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[向临床培训的过渡会改变学生对职业选择、医生角色和临床前学习的认知吗?]

[Does the transition to clinical training change students' perception of career choice, physician's character and preclinical studies?].

作者信息

Lotan Eyal, Kimhi Oded, Lishner Michael, Notzer Netta

机构信息

Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.

出版信息

Harefuah. 2010 Apr;149(4):222-6, 263.

Abstract

BACKGROUND

In Israel, the transition to clinical training in hospitals is the first direct encounter of the medical student with the reality of the profession. This is a significant socialization step for his upcoming professional decisions.

AIMS

This study aimed to identify how this encounter influences students' perceptions of career choice, physician's character and preclinical studies.

METHODS

Fourth year Israeli medical students at the Tel Aviv University voluntarily completed a questionnaire before and after their first clinical clerkship. The questionnaire was comprised of 30 5-point Likert scale statements and 3 multiple choice questions with the possibility to add remarks.

RESULTS

The random response rate was 90% (81/90) before the clerkship and 82% (90/110) at its end. Results indicate that the students are satisfied with their medical studies at both junctures. However, after the clerkship, 23% of the students consider alternatives to clinical medicine compared with only 6% before, and 16% would rethink studying medicine. Physicians are perceived as professional, compassionate, respectful to colleagues and actively participating in students' education. Physicians' levels of workload and bitterness are evaluated as high and moderate, respectively, while their levels of reward and satisfaction with medicine are evaluated as low and moderate, respectively. Their evaluation of the contribution of preclinical studies as preparation for clinical studies had not changed after the clerkship and was moderate, and earlier exposure to patients and clinical relevancy of the learned subjects were preferred.

SUMMARY AND DISCUSSION

The students enter the medical world highly satisfied, and this feeling shall be maintained until the stage of being independent physicians and choosing their specialties. The picture that evolved, in which a high proportion of the students consider alternatives to clinical medicine, is disappointing. Educators should be aware of their role model function not only in knowledge and skills, but also in behavior and communication with patients. The students pointed to necessary changes in the medical curriculum to make basic sciences more relevant to clinical medicine. A broader study at different stages of studies in the rest of the medical faculties in Israel may be needed.

摘要

背景

在以色列,向医院临床培训的过渡是医学生首次直接接触职业现实。这是他未来职业决策的一个重要社会化步骤。

目的

本研究旨在确定这种接触如何影响学生对职业选择、医生性格和临床前学习的看法。

方法

特拉维夫大学的四年级以色列医学生在首次临床实习前后自愿完成一份问卷。问卷由30条5级李克特量表陈述和3道多项选择题组成,并可添加备注。

结果

实习前随机回复率为90%(81/90),实习结束时为82%(90/110)。结果表明,学生在两个阶段都对医学学习感到满意。然而,实习后,23%的学生考虑选择临床医学以外的职业,而实习前只有6%的学生这样考虑,16%的学生会重新考虑学医。学生认为医生专业、有同情心、尊重同事并积极参与学生教育。医生的工作量和痛苦程度分别被评为高和中等,而他们的回报和对医学的满意度分别被评为低和中等。他们对临床前学习对临床学习准备的贡献的评价在实习后没有改变,为中等,并且他们更倾向于更早接触患者以及所学课程与临床的相关性。

总结与讨论

学生进入医学领域时非常满意,这种感觉应一直保持到成为独立医生并选择专业阶段。出现的情况令人失望,即有很大比例的学生考虑选择临床医学以外的职业。教育工作者不仅应意识到自己在知识和技能方面的榜样作用,还应意识到在行为和与患者沟通方面的榜样作用。学生指出医学课程需要进行必要的改革,以使基础科学与临床医学更相关。可能需要在以色列其他医学院的不同学习阶段进行更广泛的研究。

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