Greenland P, Castle C H, Cohen J D, Davidson D M, Krakoff L R, Nowacek G A, Pearson T A, Riemenschneider T A, VanCitters R L, Stone E J
School of Medicine and Dentistry, University of Rochester Medical Center, New York 14642.
Prev Med. 1988 Nov;17(6):700-11. doi: 10.1016/0091-7435(88)90089-8.
First-year medical students at eight U.S. medical schools were surveyed by written questionnaire in 1983-1985 to determine their attitudes toward cardiovascular diseases prevention at medical school entry. An overall response rate of 92% was achieved (2,654 questionnaires), and 97% of responders provided complete and analyzable survey data. Response rates at five of eight medical schools were 98-100%, and one school each had rates of 67, 84, or 90%. Differences in mean attitude responses from school to school were small, as were differences between men and women or between blacks and whites. This survey found that entering medical students have generally positive attitudes toward the effectiveness of preventive cardiology practice as well as toward the importance of research efforts in cardiovascular disease prevention. Students frequently indicated, however, that it is "extremely difficult" to change patients' unhealthful habits and that "physician encouragement" may not be sufficient to help patients achieve more healthful behaviors. These findings could be helpful in directing educational efforts for medical students. The data suggest that major emphasis should be placed on conveying facts regarding the physicians' efficacy in clinical preventive cardiology and on teaching the skills of preventive cardiology practice. Less emphasis appears to be necessary on encouraging positive attitudes about the importance of prevention since current students' attitudes appear to be already positive in this dimension.
1983年至1985年期间,对美国8所医学院校的一年级医学生进行了书面问卷调查,以确定他们入学时对心血管疾病预防的态度。总体回复率达到92%(共2654份问卷),97%的回复者提供了完整且可分析的调查数据。8所医学院校中有5所的回复率为98%至100%,另外三所学校的回复率分别为67%、84%或90%。不同学校之间平均态度回复的差异较小,男女之间以及黑人和白人之间的差异也较小。这项调查发现,即将入学的医学生对预防心脏病学实践的有效性以及心血管疾病预防研究工作的重要性普遍持积极态度。然而,学生们经常表示,改变患者的不健康习惯“极其困难”,而且“医生的鼓励”可能不足以帮助患者养成更健康的行为。这些发现可能有助于指导针对医学生的教育工作。数据表明,应主要强调传达有关医生在临床预防心脏病学方面疗效的事实,并教授预防心脏病学实践技能。由于目前学生在这方面的态度似乎已经很积极,因此似乎没有必要过多强调鼓励对预防重要性的积极态度。