Kangwon National University School of Medicine, Chuncheon, Korea.
Eulji University School of Medicine, Daejeon, Korea.
Korean J Med Educ. 2022 Dec;34(4):259-271. doi: 10.3946/kjme.2022.235. Epub 2022 Nov 29.
This study analyzed the current status of and correlations between Korean medical students' experiences and perspectives surrounding patient-centered medical education (PCME).
A structured PCME questionnaire composed of three categories, understanding patients within social and cultural contexts, understanding patients' individual health contexts through communication, and placement of patients at the center of medical education, was used. The students were stratified into pre-medical (Pre-med), medical (Med), and policlinic (PK) groups because of curriculum differences by grade. The χ2 test was applied to analyze the association between students' experiences with and perspectives on PCME. A Cramer's V of 0.200 was considered a large effect size for any association between experiences with and perspectives on PCME.
Among the respondents, 50.6% answered that they did not know about patient-centered medicine before the survey. With increasing school years went up from Pre-med to PK, fewer students agreed that PCME should be added to pre-clinical medicine curricula (p<0.001), that patients should be in the center throughout medical education (p=0.011), and that patients' personal histories, values, and objectives are important PCME (p=0.001). Students who said they learned PCME for each category were more likely to consider PCME important (Cramer's V was 0.219 and 0.271 for "with," and "for the patients" respectively, p<0.001 for "about/with/for the patients"). Students in all groups chose clinical practice as the best method for PCME (p=0.021). Med group chose the lectures as the most effective tool to learn about the importance of communication (p<0.001).
Students who experienced PCME were likely to perceive PCME as important and it showed that experiences of PCME had positive effects on PCME perceptions. Despite students' preferences for clinical practice as the best method for PCME, PK reported that they did not learn PCME, and regarded PCME as less important compared to students at earlier stages of their medical education. Therefore, more intensive and holistic PCME curricula rather than only clinical practice exposure may be necessary.
本研究分析了韩国医学生在以患者为中心的医学教育(PCME)方面的经历和观点的现状及其相关性。
采用由三个类别组成的结构化 PCME 问卷,分别是理解患者的社会和文化背景、通过沟通理解患者的个体健康背景,以及将患者置于医学教育的中心。由于年级不同,学生分为医学预科(Pre-med)、医学(Med)和门诊(PK)组。学生的 PCME 经历与对 PCME 的看法之间的关联采用 χ2 检验进行分析。对于 PCME 经历与对 PCME 的看法之间的任何关联,Cramer's V 为 0.200 被认为是大效应量。
在回答者中,50.6%的人在调查前不知道以患者为中心的医学。随着从 Pre-med 到 PK 的年级增加,越来越少的学生同意将 PCME 添加到临床前医学课程中(p<0.001),认为患者应该贯穿整个医学教育(p=0.011),以及患者的个人病史、价值观和目标是重要的 PCME(p=0.001)。对于每个类别都表示学习了 PCME 的学生更可能认为 PCME 很重要(Cramer's V 对于“关于/与/为患者”分别为 0.219 和 0.271,p<0.001)。所有组的学生都选择临床实践作为 PCME 的最佳方法(p=0.021)。医学组选择讲座作为了解沟通重要性的最有效工具(p<0.001)。
经历过 PCME 的学生更有可能认为 PCME 很重要,并且 PCME 的经历对 PCME 的认知有积极影响。尽管学生更喜欢将临床实践作为 PCME 的最佳方法,但 PK 组报告称他们没有学习 PCME,并且与医学教育早期阶段的学生相比,他们认为 PCME 不那么重要。因此,可能需要更密集和全面的 PCME 课程,而不仅仅是临床实践。