Chéron Magalie, Ademi Mirlinda, Kraft Felix, Löffler-Stastka Henriette
Department for Psychoanalysis and Psychotherapy, Advanced Postgraduate Program for Psychotherapy Research, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.
BMC Med Educ. 2016 Feb 2;16:41. doi: 10.1186/s12909-016-0564-x.
Investigating and understanding how students learn on their own is essential to effective teaching, but studies are rarely conducted in this context. A major aim within medical education is to foster procedural knowledge. It is known that case-based questioning exercises drive the learning process, but the way students deal with these exercises is explored little.
This study examined how medical students deal with case-based questioning by evaluating 426 case-related questions created by 79 fourth-year medical students. The subjects covered by the questions, the level of the questions (equivalent to United States Medical Licensing Examination Steps 1 and 2), and the proportion of positively and negatively formulated questions were examined, as well as the number of right and wrong answer choices, in correlation to the formulation of the question.
The evaluated case-based questions' level matched the United States Medical Licensing Examination Step 1 level. The students were more confident with items aiming on diagnosis, did not reject negatively formulated questions and tended to prefer handling with right content, while keeping wrong content to a minimum.
These results should be taken into consideration for the formulation of case-based questioning exercises in the future and encourage the development of bedside teaching in order to foster the acquisition of associative and procedural knowledge, especially clinical reasoning and therapy-oriented thinking.
研究并了解学生如何自主学习对于有效教学至关重要,但在此背景下开展的研究很少。医学教育的一个主要目标是培养程序性知识。已知基于案例的提问练习能推动学习过程,但学生处理这些练习的方式却鲜有探讨。
本研究通过评估79名四年级医学生提出的426个与案例相关的问题,考察了医学生如何处理基于案例的提问。研究了问题所涵盖的主题、问题的水平(相当于美国医学执照考试第1步和第2步)、正向和负向表述问题的比例,以及正确和错误答案选项的数量与问题表述的相关性。
所评估的基于案例的问题水平与美国医学执照考试第1步水平相当。学生对旨在诊断的题目更有信心,不排斥负向表述的问题,并且倾向于优先处理正确内容,同时尽量减少错误内容。
未来在制定基于案例的提问练习时应考虑这些结果,并鼓励开展床边教学,以促进联想性和程序性知识的获取,尤其是临床推理和以治疗为导向的思维。