Heckmann Markus B, Mages Christine, Finke Daniel, Reich Christoph, Haney Ailís Ceara, Riedel Caroline, Bugaj Till Johannes, Frey Norbert, Rahm Ann-Kathrin
Department for Cardiology, Angiology, and Pneumology, Heidelberg University Hospital, Heidelberg, Germany.
German Centre for Cardiovascular Research: DZHK, Partner site Heidelberg, Mannheim, Germany.
PLoS One. 2025 Sep 2;20(9):e0331057. doi: 10.1371/journal.pone.0331057. eCollection 2025.
Final year medical students (FYMS) in Germany transfer theoretical knowledge to clinical practice. However, there is a deficiency in structured guidance and feedback and self-reflective practices are often neglected. This study aims to investigate the impact of three mentoring strategies on cultivating self-reflection and introspection in FYMS and to assess competence during routine activities.
Final year medical students (n = 46) completing a mandatory internal medicine rotation at Heidelberg University Hospital were randomized to either passive mentoring or active mentoring (split into structured and unstructured sessions). Across an 8-week rotation, we assessed the influence of mentoring styles on self-reflection and introspection (SRIS) at the beginning and at the end of the rotation. Changes in SRIS were compared by Mann Whitney U tests. Translated, adapted and newly generated questionnaires were analysed calculating cronbach's alpha and optimized using an item-drop analysis.
Key findings include: a general reluctance to initiate mentor-mentee relationships (1 out of 15 in the passive group sought meetings, p < 0.0001), a propensity for FYMS to undervalue their competence compared to external evaluations (3.6 vs. 4.5 p < 0.0001), a tendency for female FYMS to have higher perceived competence (PCS) than males, with means of 3.8 vs. 3.3 (p = 0.0021), and a measurable improvement in introspection (SRIS-IN) across all participants by the program's end, regardless of the mentoring style received (median change on scale: 0.25, p = 0.0016). However, the mentoring intervention itself revealed no significant impact on self-reflection.
Active mentoring had little to no effect on self-reflection and insight of final year medical students in Germany in the setting of an 8-week rotation. Interventional learning studies were well accepted, and participation rate was high. However, form completion rates were low. Future studies should focus on increasing form completion rates through additional incentives.
德国的医学专业最后一年学生(FYMS)将理论知识应用于临床实践。然而,在结构化指导和反馈方面存在不足,自我反思的实践也常常被忽视。本研究旨在调查三种指导策略对培养FYMS自我反思和内省能力的影响,并评估其在日常活动中的能力。
在海德堡大学医院完成内科强制轮转的医学专业最后一年学生(n = 46)被随机分为被动指导组或主动指导组(分为结构化和非结构化课程)。在为期8周的轮转期间,我们在轮转开始和结束时评估了指导方式对自我反思和内省(SRIS)的影响。通过曼-惠特尼U检验比较SRIS的变化。对翻译、改编和新生成的问卷进行分析,计算克朗巴哈系数,并使用项目删除分析进行优化。
主要发现包括:普遍不愿建立师徒关系(被动组15人中只有1人寻求会面,p < 0.0001),与外部评估相比,FYMS倾向于低估自己的能力(3.6对4.5,p < 0.0001),女性FYMS的自我感知能力(PCS)往往高于男性,均值分别为3.8和3.3(p = 0.0021),到项目结束时,所有参与者的内省能力(SRIS-IN)都有可测量的提高,无论接受何种指导方式(量表中位数变化:0.25,p = 0.0016)。然而,指导干预本身对自我反思没有显著影响。
在为期8周的轮转中,主动指导对德国医学专业最后一年学生的自我反思和洞察力几乎没有影响。干预性学习研究得到了很好的接受,参与率很高。然而,表格填写率很低。未来的研究应侧重于通过额外的激励措施提高表格填写率。