Centre for Healthcare Education Research and Innovation (CHERI), University of Aberdeen, Aberdeen, UK.
Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Med Educ. 2018 Nov;52(11):1113-1124. doi: 10.1111/medu.13657. Epub 2018 Sep 26.
In everyday life, the choices we make are influenced by our preferences for the alternatives available to us. The same is true when choosing medical education, training and jobs. More often than not, those alternatives comprise multiple attributes and our ultimate choice will be guided by the value we place on each attribute relative to the others. In education, for example, choice of university is likely to be influenced by preferences for institutional reputation, location, cost and course content; but which of these attributes is the most influential? An understanding of what is valued by applicants, students, trainees and colleagues is of increasing importance in the higher education and medical job marketplaces because it will help us to develop options that meet their needs and preferences.
In this article, we describe the discrete choice experiment (DCE), a survey method borrowed from economics that allows us to quantify the values respondents place on the attributes of goods and services, and to explore whether and to what extent they are willing to trade less of one attribute for more of another.
To date, DCEs have been used to look at medical workforce issues but relatively little in the field of medical education. However, many outstanding questions within medical education could be usefully addressed using DCEs. A better understanding of which attributes have most influence on, for example, staff or student satisfaction, choice of university and choice of career, and the extent to which stakeholders are prepared to trade one attribute against another is required. Such knowledge will allow us to tailor the way medical education is provided to better meet the needs of key stakeholders within the available resources.
在日常生活中，我们所做的选择受到我们对可供选择的偏好的影响。在选择医学教育、培训和工作时也是如此。这些选择往往包含多个属性，我们的最终选择将取决于我们对每个属性相对于其他属性的重视程度。例如，在教育方面，选择大学可能会受到对机构声誉、地点、成本和课程内容的偏好的影响；但这些属性中哪一个最具影响力？了解申请人、学生、受训者和同事重视什么，在高等教育和医疗就业市场中变得越来越重要，因为这将帮助我们开发满足他们需求和偏好的选择。
在本文中，我们描述了离散选择实验（DCE），这是一种从经济学中借鉴的调查方法，它使我们能够量化受访者对商品和服务属性的重视程度，并探索他们是否愿意以及在多大程度上愿意用较少的一个属性换取更多的另一个属性。
迄今为止，DCE 已被用于研究医疗劳动力问题，但在医学教育领域相对较少。然而，医学教育领域的许多悬而未决的问题都可以通过 DCE 来很好地解决。更好地了解哪些属性对员工或学生满意度、大学选择和职业选择的影响最大，以及利益相关者愿意在多大程度上权衡一个属性来换取另一个属性，这是非常有必要的。这种知识将使我们能够调整医学教育的提供方式，以更好地满足现有资源内的关键利益相关者的需求。
