Chao Chia-Ter, Wu Mei-Yi, Hung Kuan-Yu, Wu Mai-Szu, Liang Jyh-Chong
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Division of Nephrology, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Kidney Int Rep. 2024 Jan 12;9(4):877-887. doi: 10.1016/j.ekir.2024.01.018. eCollection 2024 Apr.
Postgraduate medical education assumes rising importance in the rapidly advancing field of medicine. Case-based learning (CBL), a learner-centered pedagogy employing clinical cases to improve decision-making, is widely embraced in postgraduate medical education, including nephrology. Studies suggest that learning self-efficacy (SE) was closely associated with learning motivation and academic performance; however, very few studies examined this association in postgraduate nephrology education. None evaluated whether there were interprofessional differences concerning such association.
In 2022, we prospectively enrolled physicians and nurses participating in chronic kidney disease (CKD) care from institutions around Taiwan. They completed the Professional Medical Learning Self-efficacy (PMLS) questionnaire after attending >1 CBL session involving CKD care. We undertook confirmatory factor analysis (CFA), followed by structural equation modeling (SEM) to evaluate associations between 5 dimensions of learning SE (conceptual understanding [CU], higher-order cognitive skills [HC], practical work [PW], everyday application [EA], and medical science communication [MSC]) and their professional SE in nephrology according to participants' medical professions.
A total of 513 healthcare providers were surveyed. The convergent and construct validity of our questionnaire were satisfied after analyses. We found that better perceived professional performance in the form of higher professional SE in nephrology was significantly associated with all 5 dimensions of learning SE among physicians and nurses. Only CU and PW were significantly associated with physicians' professional performance; whereas among nurses, only HC and MSC were significantly associated.
We showed that learning SE was an important determinant of nephrology professional performance. Different medical professions posed influences on major SE dimensions.
在医学快速发展的领域中，研究生医学教育的重要性日益凸显。基于案例的学习（CBL）是一种以学习者为中心的教学方法，通过临床案例来提高决策能力，在包括肾脏病学在内的研究生医学教育中被广泛采用。研究表明，学习自我效能感（SE）与学习动机和学业成绩密切相关；然而，很少有研究在研究生肾脏病学教育中考察这种关联。也没有研究评估在这种关联方面是否存在跨专业差异。
2022年，我们前瞻性地招募了来自台湾各地机构参与慢性肾脏病（CKD）护理的医生和护士。他们在参加了超过1次涉及CKD护理的CBL课程后，完成了专业医学学习自我效能感（PMLS）问卷。我们进行了验证性因素分析（CFA），随后进行结构方程建模（SEM），以根据参与者的医学专业评估学习SE的5个维度（概念理解[CU]、高阶认知技能[HC]、实践工作[PW]、日常应用[EA]和医学科学交流[MSC]）与他们在肾脏病学方面的专业SE之间的关联。
共对513名医疗服务提供者进行了调查。分析后，我们的问卷的收敛效度和结构效度得到了满足。我们发现，在肾脏病学中，以更高的专业SE形式表现出的更好的专业表现与医生和护士学习SE的所有5个维度显著相关。只有CU和PW与医生的专业表现显著相关；而在护士中，只有HC和MSC显著相关。
我们表明学习SE是肾脏病学专业表现的重要决定因素。不同的医学专业对主要的SE维度有影响。
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