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安大略省医生学习方法的邮政调查:对继续医学教育的启示

Postal survey of approaches to learning among Ontario physicians: implications for continuing medical education.

作者信息

Delva M Dianne, Kirby John R, Knapper Christopher K, Birtwhistle R V

机构信息

Department of Family Medicine, Queen's University, Kingston, Ontario, Canada K7l 5E9.

出版信息

BMJ. 2002 Nov 23;325(7374):1218. doi: 10.1136/bmj.325.7374.1218.

Abstract

OBJECTIVES

To understand the approaches to learning of practising physicians in their workplace and to assess the relation of these approaches to their motivation for, preferred methods of, and perceived barriers to continuing medical education.

DESIGN

Postal survey of 800 Ontario physicians.

PARTICIPANTS

373 physicians who responded.

MAIN OUTCOME MEASURES

Correlations of approaches to learning and perceptions of workplace climate with methods, motives, and barriers to continuing medical education.

RESULTS

Perceived heavy workload was significantly associated with the surface disorganised (r=0.463, P<0.01) and surface rational approach (r=0.135, P<0.05) to learning. The deep approach to learning was significantly correlated with a perception of choice-independence and a supportive-receptive climate at work (r=0.341 and 0.237, P<0.01). Physicians who adopt a deep approach to learning seem to be internally motivated to learn, whereas external motivation is associated with surface approaches to learning. Heavy workload and a surface disorganised approach to learning were correlated with every listed barrier to continuing medical education. The deep approach to learning was associated with independent learning activities and no barriers.

CONCLUSIONS

Perception of the workplace climate affects physicians' approaches to learning at work and their motivation for and perceived barriers to continuing medical education. Younger, rural, family physicians may be most vulnerable to feeling overworked and adopting less effective approaches to learning. Further work is required to determine if changing the workplace environment will help physicians learn more effectively.

摘要

目的

了解在职医生在工作场所的学习方式,并评估这些方式与他们继续医学教育的动机、偏好方法及感知到的障碍之间的关系。

设计

对800名安大略省医生进行邮寄调查。

参与者

373名做出回应的医生。

主要观察指标

学习方式与工作场所氛围感知与继续医学教育的方法、动机和障碍之间的相关性。

结果

感知到的繁重工作量与表面无序的学习方式(r = 0.463,P < 0.01)和表面理性的学习方式(r = 0.135,P < 0.05)显著相关。深入的学习方式与工作中的选择独立性感知和支持性接受氛围显著相关(r = 0.341和0.237,P < 0.01)。采用深入学习方式的医生似乎有内在的学习动力,而外在动力与表面的学习方式相关。繁重的工作量和表面无序的学习方式与继续医学教育列出的每一项障碍都相关。深入的学习方式与自主学习活动相关且没有障碍。

结论

对工作场所氛围的感知会影响医生在工作中的学习方式以及他们继续医学教育的动机和感知到的障碍。年轻的、农村的家庭医生可能最容易感到工作过度,并采用效率较低的学习方式。需要进一步开展工作以确定改变工作场所环境是否有助于医生更有效地学习。

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