.14 respectively. The standard deviations for these scores were 1.03, 1.08, 1.17, 1.29, 1.04, and 1.27 respectively. The median scores for these six tests were 17.8, 16.8, 14.1, 27.8, 22.2, and 21.8 respectively. The score ranges were 13.3–20.3, 13.8–19.6, 12.1–18.2, 20.7–29.7, 20.8–25.8, and 19.6–26.8 respectively. Table 1 shows the mean scores of the pre- and post-test (knowledge acquisition tests, skill acquisition assessments, and clinical decision-making evaluations) for each group. The MDT teaching mode group had a higher mean score in both the multiple-choice questions and the practical skills evaluation. The difference in mean scores between the two groups was statistically significant (p < 0.05).

3.2 Descriptive statistics

Subsequently, we conducted a correlation analysis on different teaching modes in our dataset to explore whether there is a correlation between the six exam scores of two groups of students and other different variables (such as gender, age, height, weight, place of birth, and whether students wear myopia glasses). We conducted different correlation analyses based on the data types of the variables. For continuous variables such as height and weight, we performed Spearman correlation analysis (Figs. 2). For discrete variables, we examined the distribution of the six scores across different categories of each variable (Figs. 3).

In the correlation analysis between the six test scores of the traditional teaching model group and the MDT teaching model group and other variables, the correlation coefficient ranges from − 1 to 1, with values close to 1 indicating strong positive correlation, and values close to -1 Indicates a strong negative correlation. We found no significant correlations between any of the continuous variables and test scores regardless of the instructional mode (traditional or MDT). In the experimental group, student age had the strongest correlation with clinical decision assessment scores, but it was not statistically significant (R = 0.2, P = 0.094) (Fig. 2A). In the control group, students' height had the strongest correlation with pre-test knowledge acquisition scores, but it was also not statistically significant (R=-0.18, P = 0.14) (Fig. 2B).

In a correlation analysis of discrete variables, we found no variables that were correlated with student achievement (Fig. 3). These results suggest that students' individual baseline characteristics have little impact on their performance and that score differences between the two groups may be attributable to different teaching methods.

3.3 Analysis of Pre- and Post-training Performance Discrepancies

We conducted a comparative analysis of pre- and post-training test scores for two groups of students. The results showed significant differences in post-test scores for knowledge acquisition, skill acquisition assessment, and clinical decision-making assessment for both the experimental and control groups (P < 2.2e-16) (Fig. 4). This indicates that receiving training has a significant impact on student performance, regardless of the training mode, and can improve their clinical abilities.

3.4 Analysis of differences in academic performance between experimental group and control group

We conducted a Wilcoxon rank sum test (also known as the Mann-Whitney U test), a non-parametric test, to analyze whether different teaching modes had an impact on student test scores. This test is suitable for comparing independent samples when the data does not follow a normal distribution.

First, we compared the pre-test scores for knowledge acquisition, skill acquisition assessment, and clinical decision-making assessment between the two groups of students. The results showed that the experimental group had higher pre-test scores for knowledge acquisition and skill acquisition assessment compared to the control group (P = 0.066, P = 0.067), while the scores for clinical decision-making assessment were lower (P = 0.8) (Fig. 5A-5C). However, these differences did not reach statistical significance.

Next, we compared the post-test scores for knowledge acquisition, skill acquisition assessment, and clinical decision-making assessment between the two groups. The analysis revealed that the experimental group had significantly higher scores in all three areas compared to the control group, with P-values of 0.0016, 2.8e-09, and 3.6e-07, respectively (Fig. 5D-5F). These findings suggest that the MDT teaching mode used in the experimental group had a better training effect on students compared to the traditional teaching mode in the control group.

3.5 Long term analysis

Students in both the experimental group and the control group chose to continue studying for a master's degree after completing their undergraduate studies. We conducted a statistical analysis of the master's majors they chose. Among the students who chose to study the master's degree in breast surgery, there were more students in the MDT teaching model group than in the traditional teaching model group, but the difference between the two is not statistically significant. There are also more students in the MDT teaching model group who choose surgical majors (including thoracic surgery, gastrointestinal surgery, thyroid surgery, plastic surgery, hepatobiliary surgery, neurosurgery, cardiac surgery, orthopedics, etc.) when pursuing their master's degree than those in the traditional teaching group, but the difference between the two is not statistically significant, too (Fig. 6, Table 2). These findings indicate the sustained effectiveness of the MDT teaching mode in enhancing student learning outcomes. For students pursuing a master's, no statistically significant differences in specialty choice were observed between groups, though a trend towards more MDT students choosing surgical specialties was noted. This indicates potential sustained benefits of MDT teaching on career trajectory.

