Dolmans D H, Wolfhagen H A, Essed G G, Scherpbier A J, van der Vleuten C P
University of Maastricht Medical School, Maastricht, The Netherlands.
Med Teach. 2001;23(5):471-5. doi: 10.1080/01421590120075706.
Some rotations during clinical education are characterized by a high number of hours spent per week in the hospital because students panicipate in a hospital on-call system, i.e. hours beyond usual working hours, e.g. at night. However, students complain about spending too many hours in the hospital on non-instructive activities. This study was undertaken to investigate differences among rotations in time spent in hospital, in on-call hours, in self-study and in non-instructive activities and to investigate the relationship between time spent on the various activities and the overall effectiveness as perceived by students. A questionnaire was administered to students at the end of various clinical rotations. Rotations differ considerably in time spent in hospital, on call (i.e. beyond usual working hours), on self-study and on non-instructive activities. In some rotations students report spending on average 18-20% of their time in the hospital on non-instructive activities. Furthermore, the numbers of hours spent in hospital do not correlate with the overall effectiveness as perceived by students, unless the numbers of hours spent in non-instructive activities are taken into account. The effectiveness of a rotation does not automatically improve if students spend more hours in hospital. The number of hours spent on non-instructive activities should be reduced in some rotations and should be kept as low as possible. Further research is needed to find out which activities are perceived as non-instructive.
临床教育期间的一些轮转实习具有每周在医院花费大量时间的特点，因为学生要参与医院的值班制度，即在正常工作时间之外值班，比如在夜间。然而，学生们抱怨在医院花费过多时间从事无意义的活动。本研究旨在调查不同轮转实习在医院停留时间、值班时长、自学时间以及无意义活动时间方面的差异，并探究在各项活动上所花费的时间与学生所感知的整体成效之间的关系。在不同临床轮转实习结束时，向学生发放了问卷。不同轮转实习在医院停留时间、值班（即超出正常工作时间）、自学以及无意义活动时间方面存在显著差异。在某些轮转实习中，学生报告称平均有18% - 20%的医院时间花费在无意义活动上。此外，在医院花费的时长与学生所感知的整体成效并无关联，除非将无意义活动所花费的时长考虑在内。如果学生在医院花费更多时间，轮转实习的成效并不会自动提高。在某些轮转实习中，应减少无意义活动所花费的时间，并尽可能使其保持在较低水平。需要进一步研究以找出哪些活动被视为无意义。
