Department of Family Medicine, Oregon Health and Science University, Portland, Oregon 97239, USA.
Acad Med. 2010 Jan;85(1):169-76. doi: 10.1097/ACM.0b013e3181c464c0.
The Institute of Medicine (IOM) report on social and behavioral sciences (SBS) indicated that 50% of morbidity and mortality in the United States is associated with SBS factors, which the report also found were inadequately taught in medical school. A multischool collaborative explored whether the Association of American Medical Colleges Graduation Questionnaire (GQ) could be used to study changes in the six SBS domains identified in the IOM report.
A content analysis conducted with the GQ identified 30 SBS variables, which were narrowed to 24 using a modified Delphi approach. Summary data were pooled from nine medical schools for 2006 and 2007, representing 1,126 students. Data were generated on students' perceptions of curricular experiences, attitudes related to SBS curricula, and confidence with relevant clinical knowledge and skills. The authors determined the sample sizes required for various effect sizes to assess the utility of the GQ.
The 24 variables were classified into five of six IOM domains representing a total of nine analytic categories with cumulative scale means ranging from 60.8 to 93.4. Taking into account the correlations among measures over time, and assuming a two-sided test, 80% power, alpha at .05, and standard deviation of 4.1, the authors found that 34 medical schools would be required for inclusion to attain an estimated effect size of 0.50 (50%). With a sample size of nine schools, the ability to detect changes would require a very high effect size of 107%.
Detecting SBS changes associated with curricular innovations would require a large collaborative of medical schools. Using a national measure (the GQ) to assess curricular innovations in most areas of SBS is possible if enough medical schools were involved in such an effort.
美国医学研究所（IOM）关于社会和行为科学（SBS）的报告指出，美国 50%的发病率和死亡率与 SBS 因素有关，该报告还发现这些因素在医学院中教授不足。一个多校合作项目探讨了美国医学院协会毕业问卷（GQ）是否可用于研究 IOM 报告中确定的六个 SBS 领域的变化。
对 GQ 进行的内容分析确定了 30 个 SBS 变量，通过改良德尔菲法将其缩小到 24 个。汇总了来自 9 所医学院 2006 年和 2007 年的数据，代表 1126 名学生。数据生成于学生对课程体验的看法、与 SBS 课程相关的态度，以及对相关临床知识和技能的信心。作者确定了评估 GQ 效用所需的各种效应大小的样本量。
这 24 个变量分为代表六个 IOM 领域的五个领域，共包含九个分析类别，累积量表均值从 60.8 到 93.4。考虑到随着时间的推移，测量值之间的相关性，并假设双侧检验、80%的功效、0.05 的α值和 4.1 的标准差，作者发现需要 34 所医学院才能达到估计的 0.50（50%）效应大小。在 9 所学校的样本量下，要检测到课程创新相关的变化，需要非常高的 107%效应大小。
要检测与课程创新相关的 SBS 变化，需要一个大型的医学学校合作项目。如果有足够多的医学院参与这项工作，使用全国性的测量工具（GQ）评估 SBS 大多数领域的课程创新是可能的。
