McGrath Deirdre, Crowley Louise, Rao Sanath, Toomey Margaret, Hannigan Ailish, Murphy Lisa, Dunne Colum P
Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity {4i}, University of Limerick, Limerick, Ireland.
BMC Med Educ. 2015 Feb 19;15:21. doi: 10.1186/s12909-015-0301-x.
Existing literature is mixed as to whether self-directed learning (SDL) delivers improvements in knowledge, skills or attitudes of medical students compared with traditional learning methods. This study aimed to determine whether there is an association between engagement in SDL and student performance in clinical examinations, the factors that influence student engagement with SDL in clinical skills, and student perceptions of SDL.
A retrospective analysis of electronic records of student bookings of SDL sessions from 2008 to 2010 was performed for students in the pre-clinical years of an Irish Graduate Entry Medical programme to assess their level of engagement with SDL. The extent to which this engagement influenced their performance in subsequent summative examinations was evaluated. A cross-sectional survey of students across the four years of the programme was also conducted to determine student perceptions of SDL and the factors that affect engagement.
The level of engagement with SDL decreased over time from 95% of first years in 2008 to 49% of first years in 2010. There was no significant difference between the median exam performance for any clinical skills tested by level of engagement (none, one or more sessions) except for basic life support in first year (p =0.024). The main reason for engaging with SDL was to practice a clinical skill prior to assessment and the majority of respondents agreed that SDL sessions had improved their performance of the specific clinical skills being practised.
Students viewed SDL as an opportunity to practise skills prior to assessment but there were no significant differences in subsequent summative assessment by the level of engagement for most clinical skills.
与传统学习方法相比，自主学习（SDL）是否能提高医学生的知识、技能或态度，现有文献的观点不一。本研究旨在确定自主学习的参与度与学生临床考试成绩之间是否存在关联，影响学生在临床技能方面参与自主学习的因素，以及学生对自主学习的看法。
对爱尔兰医学研究生入学项目临床前几年学生2008年至2010年自主学习课程预约的电子记录进行回顾性分析，以评估他们自主学习的参与程度。评估这种参与程度对他们随后的总结性考试成绩的影响程度。还对该项目四年制的学生进行了横断面调查，以确定学生对自主学习的看法以及影响参与度的因素。
自主学习的参与程度随时间下降，从2008年一年级学生的95%降至2010年一年级学生的49%。除了一年级的基本生命支持技能外，按参与程度（无、参加一次或多次课程）划分，任何临床技能测试的考试成绩中位数之间没有显著差异（p = 0.024）。参与自主学习的主要原因是在评估前练习临床技能，大多数受访者认为自主学习课程提高了他们所练习的特定临床技能的表现。
学生将自主学习视为评估前练习技能的机会，但对于大多数临床技能，随后的总结性评估在参与程度上没有显著差异。
