Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
BMC Med Educ. 2021 May 6;21(1):260. doi: 10.1186/s12909-021-02679-8.
Graduating from medical school and beginning independent practice appears to be a major transition for medical students across the world. It is often reported that medical graduates are underprepared for independent practice. Most previous studies on undergraduates' preparedness are cross-sectional. This study aimed to characterize the development and trend of medical students' preparedness and its association with other objective and subjective indicators from the undergraduate to postgraduate periods.
This was a prospective cohort study. The participants were recruited and followed from two years before graduation to the postgraduate period. The preparedness for independent practice, professional identity, and teamwork experience were biannually measured using previously validated questionnaires. The participants' basic demographic information, clinical learning marks from the last two years, and national board exam scores were also collected.
A total of 85 participants completed 403 measurements in the 5 sequential surveys. The mean age at recruitment was 23.6, and 58 % of participants were male. The overall total preparedness score gradually increased from 157.3 (SD=21.2) at the first measurement to 175.5 (SD=25.6) at the fifth measurement. The serial individual preparedness scores revealed both temporal differences within the same learner and individual differences across learners. Despite the variations, a clear, steady increase in the overall average score was observed. Participants were least prepared in the domain of patient management at first, but the score increased in the subsequent measurements. The participants with better final preparedness had better professional identity (p<0.01), better teamwork experience (p < 0.01), and higher average clinical rotation marks (p<0.05).
The preparedness for practice of medical students from the undergraduate to postgraduate periods is associated with their professional identity, teamwork experience, and objective clinical rotation endpoint. Although preparedness generally increases over time, educators must understand that there are temporal fluctuations and individual differences in learners' preparedness.
从医学院毕业并开始独立行医，对全世界的医学生来说，似乎都是一个重大的转变。通常有报道称，医学生毕业后还未准备好独立行医。以前大多数关于本科生准备情况的研究都是横断面研究。本研究旨在从本科到研究生阶段，描述医学生准备情况的发展和趋势，并探讨其与其他客观和主观指标的关系。
这是一项前瞻性队列研究。参与者从毕业前两年开始招募并跟踪到研究生阶段。使用先前验证过的问卷，每两年一次测量独立行医准备情况、专业身份和团队合作经验。还收集了参与者的基本人口统计学信息、过去两年的临床学习成绩和国家委员会考试成绩。
共有 85 名参与者完成了 5 次连续调查中的 403 次测量。招募时的平均年龄为 23.6 岁，58%的参与者为男性。总体准备总评分从第一次测量的 157.3（SD=21.2）逐渐增加到第五次测量的 175.5（SD=25.6）。系列个体准备评分既揭示了同一学习者内部的时间差异，也揭示了学习者之间的个体差异。尽管存在差异，但总体平均分数明显且稳步增加。参与者在第一次测量时在患者管理方面准备最不充分，但在随后的测量中得分有所提高。最终准备情况较好的参与者具有更好的专业身份（p<0.01）、更好的团队合作经验（p<0.01）和更高的平均临床轮转成绩（p<0.05）。
从本科到研究生阶段，医学生的实践准备情况与他们的专业身份、团队合作经验和客观的临床轮转终点有关。尽管准备情况总体上随时间推移而增加，但教育者必须了解学习者准备情况存在时间波动和个体差异。
