McManus I C, Livingston G, Katona Cornelius
Department of Psychology, University College London, London WC1E 6BT, UK.
BMC Med Educ. 2006 Feb 21;6:11. doi: 10.1186/1472-6920-6-11.
The motivational and other factors used by medical students in making their career choices for specific medical specialities have been looked at in a number of studies in the literature. There are however few studies that assess the generic factors which make medicine itself of interest to medical students and to potential medical students. This study describes a novel questionnaire that assesses the interests and attractions of different aspects of medical practice in a varied range of medical scenarios, and relates them to demographic, academic, personality and learning style measures in a large group of individuals considering applying to medical school.
A questionnaire study was conducted among those attending Medlink, a two-day conference for individuals considering applying to medical school for a career in medicine. The main outcome measure was the Medical Situations Questionnaire, in which individuals ranked the attraction of three different aspects of medical practise in each of nine detailed, realistic medical scenarios in a wide range of medical specialities. As well as requiring clear choices, the questionnaire was also designed so that all of the possible answers were attractive and positive, thereby helping to eliminate social demand characteristics. Factor analysis of the responses found four generic motivational dimensions, which we labelled Indispensability, Helping People, Respect and Science. Background factors assessed included sex, ethnicity, class, medical parents, GCSE academic achievement, the 'Big Five' personality factors, empathy, learning styles, and a social desirability scale.
2867 individuals, broadly representative of applicants to medical schools, completed the questionnaire. The four generic motivational factors correlated with a range of background factors. These correlations were explored by multiple regression, and by path analysis, using LISREL to assess direct and indirect effects upon the factors. Helping People was particularly related to agreeableness; Indispensability to a strategic approach to learning; Respect to a surface approach to learning; and Science to openness to experience. Sex had many indirect influences upon generic motivations. Ethnic origin also had indirect influences via neuroticism and surface learning, and social class only had indirect influences via lower academic achievement. Coming from a medical family had no influence upon generic motivations.
Generic motivations for medicine as a career can be assessed using the Medical Situations Questionnaire, without undue response bias due to demand characteristics. The validity of the motivational factors is suggested by the meaningful and interpretable correlations with background factors such as demographics, personality, and learning styles. Further development of the questionnaire is needed if it is to be used at an individual level, either for counselling or for student selection.
医学文献中的多项研究探讨了医学生在选择特定医学专业时的动机及其他因素。然而，很少有研究评估使医学本身吸引医学生及潜在医学生的一般因素。本研究描述了一种新颖的问卷，该问卷评估了在各种医学场景中医疗实践不同方面的兴趣和吸引力，并将其与一大群考虑申请医学院的个体的人口统计学、学术、个性和学习风格指标相关联。
对参加Medlink的人员进行了问卷调查，Medlink是一个为期两天的会议，参会人员为考虑申请医学院从事医学职业的个体。主要的结果测量指标是《医疗情境问卷》，在该问卷中，个体对广泛医学专业的九个详细、现实的医疗场景中每个场景里医疗实践的三个不同方面的吸引力进行排序。除了要求做出明确选择外，问卷的设计还使得所有可能的答案都具有吸引力且积极，从而有助于消除社会期望特征。对回答进行因素分析发现了四个一般动机维度，我们将其标记为不可或缺性、帮助他人、尊重和科学。评估的背景因素包括性别、种族、阶层、父母是医生、普通中等教育证书考试的学术成绩、“大五”人格因素、同理心、学习风格以及社会期望量表。
2867名个体完成了问卷，这些个体大致代表了医学院的申请者。这四个一般动机因素与一系列背景因素相关。通过多元回归和路径分析探讨了这些相关性，使用LISREL评估对这些因素的直接和间接影响。帮助他人尤其与宜人性相关；不可或缺性与学习的策略性方法相关；尊重与表面学习方法相关；科学与对新体验的开放性相关。性别对一般动机有许多间接影响。种族起源也通过神经质和表面学习有间接影响，而社会阶层仅通过较低的学术成就有间接影响。来自医学世家对一般动机没有影响。
使用《医疗情境问卷》可以评估将医学作为职业的一般动机，且不会因需求特征产生过度的反应偏差。动机因素与人口统计学、个性和学习风格等背景因素之间有意义且可解释的相关性，这表明了这些动机因素的有效性。如果要在个体层面使用该问卷进行咨询或学生选拔，则需要对其进行进一步开发。
