Department of Education of the Sixth Affiliated Hospital of Guangzhou Medical University/The People's Hospital of Qingyuan, Guangzhou, China.
School of Medicine, China Medical University, 91, Shueh-Shih Road, Taichung, 404, Taiwan.
BMC Med Educ. 2022 Jun 15;22(1):460. doi: 10.1186/s12909-022-03537-x.
Clinical medical education is essential in physician training. This study developed recommendations for medical residency course design on the basis of the perspectives of learners in China and how they interact with their environment. The central research topic was the professional development and learning process of residents, including the obstacles that hinder and factors that promote their learning, their views on existing teaching methods, interaction between teachers and medical teams, and suggestions for designing future residency training programs.
This study had a qualitative research design. Interviews were conducted between July and October 2019 with 17 specialist residents and 12 assistant general practitioner residents from the department of education of the hospital. The participants were recruited from Qingyuan People's Hospital in Guangdong Province, China. The interview outlines focused on the following four themes: clinical learning experiences and reflections on learning, experience of interaction with patients, experience of working with other medical personnel, and future learning directions.
To overcome challenges in clinical learning, the residents mainly learned from their teachers and focused specifically on their own experiences. Regarding teaching methods and designs in clinical medicine, the residents preferred large-group, small-group, and bedside teaching and reported that bedside teaching enables the resolution of clinical problems, initiates self-learning, and improves diagnostic thinking. They disliked teachers with low teaching motivation or who were reluctant to interact with them and favored teachers who had strong teaching skills and respect for their students.
The residents suggested that clinical and active learning must be the main learning method for developing general medical competencies. Residency training must be conducted in an environment that facilitates residents' learning and meaningful learning activities. The interdependent symbiotic relationships in the education ecosystem can serve as a reference for designing residency courses.
临床医学教育是医师培训的重要组成部分。本研究基于中国学习者的观点及其与环境的相互作用，为医学住院医师课程设计提出了建议。中心研究主题是住院医师的专业发展和学习过程，包括阻碍他们学习的障碍和促进他们学习的因素、他们对现有教学方法的看法、教师与医疗团队之间的互动以及对未来住院医师培训课程设计的建议。
本研究采用定性研究设计。2019 年 7 月至 10 月，对来自中国广东省清远人民医院的 17 名专科住院医师和 12 名助理全科医生住院医师进行了访谈。访谈大纲重点关注以下四个主题：临床学习经验和学习反思、与患者互动的经验、与其他医务人员合作的经验以及未来的学习方向。
为了克服临床学习中的挑战，住院医师主要向教师学习，并特别关注自己的经验。关于临床医学中的教学方法和设计，住院医师更喜欢大组、小组和床边教学，并报告说床边教学可以解决临床问题，启动自学，并提高诊断思维。他们不喜欢教学动力低或不愿与他们互动的教师，而喜欢教学技能强且尊重学生的教师。
住院医师建议临床和主动学习必须是培养普通医学能力的主要学习方法。住院医师培训必须在有利于住院医师学习和有意义的学习活动的环境中进行。教育生态系统中的相互依存共生关系可以为住院医师课程设计提供参考。
