van Diest R, van Dalen J, Bak M, Schruers K, van der Vleuten C, Muijtjens A, Scherpbier A
Department of Psychiatry and Neuropsychology, Faculty of Medicine, Maastricht University, Maastricht, The Netherlands.
Med Educ. 2004 Dec;38(12):1295-301. doi: 10.1111/j.1365-2929.2004.02022.x.
To evaluate the effectiveness of undergraduate medical education in the domains of psychiatry and behavioural sciences, we examined the growth of knowledge in those disciplines in a 6-year, problem-based learning (PBL) curriculum. Psychiatry and behavioural sciences are taught in the 4 preclinical years and in the psychiatric clerkship. The integrative nature of this PBL curriculum led us to hypothesise that the knowledge growth curves for these disciplines are similar and show a steady upward trend throughout the curriculum.
All items pertaining to psychiatry and behavioural sciences in the progress tests administered in the period from September 1993 through May 2001 were identified. For those items, the percentage of correct scores in the 6 year groups were considered a multivariate observation reflecting knowledge growth across the 6-year programme.
Knowledge growth for psychiatry and behavioural sciences increased significantly, from 12% to 59% and from 28% to 60%, respectively, between Year 1 and the end of Year 6. Apparently, students know more about behavioural sciences than about psychiatry when they enter medical school, but this difference vanishes in the last 2 years of training. Moreover, the growth curves for psychiatry and behavioural sciences started to level off after Years 3 and 4, respectively, with no additional significant growth in any of the later years.
Psychiatry and behavioural sciences showed different patterns of knowledge growth and the 2 growth curves levelled off in Years 5 through 6. Because a student-centred, horizontally and vertically integrated PBL curriculum is aimed at effecting steady growth in knowledge in all disciplines, the slowdown in growth in the later years was among the reasons for initiating a major curricular innovation in 2001.
为评估本科医学教育在精神病学和行为科学领域的成效，我们考察了在一个为期6年的基于问题的学习（PBL）课程中这些学科知识的增长情况。精神病学和行为科学在临床前4年以及精神科实习阶段进行教学。这种PBL课程的综合性使我们推测，这些学科的知识增长曲线相似，且在整个课程中呈稳定上升趋势。
确定了1993年9月至2001年5月期间进行的进展测试中所有与精神病学和行为科学相关的项目。对于这些项目，6个年级组的正确得分百分比被视为反映6年课程知识增长的多变量观察值。
在第1年到第6年末，精神病学和行为科学的知识增长显著，分别从12%增至59%和从28%增至60%。显然，学生进入医学院时对行为科学的了解多于精神病学，但这种差异在培训的最后两年消失。此外，精神病学和行为科学的增长曲线分别在第3年和第4年后开始趋于平稳，在随后的年份中均未再有显著增长。
精神病学和行为科学呈现出不同的知识增长模式，两条增长曲线在第5年至第6年趋于平稳。由于以学生为中心、横向和纵向整合的PBL课程旨在使所有学科的知识实现稳定增长，后期增长放缓是2001年启动重大课程改革的原因之一。
