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一项针对本科医学生的单次复原力与职业素养教程的整群随机交叉试验。

A cluster randomised crossover trial of single resilience and professionalism tutorials among undergraduate medical students.

作者信息

Byrne David, Hickey Anne, Harkin Denis, Ryan Aine, Moran Catherine, Boland Fiona, Illing Jan, Staines Laura, Abdelnasser Mohamed, Mellon Lisa, Kelleher Caroline, Doyle Frank

机构信息

Department of Health Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland.

Centre for Professionalism in Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Med Educ Online. 2025 Dec;30(1):2529964. doi: 10.1080/10872981.2025.2529964. Epub 2025 Jul 16.

Abstract

BACKGROUND

Evidence suggests that targeted interventions can improve medical students' perceptions of professionalism and professional identity formation, resilience and coping skills. However, it is unclear how many educational sessions are required for a meaningful impact. We aimed to determine the impact of single resilience/professionalism tutorials on Year 1 medical students' coping self-efficacy and resilience and perceptions of professionalism and professional identity formation. We also conducted a qualitative process evaluation.

METHODS

A cluster crossover design was used to evaluate tutorials. Student groups were randomly allocated to 'resilience first' and 'professionalism first' classes, followed immediately by the alternative tutorial. Students ( = 106) completed the Coping Self-Efficacy Scale (CSES) and Penn State Questionnaire on Professionalism (PSCOM) before the first tutorial, between tutorials, and after the second tutorial. Differences in CSES and PSCOM scores between groups were assessed using multivariate analysis of variance. Findings were presented to students (=6) and focus group data were analysed using reflective thematic analysis.

RESULTS

Within-group effects showed significant increases in scores for CSES and PSCOM, but irrespective of original group allocation. Qualitative results suggested three themes: positive aspects, limitations, and improving training. Several logistical issues were identified that may have inhibited tutorial efficacy.

CONCLUSION

While we found increased self-efficacy and professionalism scores, these could not be related to the efficacy of respective single tutorials, suggesting that multiple tutorials are required to impact these outcomes. While cross-over designs are feasible to implement, logistical issues may detract from their efficacy. Tutorials could potentially be improved by introducing more interactive learning methods.

摘要

背景

有证据表明,针对性干预可改善医学生对专业精神、职业身份形成、适应力和应对技能的认知。然而,尚不清楚需要多少次教育课程才能产生有意义的影响。我们旨在确定单次适应力/专业精神辅导课对一年级医学生应对自我效能感、适应力以及专业精神和职业身份形成认知的影响。我们还进行了定性过程评估。

方法

采用整群交叉设计来评估辅导课。学生小组被随机分配到“先适应力”组和“先专业精神”组,随后立即接受另一门辅导课。106名学生在第一次辅导课之前、两次辅导课之间以及第二次辅导课之后完成了应对自我效能量表(CSES)和宾夕法尼亚州立大学专业精神问卷(PSCOM)。使用多变量方差分析评估两组之间CSES和PSCOM分数的差异。向6名学生展示了研究结果,并使用反思性主题分析对焦点小组数据进行了分析。

结果

组内效应显示CSES和PSCOM分数显著提高,但与最初的分组无关。定性结果提出了三个主题:积极方面、局限性和改进培训。确定了几个可能会抑制辅导课效果的后勤问题。

结论

虽然我们发现自我效能感和专业精神分数有所提高,但这些与各自单次辅导课的效果无关,这表明需要多次辅导课才能影响这些结果。虽然交叉设计实施起来可行,但后勤问题可能会削弱其效果。通过引入更多互动式学习方法,辅导课可能会得到改善。

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