Bloomfield Leah, Harris Peter, Hughes Chris
School of Public Health and Community Medicine, Faculty of Medicine, Curriculum Unit, University of New South Wales, Sydney, Australia.
Med Educ. 2003 Feb;37(2):110-8. doi: 10.1046/j.1365-2923.2003.01430.x.
A well-aligned curriculum has consistent focus on curricular goals, teaching/learning activities and assessment. Poor alignment affects the way students budget learning time and may interfere with achievement of curricular goals. We noticed students' poor attendance in clinical clerkships prior to final examinations and hypothesised that they were responding to curricular misalignment.
To quantify the extent to which students and tutors perceived a mismatch between activities pertaining to their current clerkship and those they thought necessary to prepare for final examinations and internship.
Medical students in final (sixth) year clerkships in medicine, surgery and critical care and clinical tutors.
A self-report questionnaire on time spent in clerkship activities was administered 3 months before the final examinations.
The amounts of time spent on current activities were fairly evenly spread over teaching, study and self-directed patient contacts, and observing patient care (ward rounds, operating theatre, accident and emergency, outpatient department and clinical meetings). Less time was available for recreation. Students and tutors concurred, independently, that good examination and internship preparation required a shifting of the balance. Examination preparation redistributed time from observing patient care and recreation to study and self-directed patient contacts. Internship preparation redistributed time from teaching and recreation to observing patient care.
Students and tutors perceived that current activities were not well aligned with assessment requirements but were better aligned with the requirements of internship. If we want students to direct their attention towards curricular goals, we need to bring goals, teaching/learning activities and assessment into alignment.
一门编排合理的课程会始终聚焦课程目标、教学/学习活动及评估。编排不当会影响学生安排学习时间的方式,可能会妨碍课程目标的实现。我们注意到学生在期末考试前临床实习时出勤率较低,于是推测他们是对课程编排不当做出的反应。
量化学生和导师认为其当前实习活动与他们认为为期末考试和实习做准备所需的活动之间不匹配的程度。
医学、外科和重症监护专业最后(第六)年实习的医学生以及临床导师。
在期末考试前3个月发放一份关于在实习活动中所花时间的自填式问卷。
花在当前活动上的时间在教学、学习、自主与患者接触以及观察患者护理(查房、手术室、急诊、门诊部和临床会议)之间分布较为均匀。用于娱乐的时间较少。学生和导师各自都认为,要想为考试和实习做好充分准备,需要改变时间分配的平衡。备考会将时间从观察患者护理和娱乐重新分配到学习和自主与患者接触上。为实习做准备则会将时间从教学和娱乐重新分配到观察患者护理上。
学生和导师认为当前活动与评估要求编排不佳,但与实习要求的编排较好。如果我们希望学生将注意力导向课程目标,就需要使目标、教学/学习活动及评估保持一致。