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向尼泊尔初级卫生保健中心学习:关于尼泊尔三年级医学生体验式学习的反思性写作

Learning from Primary Health Care Centers in Nepal: reflective writings on experiential learning of third year Nepalese medical students.

作者信息

Dhital Rolina, Subedi Madhusudan, Prasai Neeti, Shrestha Karun, Malla Milan, Upadhyay Shambhu

机构信息

Department of Community Health Science, Patan Academy of Health Sciences, G P O Box 26500, Kathmandu, Nepal.

School of Medicine, Patan Academy of Health Sciences, G P O Box 26500, Kathmandu, Nepal.

出版信息

BMC Res Notes. 2015 Dec 1;8:741. doi: 10.1186/s13104-015-1727-2.

Abstract

BACKGROUND

Medical education can play important role in cultivating the willingness among the medical students to work in underprivileged areas after their graduation. Experiential learning through early exposure to primary health care centers could help students better understand the opportunities and challenges of such settings. However, the information on the real experiences and reflections of medical students on the rural primary health care settings from low-income countries like Nepal are still limited. The aim of this study is to demonstrate the learning process of the medical students through their reflective writings based on Kolb's theory of experiential learning.

METHODS

The students wrote their experiences, observations and reflections on the experiential learning from the primary health care centers on individual logbook as part of their community posting assignments. We analyzed the data of 50 logbooks through content analysis using Kolb's experiential learning cycle as a theoretical framework.

RESULTS

The students' reflections are structured around the four main learning stages of Kolb's experiential learning theory. Each learning stage consisted of different categories. The first stage consisted of concrete experiences on rural health and learning by doing. The second stage included their reflective observations on primary versus tertiary care, application of theoretical knowledge and role of supervisors. In the third stage, the students developed and refined their concepts on self-development, understanding reality, compassion and sense of responsibility. The final stage, active experimentation, included their immediate future plans, suggestions to improve curriculum, plans after becoming a doctor and suggestions to improve policies.

CONCLUSION

This study provided important insights on different stages of experiential learning of medical students on primary health care in low resource rural settings. Reflective writing of experiential learning could be an important step to address the gaps in medical education for resource constraint settings like that of Nepal and other low-income countries.

摘要

背景

医学教育在培养医学生毕业后到贫困地区工作的意愿方面可发挥重要作用。通过早期接触基层医疗保健中心进行体验式学习,有助于学生更好地理解此类环境中的机遇与挑战。然而,来自尼泊尔等低收入国家的医学生在农村基层医疗保健环境中的真实经历和思考方面的信息仍然有限。本研究的目的是基于科尔布的体验式学习理论,通过医学生的反思性写作来展示其学习过程。

方法

作为社区发布作业的一部分,学生们在个人日志中记录他们在基层医疗保健中心体验式学习的经历、观察和思考。我们以科尔布的体验式学习循环作为理论框架,通过内容分析对50本日志的数据进行了分析。

结果

学生的反思围绕科尔布体验式学习理论的四个主要学习阶段展开。每个学习阶段由不同的类别组成。第一阶段包括农村卫生方面的具体经历和通过实践学习。第二阶段包括他们对初级保健与三级保健的反思性观察、理论知识的应用以及带教老师的作用。在第三阶段,学生们发展并完善了他们关于自我发展、理解现实、同情心和责任感的概念。最后一个阶段,即积极实验阶段,包括他们近期的计划、改进课程的建议、成为医生后的计划以及改进政策的建议。

结论

本研究为低资源农村地区医学生在基层医疗保健体验式学习的不同阶段提供了重要见解。体验式学习的反思性写作可能是弥补尼泊尔和其他低收入国家等资源受限环境下医学教育差距的重要一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d474/4667515/9de52e1bacff/13104_2015_1727_Fig1_HTML.jpg

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