Centro de Desenvolvimento de Educação Médica e Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Centro de Desenvolvimento de Educação Médica e Departamento de Clínica Médica, Universidade Federal de Roraima, Boa Vista, Brazil.
PLoS One. 2021 Mar 17;16(3):e0248627. doi: 10.1371/journal.pone.0248627. eCollection 2021.
There has been a rapid increase in the number of cases of COVID-19 in Latin America, Africa, Asia and many countries that have an insufficient number of physicians and other health care personnel, and the need for the inclusion of medical students on health teams is a very important issue. It has been recommended that medical students work as volunteers, undergo appropriate training, not undertake any activity beyond their level of competence, and receive continuous supervision and adequate personal protective equipment. However, the motivation of medical students must be evaluated to make volunteering a more evidence-based initiative. The aim of our study was to evaluate the motivation of medical students to be part of health teams to aid in the COVID-19 pandemic.
We developed a questionnaire specifically to evaluate medical students' perceptions about participating in the care of patients with suspected infection with coronavirus during the COVID-19 pandemic. The questionnaire had two parts: a) one part with questions on individual characteristics, year in medical school and geographic location of the medical school and b) a second part with twenty-eight statements assessed on a 5-point Likert scale (totally agree, agree, neither agree nor disagree, disagree and totally disagree). To develop the questionnaire, we performed consensus meetings with a group of faculty and medical students. The questionnaire was sent to student organizations of 257 medical schools in Brazil and answered by 10,433 students. We used multinomial logistic regression models to analyze the data. Statements associated with greater odds ratios for participation of medical students in the COVID-19 pandemic were related to a sense of purpose or duty ("It is the duty of the medical student to put himself or herself at the service of the population in the pandemic"), altruism ("I am willing to take risks by participating in practice in the context of the pandemic"), and perception of good performance and professional identity ("I will be a better health professional for having experienced the pandemic"). Males were more prone than females to believe that only interns should participate in the care of patients with COVID-19 (odds ratio 1.36 [coefficient interval 95%:1.24-1.49]) and that all students should participate (OR 1.68 [CI:1.4-1.91]).
Medical students are more motivated by a sense of purpose or duty, altruism, perception of good performance and values of professionalism than by their interest in learning. These results have implications for the development of volunteering programs and the design of health force policies in the present pandemic and in future health emergencies.
在拉丁美洲、非洲、亚洲和许多医生和其他卫生保健人员数量不足的国家,COVID-19 病例数量迅速增加,因此需要将医学生纳入卫生团队,这是一个非常重要的问题。已经建议医学生作为志愿者工作,接受适当的培训,不从事超出其能力范围的任何活动,并接受持续的监督和足够的个人防护设备。然而,必须评估医学生的动机,以使志愿服务成为更具循证依据的举措。我们研究的目的是评估医学生参与 COVID-19 大流行期间援助卫生团队的动机。
我们专门开发了一份问卷,以评估医学生对参与疑似冠状病毒感染患者护理的看法。该问卷有两部分:a)一部分是关于个人特征、医学生年级和医学院地理位置的问题,b)第二部分是 28 个陈述,采用 5 点李克特量表评估(完全同意、同意、既不同意也不反对、不同意和完全不同意)。为了开发问卷,我们与一组教师和医学生进行了共识会议。问卷发送给了巴西 257 所医学院的学生组织,并由 10433 名学生回答。我们使用多项逻辑回归模型分析数据。与医学生参与 COVID-19 大流行的几率更高相关的陈述与使命感或责任感有关(“医学生有责任为人民服务在大流行期间”)、利他主义(“我愿意通过参与大流行背景下的实践来承担风险”)以及对良好表现和专业身份的认知(“我将成为更好的卫生专业人员,因为我经历了大流行”)。与女性相比,男性更倾向于认为只有实习医生应该参与 COVID-19 患者的护理(优势比 1.36 [95%置信区间:1.24-1.49]),并且所有学生都应该参与(OR 1.68 [CI:1.4-1.91])。
医学生的动机更多地来自使命感或责任感、利他主义、对良好表现的认知和专业精神价值观,而不是对学习的兴趣。这些结果对当前大流行和未来卫生紧急情况下志愿计划的制定和卫生人力政策的设计具有影响。