Medical Education Unit, B94 Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
BMC Med Educ. 2013 Apr 2;13:48. doi: 10.1186/1472-6920-13-48.
Students who fail to thrive on the Nottingham undergraduate medical course frequently suffer from anxiety, depression or other mental health problems. These difficulties may be the cause, or the result of, academic struggling. Early detection of vulnerable students might direct pastoral care and remedial support to where it is needed. We investigated the use of the short-form General Health Questionnaire (GHQ-12) as a possible screening tool.
Two consecutive cohorts (2006 and 2007) were invited to complete the GHQ-12. The questionnaire was administered online, during the second semester (after semester 1 exams) for the 2006 cohort and during the first semester for the 2007 cohort. All data were held securely and confidentially. At the end of the course, GHQ scores were examined in relation to course progress.
251 students entered the course in 2006 and 254 in 2007; 164 (65%) and 160 (63%), respectively, completed the GHQ-12. In both cohorts, the study and non-study groups were very similar in terms of pre-admission socio-demographic characteristics and overall course marks. In the 2006 study group, the GHQ Likert score obtained part-way through the first year was negatively correlated with exam marks during Years 1 and 2, but the average exam mark in semester 1 was the sole independent predictor of marks in semester 2 and Year 2. No correlations were found for the 2007 study group but the GHQ score was a weak positive predictor of marks in semester 2, with semester 1 average exam mark again being the strongest predictor. A post-hoc moderated-mediation analysis suggested that significant negative associations of GHQ scores with semester 1 and 2 exams applied only to those who completed the GHQ after their semester 1 exams. Students who were identified as GHQ 'cases' in the 2006 group were statistically less likely to complete the course on time (OR=4.74, p 0.002). There was a non-significant trend in the same direction in the 2007 group.
Results from two cohorts provide insufficient evidence to recommend the routine use of the GHQ-12 as a screening tool. The timing of administration could have a critical influence on the results, and the theoretical and practical implications of this finding are discussed. Low marks in semester 1 examinations seem be the best single indicator of students at risk for subsequent poor performance.
在诺丁汉本科医学课程中表现不佳的学生经常患有焦虑、抑郁或其他心理健康问题。这些困难可能是学术挣扎的原因或结果。早期发现弱势学生可能会引导他们接受辅导和补救支持。我们研究了使用简短形式的一般健康问卷（GHQ-12）作为可能的筛查工具。
连续两个队列（2006 年和 2007 年）被邀请完成 GHQ-12。该问卷在线进行，对于 2006 年队列，在第一学期考试后第二学期进行，对于 2007 年队列，在第一学期进行。所有数据都安全保密。在课程结束时，根据课程进展情况检查 GHQ 分数。
2006 年有 251 名学生入学，2007 年有 254 名学生入学；分别有 164 名（65%）和 160 名（63%）完成了 GHQ-12。在两个队列中，研究组和非研究组在入学前的社会人口统计学特征和总体课程成绩方面非常相似。在 2006 年的研究组中，第一年中途获得的 GHQ 李克特分数与第 1 年和第 2 年的考试成绩呈负相关，但第 1 学期的平均考试成绩是第 2 学期和第 2 年成绩的唯一独立预测因素。对于 2007 年的研究组没有发现相关性，但 GHQ 分数是第 2 学期成绩的微弱正预测因素，而第 1 学期平均考试成绩再次是最强的预测因素。事后调节中介分析表明，GHQ 分数与第 1 学期和第 2 学期考试的显著负相关仅适用于那些在第 1 学期考试后完成 GHQ 的学生。在 2006 年组中被确定为 GHQ“病例”的学生按时完成课程的可能性明显较低（OR=4.74，p<0.002）。在 2007 年组中，也有一个呈非显著趋势。
两个队列的结果提供的证据不足以推荐常规使用 GHQ-12 作为筛查工具。管理的时间可能对结果产生关键影响，讨论了这一发现的理论和实践意义。第 1 学期考试成绩较低似乎是后续表现不佳风险学生的最佳单一指标。
