医学培训促进还是阻碍自我导向学习？一项纵向混合方法研究。

Does medical training promote or deter self-directed learning? A longitudinal mixed-methods study.

机构信息

Dr. Premkumar is curriculum consultant and faculty development specialist, and associate professor, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Dr. Pahwa is professor, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Ms. Banerjee was a third-year master's student, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, at the time this article was written. Dr. Baptiste was a fourth-year medical student, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, at the time this article was written. Mr. Bhatt is biostatistician, University of Alberta, Edmonton, Alberta, Canada. When this article was written, he was biostatistician, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Dr. Lim is professor, Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

出版信息

Acad Med. 2013 Nov;88(11):1754-64. doi: 10.1097/ACM.0b013e3182a9262d.

DOI:10.1097/ACM.0b013e3182a9262d

PMID:24072133

Abstract

PURPOSE

The School of Medicine, University of Saskatchewan curriculum promotes self-direction as one of its learning philosophies. The authors sought to identify changes in self-directed learning (SDL) readiness during training.

METHOD

Guglielmino's SDL Readiness Scale (SDLRS) was administered to five student cohorts (N = 375) at admission and the end of every year of training, 2006 to 2010. Scores were analyzed using repeated-measurement analysis. A focus group and interviews captured students' and instructors' perceptions of self-direction.

RESULTS

Overall, the mean SDLRS score was 230.6; men (n = 168) 229.5; women (n = 197) 232.3, higher than in the average adult population. However, the authors were able to follow only 275 students through later years of medical education. There were no significant effects of gender, years of premedical training, and Medical College Admission Test scores on SDLRS scores. Older students were more self-directed. There was a significant drop in scores at the end of year one for each of the cohorts (P < .001), and no significant change to these SDLRS scores as students progressed through medical school. Students and faculty defined SDL narrowly and had similar perceptions of curricular factors affecting SDL.

CONCLUSIONS

The initial scores indicate high self-direction. The drop in scores one year after admission, and the lack of change with increased training, show that the current educational interventions may require reexamination and alteration to ones that promote SDL. Comparison with schools using a different curricular approach may bring to light the impact of curriculum on SDL.

摘要

目的

萨斯喀彻温省大学医学院的课程将自我指导作为其学习理念之一。作者试图确定培训过程中自我指导学习（SDL）准备情况的变化。

方法

2006 年至 2010 年，Guglielmino 的 SDL 准备量表（SDLRS）在入学时和培训的每一年结束时对五名学生（N=375）进行了评估。使用重复测量分析对分数进行了分析。焦点小组和访谈记录了学生和教师对自我指导的看法。

结果

总体而言，SDLRS 的平均得分为 230.6；男性（n=168）229.5；女性（n=197）232.3，高于普通成年人的平均水平。然而，作者只能在后续几年的医学教育中跟踪 275 名学生。性别、医学院入学考试成绩和预科培训年限对 SDLRS 评分没有显著影响。年龄较大的学生更具自我导向性。每个队列在第一年结束时的得分都有显著下降（P<.001），而随着学生进入医学院，这些 SDLRS 得分没有显著变化。学生和教师对 SDL 的定义狭窄，对影响 SDL 的课程因素的看法相似。