医学教育中的增值活动：对医学生第一和第二年感知及其潜在参与影响因素的多站点调查。

Value-Added Activities in Medical Education: A Multisite Survey of First- and Second-Year Medical Students' Perceptions and Factors Influencing Their Potential Engagement.

机构信息

A.N. Leep Hunderfund is assistant professor of neurology, Mayo Clinic, and associate director, Mayo Clinic Program in Professionalism and Values, Rochester, Minnesota. S.R. Starr is associate professor of pediatrics and director, Science of Health Care Delivery Education, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota. L.N. Dyrbye is professor of medical education and medicine, Mayo Clinic, Rochester, Minnesota. J.D. Gonzalo is associate professor of medicine and public health sciences and associate dean, Health Systems Education, Pennsylvania State University College of Medicine, Hershey, Pennsylvania. P. George is associate professor of family medicine and associate professor of medical science, Alpert Medical School, Brown University, Providence, Rhode Island. B.M. Miller is professor of medical education and administration and professor of clinical surgery, associate vice chancellor, Health Affairs, and senior associate dean, Health Sciences Education, Vanderbilt University School of Medicine, Nashville, Tennessee. H.K. Morgan is associate clinical professor of obstetrics and gynecology and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. A. Hoffman is assistant clinical professor of medicine, Division of Hospital Medicine, University of California, San Francisco School of Medicine, San Francisco, California. E.G. Baxley is professor of family medicine and senior associate dean, Academic Affairs, Brody School of Medicine, East Carolina University, Greenville, North Carolina. B.L. Allen is associate professor of clinical medicine and senior associate dean, Medical Student Education, Indiana University School of Medicine, Indianapolis, Indiana. T.L. Fancher is associate professor of medicine, University of California, Davis School of Medicine, Sacramento, California. J. Mandrekar is professor of biostatistics and neurology, Mayo Clinic, Rochester, Minnesota. S.E. Skochelak is group vice president for medical education, American Medical Association, Chicago, Illinois. D.A. Reed is associate professor of medical education and medicine and senior associate dean, Academic Affairs, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota.

出版信息

Acad Med. 2018 Oct;93(10):1560-1568. doi: 10.1097/ACM.0000000000002299.

DOI:10.1097/ACM.0000000000002299

PMID:29794526

Abstract

PURPOSE

To describe attitudes of first- and second-year U.S. medical students toward value-added medical education, assess their self-reported desire to participate in value-added activities, and identify potentially modifiable factors influencing their engagement.

METHOD

The authors conducted a cross-sectional survey of first- and second-year students at nine U.S. medical schools in 2017. Survey items measured students' attitudes toward value-added medical education (n = 7), desire to participate in value-added activities (n = 20), and factors influencing potential engagement (n = 18).

RESULTS

Of 2,670 students invited to participate, 1,372 (51%) responded. Seventy-six percent (1,043/1,368) moderately or strongly agreed they should make meaningful contributions to patient care. Students' desire to participate was highest for patient care activities approximating those traditionally performed by physicians, followed by systems improvement activities and lowest for activities not typically performed by physicians. Factors increasing desire to participate included opportunities to interact with practicing physicians (1,182/1,244; 95%), patients (1,177/1,246; 95%), and residents or fellows (1,166/1,246; 94%). Factors decreasing desire to participate included making changes to the health care system (365/1,227; 30%), interacting with patients via phone or electronic communication (410/1,243; 33%), and lack of curricular time (634/1,233; 51%).

CONCLUSIONS

First- and second-year medical students agree they should add value to patient care, but their desire to participate in value-added activities varies depending on the nature of the tasks. Medical schools may be able to increase students' desire to participate by enabling face-to-face interactions with patients, embedding students in health care teams, and providing dedicated curricular time.

摘要

目的

描述美国医学生对增值医学教育的态度，评估他们参与增值活动的自我报告意愿，并确定可能影响他们参与的可改变因素。

方法

作者于 2017 年在 9 所美国医学院对一、二年级学生进行了横断面调查。调查项目衡量了学生对增值医学教育的态度（n=7）、参与增值活动的意愿（n=20）和潜在参与影响因素（n=18）。

结果

在邀请的 2670 名学生中，有 1372 名（51%）做出了回应。76%（1043/1368）的学生强烈或中度同意他们应该为患者护理做出有意义的贡献。学生参与的意愿最高的是与医生传统上进行的活动类似的患者护理活动，其次是系统改进活动，而不是医生通常不进行的活动。增加参与意愿的因素包括与执业医生（1182/1244；95%）、患者（1177/1246；95%）和住院医师或研究员（1166/1246；94%）互动的机会。降低参与意愿的因素包括对医疗保健系统进行更改（365/1227；30%）、通过电话或电子通信与患者互动（410/1243；33%）和缺乏课程时间（634/1233；51%）。