Howe A, Ives G
Institute of General Practice and Primary Care, Community Sciences Centre, University of Sheffield, Northern General Hospital, Sheffield, UK.
Med Educ. 2001 Apr;35(4):391-7. doi: 10.1046/j.1365-2923.2001.00866.x.
Previous studies have shown that most medical students want a hospital-based career, but the protagonists of community-based teaching predict that increased community exposure within undergraduate curricula will alter subsequent career preferences.
To evaluate the impact on career preference and other attitudes of a year with substantial community exposure, compared with a year of hospital-based learning.
Questionnaire to student cohort before and after two consecutive levels of the course, one with, and the other prior to, substantial community placement.
Sheffield Medical School.
Total of 260 students in the third and fourth year of the MBChB degree.
There were significant differences in career preference and attitude to primary care after the year with a community placement, with more students expressing a preference for a community-based career. This was particularly true for women, and less true for non-European students. Conversely, the hospital-based students, especially men, showed a significant change toward hospital-based careers.
The findings support the hypothetical advantages of shifting medical education to primary care settings, both in encouraging a career in general practice and in the retention of appropriate professional attitudes.
先前的研究表明，大多数医学生希望从事医院工作，但以社区为基础的教学倡导者预测，本科课程中增加社区接触机会将改变他们随后的职业偏好。
与在医院学习一年相比，评估一年大量社区接触对职业偏好和其他态度的影响。
在课程的连续两个阶段前后对学生群体进行问卷调查，一个阶段有大量社区实习，另一个阶段在大量社区实习之前。
谢菲尔德医学院。
MBChB学位三、四年级的260名学生。
在有社区实习的那一年之后，职业偏好和对初级保健的态度存在显著差异，更多学生表示倾向于从事社区工作。女性尤其如此，非欧洲学生则不太明显。相反，以医院为基础学习的学生，尤其是男性，对医院工作的职业倾向有显著变化。
研究结果支持将医学教育转向初级保健环境的假设优势，这既有助于鼓励从事全科医疗工作，也有助于保持适当的职业态度。
