Diachun Laura L, Dumbrell Andrea C, Byrne Kerry, Esbaugh Jacquelin
Division of Geriatric Medicine, Department of Medicine, University of Western Ontario, London, Ontario, Canada.
J Am Geriatr Soc. 2006 Apr;54(4):696-701. doi: 10.1111/j.1532-5415.2006.00656.x.
Canada's aging population, fewer medical students training in geriatric medicine, and inadequate geriatric curricula require that medical schools immediately address how future physicians will be able to care for older people effectively. The medical literature suggests that experiential learning strategies improve undergraduate medical students' knowledge of and interest in less-popular subjects, but the durability of improvements resulting from these resource-intensive learning approaches remains unclear. In October 2001, a convenience sample of all University of Western Ontario medical students attending the geriatric component of their first year was randomized to attend one 3-hour didactic lecture or 3-hour experiential learning session. Approximately 1 year later, students completed a follow-up knowledge and attitudes survey that was matched to their first-year surveys using date-of-birth data. Of 100 completed follow-up surveys, 42 were used in formal analysis. Although initially the experiential group demonstrated a better knowledge score, at 1-year follow-up, there was no significant difference in knowledge, attitudes toward older people, or interest in geriatric medicine between the didactic (n=17) and experiential (n=25) groups. Nevertheless, these students (n=42) demonstrated better attitude scores than those (n=22) who had not attended either educational intervention. This study challenges the belief that an experiential approach is a superior training method to a didactic approach. One year after an educational intervention, there was no difference in geriatric knowledge, attitude scores, or interest in geriatric medicine between students who underwent a didactic lecture or a participatory, experiential learning session.
加拿大人口老龄化、老年医学专业培训的医学生数量减少以及老年医学课程设置不足,这就要求医学院校立即着手解决未来医生如何能够有效地照顾老年人的问题。医学文献表明,体验式学习策略能提高本科医学生对冷门学科的知识水平和兴趣,但这些资源密集型学习方法所带来的提高效果的持续性仍不明确。2001年10月,对西安大略大学所有参加第一年老年医学课程的医学生进行便利抽样,随机分为参加一场3小时的理论讲座或3小时的体验式学习课程。大约1年后,学生们完成了一项后续知识和态度调查,该调查利用出生日期数据与他们第一年的调查进行匹配。在100份完成的后续调查中,42份用于正式分析。虽然最初体验式学习组的知识得分更高,但在1年的随访中,理论授课组(n = 17)和体验式学习组(n = 25)在知识、对老年人的态度或对老年医学的兴趣方面没有显著差异。然而,这些学生(n = 42)的态度得分比那些未参加任何一种教育干预的学生(n = 22)更高。本研究对体验式方法是比理论授课方法更优越的培训方法这一观点提出了挑战。在教育干预1年后,参加理论讲座或参与式体验式学习课程的学生在老年医学知识、态度得分或对老年医学的兴趣方面没有差异。