a Medical School , University College London Medical School , London , UK.
b Department of Primary Care and Population Health , University College London , London , UK.
Med Teach. 2018 Jul;40(7):728-735. doi: 10.1080/0142159X.2018.1436757. Epub 2018 Feb 19.
Inequalities in healthcare are increasing. Engaging medical students to tackle this urgent challenge alongside clinical sciences can be demanding. This study examines medical student perceptions of a flipped approach to health inequalities co-designed by faculty and sixth-year students.
A flipped learning session was piloted for year 4 medical students combining an online lesson followed by a tutorial with a simulated patient.
A mixed-methods approach collected questionnaire data using 4-point Likert scales and free text answers. A semi-structured group interview was conducted with six voluntary participants.
Two hundred and eighty-nine students completed questionnaires. 85% (n = 246) completed the online lesson. Students agreed the session helped their understanding of key concepts (mean 3.2), was improved by having an actor (mean = 3.6), and was enjoyable (mean = 3.2). Thematic analysis of qualitative questionnaire and interview data revealed three themes: engagement; structure; and attitudes towards social determinants of health. The simulation increased clinical relevance and students gained understanding of the impact of health inequalities upon individuals.
This paper indicates flipped learning can increase clinical relevance and engagement in population health and person-centered care. Further work could assess changes in practice and attitudes of future doctors in tackling such global health challenges.
医疗保健领域的不平等现象正在加剧。让医学生与临床科学一起参与解决这一紧迫挑战可能具有挑战性。本研究调查了医学生对由教师和六年级学生共同设计的翻转式健康不平等方法的看法。
为四年级医学生试点翻转学习课程，将在线课程与模拟患者辅导相结合。
采用混合方法收集问卷调查数据，使用 4 分李克特量表和自由文本答案。对六名自愿参与者进行了半结构化小组访谈。
289 名学生完成了问卷。85%（n=246）完成了在线课程。学生们认为该课程有助于他们理解关键概念（平均值为 3.2），有演员（平均值=3.6）参与会有所改善，并且很有趣（平均值=3.2）。对定性问卷和访谈数据的主题分析揭示了三个主题：参与度；结构；以及对健康决定因素的态度。模拟增加了临床相关性，学生们了解了健康不平等对个人的影响。
本文表明，翻转学习可以提高人群健康和以人为本的护理的临床相关性和参与度。进一步的工作可以评估未来医生在应对此类全球健康挑战方面的实践和态度变化。
