Smits P B A, Verbeek J H A M, Nauta M C E, Ten Cate Th J, Metz J C M, van Dijk F J H
Netherlands School of Occupational Health, Amsterdam, The Netherlands.
Med Educ. 2004 Jul;38(7):758-66. doi: 10.1111/j.1365-2929.2004.01846.x.
To establish which personal and contextual factors are predictive of successful outcomes in postgraduate medical education.
We performed a follow-up study of 118 doctors on a postgraduate occupational health training programme on the management of mental health problems. The following personal and contextual variables were measured as potential predictors of outcome: gender; age; years of experience as a doctor; university of graduation; learning style (Kolb); present employer (occupational health service), and educational format (problem-based or lecture-based). The main outcome measures were: scores on knowledge tests consisting of true/false and open answer questions, and performance in practice based on self-report and performance indicators. To determine the effect of potential predictive factors univariate analyses of variance and repeated measurement analysis of variance was applied.
The mean scores of knowledge (P < 0.001) and performance (P = 0.001) of the participants increased after the educational programme. After multivariate analysis female gender was positively related to accruements in both knowledge and performance (both P < 0.05), independently of the influence of other factors. Accommodator learning style showed a relation with knowledge increase (P = 0.05), but had no influence on performance (P = 0.79). The problem-based educational format yielded a better performance outcome (P = 0.05), but had no influence on knowledge tests (P = 0.31).
Gender and learning style were found to be related to an increase in knowledge. Gender was also found to be related to improvement in performance after a postgraduate medical education programme. We found no interactions with course design (i.e. problem-based or non problem-based learning formats), but further research could reveal other cues, suggesting practical consequences of student characteristics for course design in postgraduate training.
确定哪些个人因素和环境因素可预测研究生医学教育的成功结果。
我们对118名参加研究生职业健康心理健康问题管理培训项目的医生进行了一项随访研究。测量了以下个人和环境变量作为结果的潜在预测因素:性别;年龄;医生工作年限;毕业院校;学习风格(科尔布学习风格);当前雇主(职业健康服务机构)以及教育形式(基于问题或基于讲座)。主要结果指标为:由是非题和开放式问题组成的知识测试得分,以及基于自我报告和绩效指标的实践表现。为确定潜在预测因素的影响,应用了单因素方差分析和重复测量方差分析。
教育项目结束后,参与者的知识平均得分(P < 0.001)和表现平均得分(P = 0.001)有所提高。多因素分析后发现,女性性别与知识和表现的提升均呈正相关(均P < 0.05),不受其他因素影响。顺应型学习风格与知识增加有关(P = 0.05),但对表现无影响(P = 0.79)。基于问题的教育形式产生了更好的表现结果(P = 0.05),但对知识测试无影响(P = 0.31)。
发现性别和学习风格与知识增加有关。还发现性别与研究生医学教育项目后的表现改善有关。我们未发现与课程设计(即基于问题或非基于问题的学习形式)的相互作用,但进一步的研究可能会揭示其他线索,表明学生特征对研究生培训课程设计的实际影响。