Chang Judy C, Odrobina Michele R, McIntyre-Seltman Kathleen
J Grad Med Educ. 2010 Sep;2(3):341-5. doi: 10.4300/JGME-D-09-00070.1.
Medical students' choice of residency specialty is based in part on their clerkship experience. Postclerkship interest in a particular specialty is associated with the students' choice to pursue a career in that field. But, many medical students have a poor perception of their obstetrics and gynecology clerkships.
To determine whether fourth-year medical students' perceptions of teaching quality and quantity and amount of experiential learning during the obstetrics-gynecology clerkship helped determine their interest in obstetrics-gynecology as a career choice.
We distributed an anonymous, self-administered survey to all third-year medical students rotating through their required obstetrics and gynecology clerkship from November 2006 to May 2007. We performed bivariate analysis and used χ(2) analysis to explore factors associated with general interest in obstetrics and gynecology and interest in pursuing obstetrics and gynecology as a career.
Eighty-one students (N = 91, 89% response rate) participated. Postclerkship career interest in obstetrics and gynecology was associated with perceptions that the residents behaved professionally (P < .0001) and that the students were treated as part of a team (P = .008). Having clear expectations on labor and delivery procedures (P = .014) was associated with postclerkship career interest. Specific hands-on experiences were not statistically associated with postclerkship career interest. However, performing more speculum examinations in the operating room trended toward having some influence (P = .068). Although more women than men were interested in obstetrics and gynecology as a career both before (P = .027) and after (P = .014) the clerkship, men were more likely to increase their level of career interest during the clerkship (P = .024).
Clerkship factors associated with greater postclerkship interest include higher satisfaction with resident professional behavior and students' sense of inclusion in the clinical team. Obstetrics and gynecology programs need to emphasize to residents their role as educators and professional role models for medical students.
医学生对住院医师专业的选择部分基于他们的临床实习经历。临床实习后对某一特定专业的兴趣与学生选择在该领域从事职业有关。但是，许多医学生对他们的妇产科临床实习评价不高。
确定四年级医学生对妇产科临床实习期间教学质量和数量以及实践学习量的看法是否有助于确定他们对妇产科作为职业选择的兴趣。
我们向2006年11月至2007年5月参加必修妇产科临床实习轮转的所有三年级医学生发放了一份匿名的自我管理调查问卷。我们进行了双变量分析，并使用χ²分析来探索与对妇产科的总体兴趣以及将妇产科作为职业追求的兴趣相关的因素。
81名学生（N = 91，应答率89%）参与了调查。临床实习后对妇产科的职业兴趣与对住院医师专业行为的看法（P <.0001）以及学生被视为团队一员的看法（P =.008）有关。对分娩程序有明确期望（P =.014）与临床实习后的职业兴趣有关。具体的实践经验与临床实习后的职业兴趣在统计学上没有关联。然而，在手术室进行更多的阴道窥器检查有产生一定影响的趋势（P =.068）。尽管在临床实习前（P =.027）和实习后（P =.014）对妇产科作为职业感兴趣的女性都多于男性，但男性在临床实习期间更有可能提高他们的职业兴趣水平（P =.024）。
与临床实习后更高兴趣相关的因素包括对住院医师专业行为的更高满意度以及学生在临床团队中的融入感。妇产科项目需要向住院医师强调他们作为医学生教育者和职业榜样的角色。
