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探索医学人文在塑造实习表现中的重要性:来自课程类别的见解

Exploring the significance of medical humanities in shaping internship performance: insights from curriculum categories.

作者信息

Chen Chao Ting, Huang Anna Y Q, Hou Po-Hsun, Lin Ji-Yang, Chen His-Han, Huang Shiau-Shian, Yang Stephen J H

机构信息

Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.

Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan.

出版信息

Med Educ Online. 2025 Dec;30(1):2444282. doi: 10.1080/10872981.2024.2444282. Epub 2025 Jan 25.

Abstract

BACKGROUND

Medical Humanities (MH) curricula integrate humanities disciplines into medical education to nurture essential qualities in future physicians. However, the impact of MH on clinical competencies during formative training phases remains underexplored. This study aimed to determine the influence of MH curricula on internship performance.

METHODS

The academic records of 1364 medical students across 8 years of admission cohorts were analyzed. Performance in basic sciences, clinical skills, MH, and internship rotations were investigated, including the subgroup analysis of MH curricula. Ten-fold cross-validation machine learning models (support vector machines, logistic regression, random forest) were performed to predict the internship grades. In addition, multiple variables regression was done to know the independent impact of MH on internship grades.

RESULTS

MH showed the important roles in predicting internship performance in the machine learning model, with substantially reduced predictive accuracy after excluding MH variables (e.g. Area Under the Curve (AUC) declining from 0.781 to 0.742 in logistic regression). Multiple variables regression revealed that MH, after controlling for the scores of other subjects, has the highest odds ratio (OR: 1.29,  < 0.0001) on internship grades. MH explained 29.49% of the variance in internship grades as the primary variable in stepwise regression. In the subgroup analysis of MH curricula, Medical Sociology and Cultural Studies, as well as Communication Skills and Interpersonal Relationships, stood out with AUC values of 0.710 and 0.705, respectively, under logistic regression.

CONCLUSION

MH had the strongest predictive association with clinical competence during formative internship training, beyond basic medical sciences. Integrating humanities merits greater prioritization in medical curricula to nurture skilled, compassionate physicians. Further research should investigate the longitudinal impacts of humanities engagement.

摘要

背景

医学人文(MH)课程将人文学科融入医学教育,以培养未来医生的基本素质。然而,在形成性培训阶段,医学人文对临床能力的影响仍未得到充分探索。本研究旨在确定医学人文课程对实习表现的影响。

方法

分析了8年入学队列中1364名医学生的学业记录。调查了基础科学、临床技能、医学人文和实习轮转方面的表现,包括医学人文课程的亚组分析。采用十倍交叉验证机器学习模型(支持向量机、逻辑回归、随机森林)预测实习成绩。此外,进行多变量回归以了解医学人文对实习成绩的独立影响。

结果

在机器学习模型中,医学人文在预测实习表现方面发挥了重要作用,排除医学人文变量后预测准确性大幅降低(例如逻辑回归中曲线下面积(AUC)从0.781降至0.742)。多变量回归显示,在控制其他学科成绩后,医学人文对实习成绩的优势比最高(OR:1.29,<0.0001)。在逐步回归中,医学人文作为主要变量解释了实习成绩29.49%的方差。在医学人文课程的亚组分析中,医学社会学与文化研究以及沟通技巧与人际关系在逻辑回归下表现突出,AUC值分别为0.710和0.705。

结论

在形成性实习培训期间,医学人文与临床能力的预测关联最强,超越基础医学。在医学课程中应更优先考虑融入人文学科,以培养有技能、有同情心的医生。进一步的研究应调查人文参与的长期影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5819/11770856/dce82cdf832d/ZMEO_A_2444282_F0001_OC.jpg

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