This study will compare the learning outcomes of clinical interns in the traditional teaching mode and the MDT teaching mode. The learning outcomes will be measured using knowledge acquisition, skill acquisition, and clinical decision-making. Statistical analysis will be conducted to determine if there is a significant difference in the learning outcomes between the two teaching modes. In our study, we found that the MDT teaching method was more effective than the traditional teaching method in the undergraduate clinical teaching of surgery breast diseases. While the traditional teaching method has its merits, the MDT teaching approach offers several unique advantages that can benefit medical students and patients.

Traditional clinical teaching refers to the training and guidance of interns through direct on-site demonstrations by doctors, which has existed in medical education for a long time. However, some limitations of this method include: First, it is affected by one person's strength, which is not conducive to the cultivation of students' comprehensive ability. Teachers are different in majors, theoretical knowledge, personal expertise, and research focus. Although they can impart knowledge and skills to students intuitively, they are relatively weak in professional knowledge related to imaging and tumors, which is not conducive to the overall development of students. The second is the lack of systematic communication and collision, and the in-depth thinking ability is not strong. Although the teaching teachers are all experts in this major, because there is no communication and discussion with experts in other departments, and there is not enough deep digging and thinking in the vertical direction and cross-border research in the horizontal direction, the students are often "specialized" rather than "multi-skilled". It is not conducive to the formation and improvement of integrated thinking ability. The third is that the traditional teaching model focuses more on teaching and governance demonstrations, but does not pay enough attention to research and exploration. Students may become good doctors who can treat diseases, but it is difficult to become integrated talents with comprehensive development¹⁵.

In contrast, MDT (Multidisciplinary Diagnosis and Treatment Team) teaching is a more comprehensive and effective teaching method. It provides medical interns with a more comprehensive, systematic and effective learning experience by bringing together different medical professionals to jointly analyze cases and propose corresponding treatment plans¹⁶. This teaching method is especially suitable for complex cases and difficult cases, which require multi-professional cooperation¹⁷. Specifically, MDT teaching has the following advantages: First, the team has obvious advantages, which is conducive to the cultivation of students' comprehensive ability¹⁸. In the MDT mode of teaching, for each case, especially difficult and severe cases, the oncology teacher will put forward his own judgment based on the characteristics of breast cancer without specific tumor markers. The imaging teacher can judge the condition of the patient's organs based on CT, ultrasound or MRI image data. This kind of communication and cooperation can improve the effect of diagnosis and treatment, and improve the comprehensive ability of students. The second is eclecticism, which is conducive to the formation of integrated thinking. In the process of diagnosis and treatment of specific cases, teachers of different disciplines have different emphases, and the special products and techniques mastered by students are also diverse¹⁹. From the intuitive status of the disease to the inquiry and collection of medical history information, from the application of tumor markers to reference image data, from the collection of pathological data to the formation of the entire treatment plan, it is integrated. Comprehensive reference, the end may be "one cure many diseases."²⁰ This process is exactly the gradual process of the formation of students' integrated thinking. If things go on like this, we will be able to achieve the good results of occupying a high position, thinking carefully, and treating scientifically. The third is conducive to the growth of "all-round and multi-specialized" talents²¹. Learn one skill from one teacher, and learn from many teachers. Through the MDT teaching mode, in the limited teaching process, the team cooperates and communicates, exchanges and learns from each other, and improves each other, which is the scientific treatment of patients and ensures the treatment effect. As for the students, they have mastered a variety of skills in the subtle process, laying a solid foundation for becoming doctors. Since the teachers of each subject are experts in their majors, students can be "multi-specialized" on the basis of "all-around". Fourth, communication and coordination capabilities have been enhanced. Learn from the strengths of other families, exchange cooperation and communicate, the communication between students and patients and their families is natural and smooth, and at the same time, the relationship with teachers and classmates is naturally straightened out, laying the foundation for the overall growth in the later period. However, there are also some potential disadvantages of the MDT teaching method. One challenge is the coordination and communication among different medical departments and faculty members. This approach requires significant resources and effort to implement effectively. In addition, some students may find the MDT teaching method overwhelming due to the volume and complexity of information presented²².

