Center for Research and Innovation in Medical Education, University of Groningen, and University Medical Center Groningen, The Netherlands.
Med Educ. 2009 Jul;43(7):674-9. doi: 10.1111/j.1365-2923.2009.03393.x.
Students' perceptions of their learning environment are of great importance to their learning process. In this study we assessed the time allocated by students to clerkship activities and the relationship between students' allocations of time and their perceptions of the quality of their clinical learning environment.
Participants were 133 undergraduate students from eight hospitals taking part in four clerkship rotations. All students recorded the time they spent on eight clerkship activities over 2 weeks and completed the Postgraduate Hospital Educational Environment Measure (PHEEM). Partial correlation analyses were undertaken to examine the relationship between the amount of time students spent on each activity and their PHEEM scores.
Students spent nearly 8 hours a day on clerkship activities. Most time was spent on observing doctors (40%), followed by participating in consultations without direct supervision (12%). The time students spent on observing doctors (r = 0.206, P < 0.05) and in consultations without direct supervision (r = 0.211, P < 0.05) was significantly related to the students' PHEEM scores. There was a significant relationship at the P < 0.10 level between the time spent on directly supervised activities and students' PHEEM scores (r = 0.165, P < 0.10).
The results suggest that the time spent on activities involving direct patient contact is positively related to students' perceptions of the quality of their learning environment. None of the activities were significantly negatively related to the students' perceptions of their clinical learning environment. Future research should examine the optimal time allocations required to enhance the perceived quality of the clinical learning environment.
学生对学习环境的感知对于他们的学习过程至关重要。在这项研究中，我们评估了学生在实习活动上所分配的时间以及学生的时间分配与他们对临床学习环境质量的感知之间的关系。
参与者是来自八所医院的 133 名本科生，他们参加了四个实习轮转。所有学生在两周内记录了他们在八项实习活动上花费的时间，并完成了研究生医院教育环境量表（PHEEM）。进行偏相关分析以检查学生在每项活动上花费的时间与他们的 PHEEM 分数之间的关系。
学生每天在实习活动上花费近 8 个小时。大部分时间用于观察医生（40%），其次是在没有直接监督的情况下参与咨询（12%）。学生观察医生的时间（r = 0.206，P < 0.05）和在没有直接监督的情况下进行咨询的时间（r = 0.211，P < 0.05）与学生的 PHEEM 分数显著相关。直接监督活动的时间与学生的 PHEEM 分数之间存在显著的相关关系（r = 0.165，P < 0.10）。
结果表明，与直接接触患者的活动相关的时间投入与学生对学习环境质量的感知呈正相关。没有任何活动与学生对临床学习环境的感知呈显著负相关。未来的研究应该检验需要多少时间投入来提高临床学习环境的感知质量。
