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患者特征对医学实习生住院教育经历感知价值的影响。

The Influence of Patient Characteristics on the Perceived Value of Inpatient Educational Experiences by Medical Trainees.

作者信息

Farrell Renée, Mahant Sanjay, Wadhwa Anupma, Bismilla Zia, Zhao Xiu Yan, Martimianakis Tina, Cohen Eyal

机构信息

School of Medicine, Queen's University, Kingston, Ontario, Canada;

Department of Pediatrics, and Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; and.

出版信息

Hosp Pediatr. 2015 Aug;5(8):409-14. doi: 10.1542/hpeds.2014-0196.

Abstract

BACKGROUND AND OBJECTIVE

Medical education relies heavily on workplace learning where trainees are educated through their clinical experience. Few studies have explored trainees' perceptions of the educational value of these patient care experiences. The aim of this study was to identify pediatric patient characteristics that medical trainees perceive as educationally valuable.

METHODS

Over 2 months, trainees on pediatric inpatient wards ranked the perceived educational value of patients under their care on a 4-point bipolar Likert scale. Three patient characteristics were examined: complex-chronic and noncomplex-chronic preexisting conditions, difficult social circumstances, and rare diseases. Patient-level predictors of cases perceived as educationally valuable (defined as scores≥3) were examined by using univariate and multivariate analyses.

RESULTS

A total of 325 patients were rated by 51 trainees (clinical medical students [45%], first-year residents [29%], third-year residents/fellows [26%]). Rare diseases had a higher educational value score (adjusted odds ratio 1.76, 95% confidence interval 1.08-2.88, P=.02). Complex-chronic and noncomplex-chronic preexisting conditions and difficult social circumstances did not affect the perceived educational value.

CONCLUSIONS

Trainees attribute the most educational value to caring for patients with rare diseases. Although trainees' perceptions of learning do not necessarily reflect actual learning, they may influence personal interest and limit learning from an educational experience. Knowledge of trainee perceptions of educational experience therefore can direct medical educators' approaches to inpatient education.

摘要

背景与目的

医学教育严重依赖于职场学习,即学员通过临床经验接受教育。很少有研究探讨学员对这些患者护理经历的教育价值的看法。本研究的目的是确定医学学员认为具有教育价值的儿科患者特征。

方法

在2个多月的时间里,儿科住院病房的学员采用4点双极李克特量表对其护理的患者的感知教育价值进行排名。研究了三个患者特征:复杂慢性和非复杂慢性既往病症、困难的社会环境和罕见疾病。通过单因素和多因素分析检查被认为具有教育价值的病例(定义为得分≥3)的患者水平预测因素。

结果

51名学员(临床医学学生[45%]、一年级住院医师[29%]、三年级住院医师/研究员[26%])对总共325名患者进行了评分。罕见疾病的教育价值得分更高(调整优势比1.76,95%置信区间1.08 - 2.88,P = 0.02)。复杂慢性和非复杂慢性既往病症以及困难的社会环境并不影响感知到的教育价值。

结论

学员认为照顾患有罕见疾病的患者具有最大的教育价值。尽管学员对学习的看法不一定反映实际学习情况,但它们可能会影响个人兴趣并限制从教育经历中的学习。因此,了解学员对教育经历的看法可以指导医学教育工作者进行住院教育的方法。

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