Morales-Gómez Antonio, Medina-Figueroa Alda María
División de Innovación Educativa, Coordinación de Educación en Salud, Instituto Mexicano del Seguro Social, Distrito Federal.
Rev Med Inst Mex Seguro Soc. 2007 Mar-Apr;45(2):123-31.
To ascertain the perception of third and fourth year medical students and interns (fifth year) about the educational environment during the clinical education phase and during the internship at Instituto Mexicano del Seguro Social (IMSS).
A questionnaire with 120 items was developed to evaluate whether IMSS educational environment encourages reflection and criticism among medical students and interns. The highest possible score of the questionnaire was 240 points. A t test was used to compare the score of the students who were classified according to the term in which they were enrolled. 1997 medical students and 1075 interns from 46 IMSS clinical settings answered the previously validated questionnaire.
Seventy percent of the students considered that the educational environment was not very favorable for reflection and criticism; 19% perceived it as favorable and 11% as unfavorable. The median score of third and fourth year medical students, was 134.9 (range 80-193; p = 0.27), interns' score was 130.4 (range 80-208; p = 0.001). The perception of the medical students in clinical settings other than Mexico City was less unfavourable (median 132.8; range 63.5-208); p = 0.003).
apparently, the occupational environment influences the educational environments where the courses take place. As long as the students advance in their courses and get involved in clinical practice, their perception of the educational environment becomes unfavorable.
确定墨西哥社会保障局（IMSS）临床教育阶段及实习期间三年级和四年级医学生以及实习生（五年级）对教育环境的看法。
编制了一份包含120个条目的问卷，以评估IMSS的教育环境是否鼓励医学生和实习生进行反思和批评。问卷的最高可能分数为240分。采用t检验比较按入学学期分类的学生的分数。来自IMSS 46个临床机构的1997名医学生和1075名实习生回答了先前经过验证的问卷。
70%的学生认为教育环境不太有利于反思和批评；19%的学生认为环境有利，11%的学生认为不利。三年级和四年级医学生的中位数分数为134.9（范围80 - 193；p = 0.27），实习生的分数为130.4（范围80 - 208；p = 0.001）。在墨西哥城以外临床机构的医学生的看法不太负面（中位数132.8；范围63.5 - 208）；p = 0.003）。
显然，职业环境会影响课程开展的教育环境。随着学生课程的推进并参与临床实践，他们对教育环境的看法变得不利。
