Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, 3311-1 Shimotsuke-city Tochigi, 329-0498 Japan.
BMC Med Educ. 2011 May 11;11:19. doi: 10.1186/1472-6920-11-19.
Community-based education has been introduced in many medical schools around the globe, but evaluation of instructional quality has remained a critical issue. Community-based education is an approach that aims to prepare students for future professional work at the community level. Instructional quality should be measured based on a program's outcomes. However, the association between learning activities and students' attitudes is unknown. The purpose of this study was to clarify what learning activities affect students' attitudes toward community health care.
From 2003 to 2009, self-administered pre- and post-questionnaire surveys were given to 693 fifth-year medical students taking a 2-week clinical clerkship. Main items measured were student attitudes, which were: "I think practicing community health care is worthwhile" ("worthwhile") and "I am confident about practicing community health care" ("confidence") using a visual analogue scale (0-100). Other items were gender, training setting, and learning activities. We analyzed the difference in attitudes before and after the clerkships by paired t test and the factors associated with a positive change in attitude by logistic regression analysis.
Six hundred forty-five students (93.1%), 494 (76.6%) male and 151(23.4%) female, completed the pre- and post-questionnaires. The VAS scores of the students' attitudes for "worthwhile" and "confidence" after the clerkship were 80.2 ± 17.4 and 57.3 ± 20.1, respectively. Both of the scores increased after the clerkship. Using multivariate logistic regression analysis, "health education" was associated with a positive change for both attitudes of "worthwhile" (adjusted RR: 1.71, 95% CI: 1.10-2.66) and "confidence" (1.56, 1.08-2.25).
Community-based education motivates students to practice community health care. In addition, their motivation is increased by the health education activity. Participating in this activity probably produces a positive effect and improves the instructional quality of the program based on its outcomes.
社区教育已在全球许多医学院校中引入，但教学质量的评估仍然是一个关键问题。社区教育是一种旨在使学生为在社区层面开展未来的专业工作做好准备的方法。教学质量应该根据课程的成果来衡量。然而，学习活动与学生态度之间的联系尚不清楚。本研究的目的是阐明哪些学习活动会影响学生对社区卫生保健的态度。
从 2003 年到 2009 年，对 693 名参加为期两周临床实习的五年级医学生进行了自我管理的预-后问卷调查。主要测量的项目是学生的态度，分别为：“我认为从事社区卫生保健工作是值得的”（“值得”）和“我对从事社区卫生保健工作有信心”（“信心”），使用视觉模拟量表（0-100）。其他项目包括性别、培训环境和学习活动。我们通过配对 t 检验分析实习前后态度的差异，并通过逻辑回归分析确定与态度积极变化相关的因素。
645 名学生（93.1%）完成了预-后问卷，其中 494 名（76.6%）为男性，151 名（23.4%）为女性。实习后，学生对“值得”和“信心”的 VAS 评分分别为 80.2 ± 17.4 和 57.3 ± 20.1。这两个分数在实习后都有所提高。使用多元逻辑回归分析，“健康教育”与“值得”（调整后的 RR：1.71，95%CI：1.10-2.66）和“信心”（1.56，1.08-2.25）态度的积极变化均相关。
社区教育激励学生从事社区卫生保健工作。此外，健康教育活动增加了他们的积极性。参与这项活动可能会产生积极的影响，并根据课程成果提高课程的教学质量。