In conclusion, our study suggests that the MDT teaching method is a promising approach for undergraduate clinical teaching of surgery breast diseases. While it requires significant resources and coordination, it offers several advantages over traditional teaching methods, including a multidisciplinary approach, active learning, and enhanced clinical skills. Further research is needed to investigate the feasibility and long-term impact of implementing the MDT teaching approach in other medical specialties and settings.

Data availability statement

The original data presented in the study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding author.

Ethics statement

These studies involving human participants were reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University, and all participants in this study signed written informed consent.

Author contributions

Nan Wang and Lin Li performed the data analysis and wrote the manuscript. Luhong Han, Shan Jiang, and Youyi Xiong contributed to the data analysis and manuscript revision. Fang Wang and Yuanting Gu contributed to literature search and data extraction. Xinxing Wang and Lin Li proof read the manuscript. Nan Wang and Xinxing Wang conceived and designed the study. All authors contributed to the article and approved the submitted version.

Funding

Education Department of Henan Province; Youth Project of Henan Natural Science Foundation; Award Number: 232300420248; Recipient: Nan Wang, M.D.

Acknowledgments

Thanks to all the teachers and medical students who participated in this research project. Special thanks to my daughter Yolanda for giving me strength.

Conflict of interest

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Consent to Publish

Not Applicable.

Ryan JF, Lesniak DM, Cordeiro E, Campbell SM, Rajaee AN. Surgeon Factors Influencing Breast Surgery Outcomes: A Scoping Review to Define the Modern Breast Surgical Oncologist. Annals Surg Oncol Aug. 2023;30(8):4695–713. 10.1245/s10434-023-13472-w.
Azadnajafabad S, Saeedi Moghaddam S, Mohammadi E, et al. Patterns of better breast cancer care in countries with higher human development index and healthcare expenditure: Insights from GLOBOCAN 2020. Front public health. 2023;11:1137286. 10.3389/fpubh.2023.1137286.
Montemurro P, Cheema M, Hedén P. Modified Delphi Technique to Identify Management of Aesthetic Breast Augmentation: Will We Reach a Consensus? Plastic and reconstructive surgery. Apr. 2023;1(4):759–70. 10.1097/prs.0000000000009992.
Will M, Liang J, Metcalfe C, Chandarlapaty S. Therapeutic resistance to anti-oestrogen therapy in breast cancer. Nat reviews Cancer Oct. 2023;23(10):673–85. 10.1038/s41568-023-00604-3.
Nolan E, Lindeman GJ, Visvader JE. Deciphering breast cancer: from biology to the clinic. Cell. Apr 13. 2023;186(8):1708–1728. 10.1016/j.cell.2023.01.040.
Khani H, Ahmady S, Sabet B, Namaki A, Zandi S, Niakan S. Teaching-learning in clinical education based on epistemological orientations: A multi-method study. PLoS ONE. 2023;18(11):e0289150. 10.1371/journal.pone.0289150.
Liao W, He J, Yang C, Qi S, Chen G, Ding C. Application of a new multi-element integrated teaching mode based on bite-sized teaching, flipped classroom, and MOOC in clinical teaching of obstetrics and gynaecology. BMC Med Educ Nov. 2023;1(1):820. 10.1186/s12909-023-04494-9.
Woods C, Naroo S, Zeri F, et al. Evidence for commonly used teaching, learning and assessment methods in contact lens clinical skills education. Contact lens anterior eye: J Br Contact Lens Association Apr. 2023;46(2):101821. 10.1016/j.clae.2023.101821.
Moehler M, Lyros O, Gockel I, Galle PR, Lang H. Multidisciplinary management of gastric and gastroesophageal cancers. World J Gastroenterol Jun. 2008;28(24):3773–80. 10.3748/wjg.14.3773.
Fleissig A, Jenkins V, Catt S, Fallowfield L. Multidisciplinary teams in cancer care: are they effective in the UK? Lancet Oncol Nov. 2006;7(11):935–43. 10.1016/s1470-2045(06)70940-8.
Carter S, Garside P, Black A. Multidisciplinary team working, clinical networks, and chambers; opportunities to work differently in the NHS. Quality & safety in health care. Dec. 2003;12(Suppl 1):i25–8. 10.1136/qhc.12.suppl_1.i25.
Kowalczyk A, Jassem J. Multidisciplinary team care in advanced lung cancer. Transl Lung Cancer Res Aug. 2020;9(4):1690–8. 10.21037/tlcr.2019.11.33.
Tattersall MH. Multidisciplinary team meetings: where is the value? Lancet Oncol Nov. 2006;7(11):886–8. 10.1016/s1470-2045(06)70916-0.
Villanueva RAM, Chen ZJ. ggplot2: elegant graphics for data analysis. Taylor & Francis; 2019.
Windsor A, Forbes A. Jul. Is the multidisciplinary team essential for the future management of patients with inflammatory bowel disease? Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland. 2007;9(6):478–9. 10.1111/j.1463-1318.2007.01293.x.
Feng P, Wu J, Jin Z, et al. Effect evaluation of competency-based education (CBE) combined with multi-disciplinary team (MDT) teaching mode in respiratory rehabilitation nursing teaching: A randomized controlled trial. Nurse Educ Pract Feb. 2024;10:76:103896. 10.1016/j.nepr.2024.103896.
Zhu Y, Jin S, Fu H, et al. Application of Internet-based multidisciplinary management in patients with genitourinary cancers in China: A brief introduction to a new model of healthcare service for cancer survivors during COVID-19 pandemic. Front public health. 2022;10:952739. 10.3389/fpubh.2022.952739.
Rembielak A, Yau T, Akagunduz B, et al. Recommendations of the International Society of Geriatric Oncology on skin cancer management in older patients. J geriatric Oncol May. 2023;14(4):101502. 10.1016/j.jgo.2023.101502.
Kershaw V, Farkas A, Radley S, Jha S. Jun. What is the role of the multidisciplinary team meeting in primary prolapse surgery and are alternative formats acceptable? International urogynecology journal. 2023;34(6):1235–41. 10.1007/s00192-022-05345-9.
Mirnezami A, Pilkington S, Monga A, Nugent KP. Multidisciplinary team meetings for pelvic floor disorders. Colorectal disease: official J Association Coloproctology Great Br Irel May. 2008;10(4):413. 10.1111/j.1463-1318.2008.01513.x.
Molokwu CN, Naqvi T, Tyson D. Multidisciplinary team management of patients with urological cancer. British journal of hospital medicine (London, England: 2005). Dec 2 2019;80(12):699–702. 10.12968/hmed.2019.80.12.699.
Balachandran A, Duckett J. Jun. What is the role of the multidisciplinary team in the management of urinary incontinence? International urogynecology journal. 2015;26(6):791–3. 10.1007/s00192-014-2579-3.

