Department of Pediatrics, National Taiwan University Hospital, #7, Rd. Chong-Shan S, Taipei, 10002, Taiwan.
Department of Medical Education, National Taiwan University Hospital, #7, Rd. Chong-Shan S, Taipei, 10002, Taiwan.
BMC Med Educ. 2019 Nov 8;19(1):410. doi: 10.1186/s12909-019-1856-8.
By learning medical humanities, medical students are expected to shift from handling the diseases only to seeing a whole sick person. Therefore, understanding medical students' learning process and outcomes of medical humanities becomes an essential issue of medical education. Few studies have been conducted to explore factors surrounding medical students' learning process and outcomes of medical humanities. The objectives were: (1) to investigate the relationships between medical students' conceptions of learning and strategies to learning; and (2) to examine the relationships between students' strategies to learning and learning outcomes for medical humanities.
We used the modified Approaches to Learning Medicine (mALM) questionnaire and Conceptions of Learning Medicine (COLM) questionnaire to measure the medical students' strategies to learning and conceptions of learning respectively. The learning outcome of medical humanities was measured using students' weighted grade in a medical humanities course. The confirmatory factor analysis (CFA) was used to validate the COLM and mALM questionnaires, in which construct validity and reliability were assessed. Pearson's correlation was used to examine the relationships among the factors of COLM, mALM, and the weighted grade. Path analysis using structural equation modeling technique (SEM) was employed to estimate the structural relationships among the COLM, mALM, and the weighted grade.
Two hundred and seventy-five first-year medical students consented to participate in this study. The participants adopting surface strategies to learning were more likely to have unsatisfactory learning outcome (β = - 0.14, p = .04). The basic-level conception of "Preparing for Testing" was negatively (β = - 0.19, p < .01) associated with deep strategies of learning, and positively (β = 0.48, p < .01) associated with surface strategies of learning (β = 0.50, p < .01). The basic-level conception of "Skills Acquisition" was positively associated with deep strategies of learning (β = 0.23, p < .01).
Medical educators should wisely employ teaching strategies to increase students' engagement with deep and self-directed learning strategies, and to avoid using surface learning strategies in the medical humanities course in order to achieve better learning outcomes.
通过学习医学人文学科，医学生有望从仅处理疾病转变为全面了解患者。因此，了解医学生学习医学人文学科的过程和结果成为医学教育的重要问题。很少有研究探讨医学生学习医学人文学科的过程和结果的相关因素。本研究的目的是：（1）调查医学生学习观念与学习策略之间的关系；（2）检验学生学习策略与医学人文学科学习成果之间的关系。
我们使用改良的医学学习方法（mALM）问卷和医学学习观念（COLM）问卷分别测量医学生的学习策略和学习观念。医学人文学科的学习成果采用学生在医学人文学科课程中的加权成绩来衡量。采用验证性因子分析（CFA）来验证 COLM 和 mALM 问卷，评估其结构效度和信度。采用皮尔逊相关检验 COLM、mALM 和加权成绩之间的关系。采用结构方程模型技术（SEM）中的路径分析来估计 COLM、mALM 和加权成绩之间的结构关系。
共有 275 名一年级医学生同意参与本研究。采用表面学习策略的学生更有可能获得不满意的学习成果（β=-0.14，p=0.04）。“应试准备”的基础观念与深层学习策略呈负相关（β=-0.19，p<.01），与浅层学习策略呈正相关（β=0.50，p<.01）。“技能习得”的基础观念与深层学习策略呈正相关（β=0.23，p<.01）。
医学教育者应明智地采用教学策略，增加学生对深层和自主学习策略的参与度，并避免在医学人文学科课程中采用浅层学习策略，以取得更好的学习成果。
