医学课程形式的改变对医学生学习动机的影响：一项前瞻性队列研究。
Effect of changes to the formal curriculum on medical students' motivation towards learning: a prospective cohort study.
作者信息
Del-Ben Cristina Marta, Shuhama Rosana, Costa Manuel João, Troncon Luiz Ernesto de Almeida
机构信息
MD, PhD. Physician and Associate Professor, Department of Neurosciences and Behavior, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil.
PhD. Psychologist and Technical Health-Assistance Agent, Department of Neurosciences and Behavior, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil.
出版信息
Sao Paulo Med J. 2019 Jun 10;137(2):112-118. doi: 10.1590/1516-3180.2018.0264090119.
BACKGROUND
One of the factors known to influence performance in the learning process is student motivation. In turn, students' motivation can be regulated by a large number of variables relating to the individual (such as sex, age and socioeconomic status) or to aspects of the academic life.
OBJECTIVE
The primary aim of this study was to evaluate the influence of curriculum changes involving reduction in content overload and increased early exposure to clinical settings, on motivation towards learning among Year 1 medical students. Secondarily, the aim was to ascertain whether this influence on motivation remained stable until the undergraduate program ended (Year 6).
DESIGN AND SETTING
Prospective study on two student cohorts at a Brazilian state-owned university.
METHODS
Two consecutive student cohorts were assessed: one with a traditional curriculum (n = 87) and the other with a reformed curriculum (n = 63), at the same medical school. Participants in both cohorts gave responses on four scales in Years 1 and 6: the Academic Motivation Scale, containing subscales for autonomous and controlled motivation, and lack of motivation towards learning; Beck's Anxiety and Depression Inventories; Spielberger's State-Trait Anxiety Inventory; and the Social Adjustment Scale. In Year 6, 68% of the initial sample (66 students with the traditional curriculum and 36 with the reformed curriculum) was reassessed.
RESULTS
No differences between Year 1 cohorts were found regarding demographic and social background, social adjustment, depression or anxiety. Students with the reformed curriculum scored significantly higher regarding autonomous and controlled motivation than those with the traditional curriculum. Comparison between Year 6 and Year 1 showed increases in controlled motivation only for the traditional curriculum cohort.
CONCLUSION
Curriculum changes were associated with increased motivation towards learning in Year 1, which persisted until Year 6.
背景
已知影响学习过程表现的因素之一是学生的动机。反过来，学生的动机可由大量与个人相关的变量（如性别、年龄和社会经济地位）或学术生活方面的变量来调节。
目的
本研究的主要目的是评估课程改革（包括减少内容负担和增加早期临床实习机会）对一年级医学生学习动机的影响。其次，目的是确定这种对动机的影响在本科课程结束（六年级）之前是否保持稳定。
设计与背景
对巴西一所国立大学的两个学生队列进行前瞻性研究。
方法
在同一所医学院对两个连续的学生队列进行评估：一个采用传统课程（n = 87），另一个采用改革后的课程（n = 63）。两个队列的参与者在一年级和六年级时在四个量表上做出回应：学术动机量表，包括自主动机、受控动机和学习动机缺乏的子量表；贝克焦虑和抑郁量表；斯皮尔伯格状态-特质焦虑量表；以及社会适应量表。在六年级时，对初始样本的68%（66名采用传统课程的学生和36名采用改革后课程的学生）进行了重新评估。
结果
在人口统计学和社会背景、社会适应、抑郁或焦虑方面，一年级队列之间没有发现差异。采用改革后课程的学生在自主动机和受控动机方面的得分显著高于采用传统课程的学生。六年级与一年级的比较显示，只有传统课程队列的受控动机有所增加。
结论
课程改革与一年级学习动机的增加相关，这种增加一直持续到六年级。
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