Table 1 The average scores before and after the test of the MDT teaching model group and the traditional teaching model group.

Table 2 The number of students in both groups who chose breast surgery and surgical specialties when pursuing a master's degree.

surgical specialties including thoracic surgery, gastrointestinal surgery, thyroid surgery, plastic surgery, hepatobiliary surgery, neurosurgery, cardiac surgery, orthopedics, etc.

No competing interests reported.

SupplementaryTable1.xlsx

Download PDF

Reviews received at journal
28 Jun, 2024
Reviewers agreed at journal
28 Jun, 2024
Reviewers invited by journal
20 Jun, 2024
Editor assigned by journal
30 May, 2024
Editor invited by journal
13 Mar, 2024
Submission checks completed at journal
13 Mar, 2024
First submitted to journal
06 Mar, 2024

You are reading this latest preprint version

Application of Multidisciplinary Diagnosis and Treatment (MDT) Clinical Teaching Model in the Clinical Teaching of Some Undergraduates of Breast Diseases in Surgery

Status:

Version 1

Abstract

Background

Methods

Results

Conclusion

Figures

1. Introduction

2. Objectives and Methods

2.1 Objectives

2.2 Participants

2.3 Interventions

2.4 Ethics approval and informed consent

2.5 Teaching content

2.6 Observation Indicators

2.7 Long term analysis

2.8 Statistical Analysis

3. Results

3.1 Descriptive statistics

3.2 Descriptive statistics

3.3 Analysis of Pre- and Post-training Performance Discrepancies

3.4 Analysis of differences in academic performance between experimental group and control group

3.5 Long term analysis

4. Discussion

5. Conclusion

Declarations

References

Tables

Additional Declarations

Supplementary Files

Status:

Version 1