Herwig Anna, Viehmann Anja, Thielmann Anika, Gesenhues Stefan, Weltermann Birgitta
Institute for General Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
BMJ Open. 2017 Mar 15;7(3):e012794. doi: 10.1136/bmjopen-2016-012794.
Exposure to family medicine (FM) can serve to promote students' interest in this field. This study aimed at identifying clerkship characteristics which decrease or increase students' interest in FM.
This cross-sectional questionnaire study analysed students' clerkship evaluations between the years 2004 and 2014. Descriptive statistics were used to compare four predefined groups: (1) high interest in FM before and after the clerkship (Remained high), (2) poor interest before and after the clerkship (Remained low), (3) poor interest before the clerkship which improved (Increased) and (4) high interest before the clerkship which decreased (Decreased).
Students' evaluations of FM clerkships in the fourth of 6 years of medical school.
All questionnaires with complete answers on students' interest in FM and its change as a result of the clerkship (2382 of 3963; 60.1%). The students' mean age was 26 years (± 3.9), 62.7% (n=1505) were female.
The outcome was a change in students' interest in FM after completing the clerkship.
Interest in FM after the clerkship was as follows: 40.1% (n=954) Remained high, 5.5% (n=134) Remained low, 42.1% (n=1002) Increased and 12.3% (n=292) Decreased. Students with decreased interest had performed a below-average number of learning activities (4 vs 6 activities). A total of 45.9% (n=134 of 292) of the students with decreased interest reported that the difficulty of the challenge was inadequate for their educational level: 81.3% (n=109) felt underchallenged and 18.7% (n=25) overchallenged.
In more than 50% of cases, the clerkship changed the students' interest in FM. Those with decreased interest were more frequently underchallenged. We observed an increase in FM if at least six learning activities were trained. Our findings stress the importance of well-designed FM clerkships. There is a need for standardised educational strategies which enable teaching physicians to operationalise educational requirements.
接触家庭医学（FM）有助于提高学生对该领域的兴趣。本研究旨在确定会降低或提高学生对家庭医学兴趣的临床实习特征。
这项横断面问卷调查研究分析了2004年至2014年间学生的临床实习评价。描述性统计用于比较四个预定义组：（1）临床实习前后对家庭医学兴趣高（保持高），（2）临床实习前后兴趣低（保持低），（3）临床实习前兴趣低但有所提高（增加），以及（4）临床实习前兴趣高但有所下降（下降）。
医学院6年制中第四年学生对家庭医学临床实习的评价。
所有对学生对家庭医学的兴趣及其因临床实习而产生的变化给出完整答案的问卷（3963份中的2382份；60.1%）。学生的平均年龄为26岁（±3.9），62.7%（n = 1505）为女性。
观察指标为完成临床实习后学生对家庭医学兴趣的变化。
临床实习后对家庭医学的兴趣情况如下：40.1%（n = 954）保持高，5.5%（n = 134）保持低，42.1%（n = 1002）增加，12.3%（n = 292）下降。兴趣下降的学生所进行的学习活动数量低于平均水平（4项对6项活动）。在兴趣下降的学生中，共有45.9%（n = 292人中的134人）报告称挑战难度与他们的教育水平不匹配：81.3%（n = 109）感到挑战不足，18.7%（n = 25）感到挑战过度。
在超过50%的情况下，临床实习改变了学生对家庭医学的兴趣。兴趣下降的学生更常面临挑战不足的情况。我们观察到，如果至少进行六项学习活动，对家庭医学的兴趣会增加。我们的研究结果强调了精心设计家庭医学临床实习的重要性。需要标准化的教育策略，使带教医生能够落实教育要求。
