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本科医学生对临床督导满意度的决定因素:一项针对纵向结构化六年级临床实习的队列研究。

Determinants of undergraduate medical students' satisfaction with clinical supervision: A cohort study in a longitudinally structured sixth year clinical placement.

作者信息

Wagner-Menghin Michaela, Hofhansl Angelika, Bach Lena, Mayer Anna-Maria, Rieder Anita, Zlabinger Gerhard

机构信息

Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090, Vienna, Austria.

Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, 1090, Vienna, Austria.

出版信息

Wien Klin Wochenschr. 2024 Dec 6. doi: 10.1007/s00508-024-02477-4.

Abstract

BACKGROUND

Work satisfaction is associated with fewer employee turnover intentions, increased job engagement and interest, and has a greater impact on employee well-being than environmental factors, such as workload. In workplace learning, clinical supervisors promote student satisfaction by meeting students' supervision needs in providing safe practice opportunities, training, and guidance in the social field. To quantitatively investigate this relationship, we proposed a supervision deficit index as a measure of learner-centered supervision received and explored its correlation with satisfaction in workplace learning.

METHOD

In total, 1017 Austrian medical students (2015-2017) in year 6 selected the 5 most helpful supervisory activities (from 26 options) and rated their experience levels of these activities during surgery and internal medicine placement. A supervision deficit index was then created (range 0-3; 0 = no deficit).

RESULTS

Students with no, minor or moderate supervision deficits reported higher overall satisfaction with their placements than those experiencing considerable deficits. Students' gender, clinical experience, hospital size, placement year, and clinical field did not influence the relationship. The deficit index's psychometric qualities were good. Training activities supporting competence, such as discussing patients, planning disease management, and practicing skills, were selected more often than activities supporting autonomy, such as an appropriate level of clinical duties, and social relatedness.

DISCUSSION

Students favored competence support. Highlighting the importance of autonomy support to students and encouraging supervisors to engage in learner-centered supervision may improve the supervision experience and work satisfaction for both. The deficit index can be used to evaluate the effects of such interventions.

摘要

背景

工作满意度与较低的员工离职意愿、更高的工作投入度和兴趣相关,并且相较于工作量等环境因素,对员工幸福感的影响更大。在 workplace learning 中,临床督导通过满足学生在提供安全实践机会、培训以及社交领域指导方面的督导需求来提升学生满意度。为了定量研究这种关系,我们提出了一个督导不足指数,作为衡量以学习者为中心的督导接受程度的指标,并探究其与 workplace learning 满意度之间的相关性。

方法

总共 1017 名奥地利医学专业六年级学生(2015 - 2017 年)从 26 个选项中选出 5 项最有帮助的督导活动,并对他们在外科和内科实习期间这些活动的体验水平进行评分。然后创建了一个督导不足指数(范围为 0 - 3;0 = 无不足)。

结果

没有、有轻微或中度督导不足的学生对实习的总体满意度高于有严重督导不足的学生。学生的性别、临床经验、医院规模、实习年份和临床领域并未影响这种关系。该不足指数的心理测量学质量良好。支持能力的培训活动,如讨论患者、规划疾病管理和练习技能,比支持自主性的活动,如适当水平的临床职责和社交相关性,被选取得更频繁。

讨论

学生更倾向于能力支持。向学生强调自主性支持的重要性,并鼓励督导进行以学习者为中心的督导,可能会改善双方的督导体验和工作满意度。该不足指数可用于评估此类干预措施效果。

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