Robinson Geoffrey
Lake Road Research and Development Practice, Portsmouth, UK.
Med Teach. 2002 Jan;24(1):71-8. doi: 10.1080/01421590120091078.
US studies have shown that a clinician's risk-taking propensity significantly predicts clinical behaviour. Other US studies examining relationships between family practice doctors' preferences for CME and their Kolb learning style have described conflicting findings. The aim of the present study was to investigate GPs' learning styles, risk-taking propensities and CME preferences, and to explore links between them. A descriptive confidential cross-sectional postal questionnaire survey of the 304 general practitioner principals within Portsmouth and South East Hampshire Health Authority was conducted. Two hundred and seventy-four GPs returned questionnaires, a response rate of 90.1%. The Kolb learning style types were assimilators 43.8% (predominant learning abilities watching and thinking), divergers 21.1% (feeling and watching), convergers 18.3% (doing and thinking), and accommodators 16.8% (doing and feeling). The Pearson risk-taking propensities were 65.8% risk neutral, 19.4% risk seeking and 14.8% risk averse. Risk-seeking GPs were significantly more likely to be accommodators or convergers than divergers or assimilators (p = 0.006). Majorities of 54.9% stated that the present PGEA system works well, 85% welcomed feedback from their peers, and 76.8% stated that learning should be an activity for all the practice team. Further majorities would welcome help to decide their learning needs (63.8%) and are looking to judge CME effectiveness by changes in GP performance or patient care (54.8%). Further significant correlations and cross-tabulations were found between learning style and risk-taking and CME attitudes, experiences and preferences. It is concluded that risk seekers and accommodators (doing and feeling) prefer feedback, interaction and practical hands-on learning, and assimilators (watching and thinking) and the risk averse tend towards lectures, theoretical learning formats and less interactive activities. Sharing feelings in groups may be difficult for the risk averse and assimilators. The success of a combined educational strategy will depend on an inclusive philosophy, both recognizing and engaging the wide range of differences in learning style and risk taking for all the individuals who make up learning teams.
美国的研究表明,临床医生的冒险倾向能显著预测其临床行为。美国其他一些研究探讨了家庭医生对继续医学教育(CME)的偏好与其科尔布学习风格之间的关系,结果却相互矛盾。本研究的目的是调查全科医生的学习风格、冒险倾向和对继续医学教育的偏好,并探索它们之间的联系。对朴茨茅斯和汉普郡东南部卫生局的304名全科医生负责人进行了一项描述性的保密横断面邮政问卷调查。274名全科医生返回了问卷,回复率为90.1%。科尔布学习风格类型中,同化者占43.8%(主要学习能力为观察和思考),发散者占21.1%(感受和观察),聚合者占18.3%(行动和思考),适应者占16.8%(行动和感受)。皮尔逊冒险倾向中,65.8%为风险中性,19.4%为风险寻求型,14.8%为风险厌恶型。与发散者或同化者相比,风险寻求型全科医生更有可能是适应者或聚合者(p = 0.006)。54.9%的多数人表示目前的继续医学教育认证系统运作良好,85%的人欢迎同行的反馈,76.8%的人表示学习应该是整个医疗团队的活动。更多数人欢迎在确定学习需求方面得到帮助(63.8%),并希望通过全科医生表现或患者护理的变化来评判继续医学教育的效果(54.8%)。在学习风格、冒险倾向与继续医学教育态度、经历和偏好之间还发现了进一步的显著相关性和交叉表。研究得出结论,风险寻求者和适应者(行动和感受)更喜欢反馈、互动和实践动手学习,同化者(观察和思考)和风险厌恶者倾向于讲座、理论学习形式和互动性较低的活动。对于风险厌恶者和同化者来说,在小组中分享感受可能会很困难。综合教育策略的成功将取决于一种包容的理念,既要认识到构成学习团队的所有个体在学习风格和冒险方面存在的广泛差异,又要让他们参与进来。