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新冠疫情前、疫情期间和疫情高峰期后医学教育的差异——探讨高年级医学生的态度。

Differences in medical education before, during, and in the post-peak period of the COVID-19 pandemic-exploring senior medical students' attitudes.

机构信息

Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, San Pedro Garza Garcia, Nuevo Leon, Mexico.

Pontificia Universidad Católica del Ecuador, 12 de Octubre #1076, Quito, Pichincha, Ecuador.

出版信息

BMC Med Educ. 2023 Jul 13;23(1):506. doi: 10.1186/s12909-023-04489-6.

Abstract

BACKGROUND

The burden that COVID-19 has brought to the economy, healthcare systems, and education is unmatched. Public health and social measures were implemented to halt transmission. Thus, social gathering and in-person learning, core aspects of medical education, were interrupted. Studies have documented the detrimental impact students graduating during the pandemic have had on their confidence and skills. However, data comparing pre-pandemic, pandemic, and post-peak students still lack. This study aimed to identify senior medical students' attitudes regarding their education and compare them according to the three previously described periods.

METHODS

In this cross-sectional study, the survey employed was designed based on a previous questionnaire and applied to senior medical students before graduating between January 2018 and June 2022. Answers were collected using a three-point Likert scale and Yes/No questions. Associations between variables were examined using Chi-squared, Fisher's Exact tests, and ANOVA, employing logistic regression to calculate odds ratio (OR) when appropriate.

RESULTS

A total of 679 responses were analyzed. Most students (59%) were women. Up to 383, 241, and 55 senior medical students answered the survey before, during, and in the post-peak period of the COVID-19 pandemic, respectively. There was a staggering decrease in the percentage of students in the post-peak compared to the pre-pandemic period that considered certain factors such as being taught about the doctor-patient relationship (62% vs 75%), practicing teamwork (33% vs 54%), preclinical & clinical subjects (44% vs 63%), and being taught to conduct research (22% vs 32%) as "very useful" to their professional traineeship. There was a significant difference between pre-pandemic, pandemic, and post-peak students when asked if the study curriculum accomplished the goal of training a professional with integrity (89% vs 66% vs 64%, p < 0.001), respectively. In a multivariate analysis graduating during the pandemic (OR 3.92; 95% CI, 2.58-5.94) and in the post-peak period (OR 4.24; 95% CI, 2.23-8.07) were independent factors for the appreciation that the study curriculum did not meet its objective.

CONCLUSIONS

The pandemic has hindered medical education. Students' appreciation of their instruction has deteriorated. Urgent interventions that halt the negative impact on training, ensure readiness for future problems and improve schooling worldwide are needed.

摘要

背景

新冠疫情给经济、医疗系统和教育带来了前所未有的负担。为了阻止病毒传播,实施了公共卫生和社会措施。因此,作为医学教育核心内容的社交聚会和面对面学习被中断。研究记录了在疫情期间毕业的学生对自己的信心和技能产生的不利影响。然而,仍缺乏对疫情前、疫情中和疫情高峰后学生进行比较的数据。本研究旨在确定高年级医学生对其教育的态度,并根据上述三个时期进行比较。

方法

在这项横断面研究中,调查问卷是基于之前的问卷设计的,在 2018 年 1 月至 2022 年 6 月期间,在即将毕业的高年级医学生中进行调查。使用三点李克特量表和是/否问题收集答案。使用卡方检验、Fisher 确切检验和 ANOVA 检验来检验变量之间的关联,适当时使用逻辑回归计算比值比(OR)。

结果

共分析了 679 份回复。大多数学生(59%)为女性。分别有 383、241 和 55 名高年级医学生在疫情前、疫情中和疫情高峰后回答了调查。与疫情前相比,在疫情高峰后,认为某些因素对他们的专业实习非常有用的学生比例大幅下降,如医患关系教学(62%对 75%)、团队合作实践(33%对 54%)、临床前和临床科目(44%对 63%)以及进行研究教学(22%对 32%)。当被问及学习课程是否实现了培养有操守的专业人员的目标时,疫情前、疫情中和疫情高峰后的学生之间存在显著差异(89%对 66%对 64%,p<0.001)。在多变量分析中,在疫情期间毕业(OR 3.92;95%CI,2.58-5.94)和在疫情高峰后毕业(OR 4.24;95%CI,2.23-8.07)是学习课程未达到目标的独立因素。

结论

疫情阻碍了医学教育。学生对教学的满意度下降。需要采取紧急干预措施,阻止对培训的负面影响,为未来的问题做好准备,并改善全球的学校教育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/602b/10339490/f789234e6e84/12909_2023_4489_Fig1_HTML.jpg

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