住院医师培训期间学术动机与终身学习的关系：一项针对精神科住院医师的研究

The Relationship Between Academic Motivation and Lifelong Learning During Residency: A Study of Psychiatry Residents.

作者信息

Sockalingam Sanjeev, Wiljer David, Yufe Shira, Knox Matthew K, Fefergrad Mark, Silver Ivan, Harris Ilene, Tekian Ara

机构信息

S. Sockalingam is deputy psychiatrist-in-chief, Toronto General Hospital and Princess Margaret Cancer Centre, University Health Network, and director of continuing professional and practice development and associate professor, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.D. Wiljer is senior director, Transformational Education and Academic Advancement, Centre for Addiction and Mental Health, and associate professor, Department of Psychiatry and Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.S. Yufe is an MA candidate, Department of Psychology, York University, Toronto, Ontario, Canada.M.K. Knox is psychiatrist and clinical lead in consultation-liaison psychiatry, St. Joseph's Health Centre, Toronto, Ontario, Canada.M. Fefergrad is director of postgraduate education and assistant professor, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.I. Silver is vice president of education, Centre for Addiction and Mental Health, and professor, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.I. Harris is professor, head, and director of graduate studies in health professions education, Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois.A. Tekian is associate professor and director of international affairs, Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois.

出版信息

Acad Med. 2016 Oct;91(10):1423-1430. doi: 10.1097/ACM.0000000000001256.

DOI:10.1097/ACM.0000000000001256

PMID:27306971

Abstract

PURPOSE

To examine the relationship between lifelong learning (LLL) and academic motivation for residents in a psychiatry residency program, trainee factors that influence LLL, and psychiatry residents' LLL practices.

METHOD

Between December 2014 and February 2015, 105 of 173 (61%) eligible psychiatry residents from the Department of Psychiatry, University of Toronto, completed a questionnaire with three study instruments: an LLL needs assessment survey, the Jefferson Scale of Physician Lifelong Learning (JeffSPLL), and the Academic Motivation Scale (AMS). The AMS included a relative autonomy motivation score (AMS-RAM) measuring the overall level of intrinsic motivation (IM).

RESULTS

A significant correlation was observed between JeffSPLL and AMS-RAM scores (r = 0.39, P < .001). Although there was no significant difference in JeffSPLL and AMS-RAM scores based on respondents' level of training (senior vs. junior resident), gender, or age, analysis of AMS subdomains showed that junior residents had a significantly higher score on the extrinsic motivation identification domain (mean difference [M] = 0.38; 95% confidence interval [CI] [0.01, 0.75]; P = .045; d = 0.44) compared with senior residents. Clinician scientist stream (CSS) residents had significantly higher JeffSPLL scores compared with non-CSS residents (M = 3.15; 95% CI [0.52, 5.78]; P = .020; d = 0.57).

CONCLUSIONS

The use of rigorous measures to study LLL and academic motivation confirmed prior research documenting the positive association between IM and LLL. The results suggest that postgraduate curricula aimed at enhancing IM, for example, through support for learning autonomously, could be beneficial to cultivating LLL in learners.

摘要

目的

研究精神病学住院医师培训项目中住院医师的终身学习（LLL）与学术动机之间的关系、影响LLL的学员因素以及精神病学住院医师的LLL实践。

方法

2014年12月至2015年2月期间，多伦多大学精神病学系173名符合条件的精神病学住院医师中有105名（61%）完成了一份包含三种研究工具的问卷：一份LLL需求评估调查、杰斐逊医生终身学习量表（JeffSPLL）和学术动机量表（AMS）。AMS包括一个相对自主动机得分（AMS-RAM），用于衡量内在动机（IM）的总体水平。

结果

观察到JeffSPLL与AMS-RAM得分之间存在显著相关性（r = 0.39，P <.001）。尽管根据受访者的培训水平（高年级与低年级住院医师）、性别或年龄，JeffSPLL和AMS-RAM得分没有显著差异，但对AMS子领域的分析表明，与高年级住院医师相比，低年级住院医师在外在动机识别领域的得分显著更高（平均差异[M] = 0.38；95%置信区间[CI] [0.01, 0.75]；P =.045；d = 0.44）。临床科学家流（CSS）住院医师的JeffSPLL得分显著高于非CSS住院医师（M = 3.15；95% CI [0.52, 5.78]；P =.020；d = 0.57）。