Grainger Brian, Yielder Jill, Reid Papaarangi, Bagg Warwick
Clinical Medical Education Fellow in Medical Programme Directorate, Faculty of Medical and Health Sciences, University of Auckland, Auckland.
Senior Lecturer, Medical Programme Directorate, Faculty of Medical and Health Sciences, University of Auckland, Auckland.
N Z Med J. 2017 Aug 11;130(1460):73-82.
The purpose of this study was to identify predictors of remediation in a medical programme and assess the underlying causes and the quality of remediation provided within the context of a recent curriculum change.
A mixed methods study incorporating a retrospective cohort analysis of demographic predictors of remediation during 2013 and 2014, combined with thematic qualitative analysis of educator perspectives derived by interview on factors underlying remediation and the quality of that currently provided by the faculty.
17.7% of all students required some form of remedial assistance and 93% of all students offered remediation passed their year of study. Multivariate analysis showed international students (OR 4.59 95% CI 2.62-7.98) and students admitted via the Māori and Pacific Admission Scheme (OR 3.43 2.29-5.15) were significantly more likely to require remediation. Male students were also slightly more likely than their female classmates to require assistance. No effect was observed for rural origin students, completion of a prior degree or completion of clinical placement in a peripheral hospital. Knowledge application and information synthesis were the most frequently identified underlying problems. Most faculty believed remediation was successful, however, flexibility in the programme structure, improved diagnostics and improved access to dedicated teaching staff were cited as areas for improvement.
Remediation is required by nearly a fifth of University of Auckland medical students, with MAPAS and international students being particularly vulnerable groups. Remediation is largely successful, however, interventions addressing reasoning and knowledge application may improve its effectiveness.
本研究旨在确定医学课程中补救措施的预测因素，并在近期课程改革的背景下评估补救措施的根本原因和质量。
采用混合方法研究，包括对2013年和2014年补救措施的人口统计学预测因素进行回顾性队列分析，并对教育工作者关于补救措施的潜在因素和教师目前提供的补救措施质量的观点进行主题定性分析。
所有学生中有17.7%需要某种形式的补救帮助，所有接受补救措施的学生中有93%通过了学年学习。多变量分析显示，国际学生（比值比4.59，95%置信区间2.62 - 7.98）以及通过毛利和太平洋入学计划录取的学生（比值比3.43，2.29 - 5.15）明显更有可能需要补救措施。男学生比女学生也略更有可能需要帮助。未观察到农村生源学生、先前学位的完成情况或在外围医院完成临床实习有影响。知识应用和信息综合是最常被确定的根本问题。大多数教师认为补救措施是成功的，然而，课程结构的灵活性、改进诊断和增加与专职教师的接触被认为是需要改进的方面。
奥克兰大学近五分之一的医学生需要补救措施，毛利和太平洋入学计划学生以及国际学生是特别脆弱的群体。补救措施在很大程度上是成功的，然而，针对推理和知识应用的干预措施可能会提高其有效性。
