Julian T M
Department of Obstetrics and Gynecology, University of Wisconsin Medical School, Madison 53792, USA.
WMJ. 1998 Feb;97(2):56-62.
To determine how graduating medical students perceive instructional settings, materials, and teachers as to importance or influence upon their education and how they would change curriculum and allocate educational resources based on their experience.
One hundred thirty-nine graduating medical students at the University of Wisconsin, Madison were offered five dollars to complete and return the survey. Students were asked to rate the importance or influence (1 = most important or influential, 5 = least important or influential) of more than forty educational settings, materials, teachers, and which aspects of the curriculum should be emphasized or preserved when educational resources become more limited. Open-ended responses were also allowed. Ratings were analyzed determining a mean and standard deviation. One way analysis of variance was used to determine whether there were differences among groups. When statistically significant differences existed, the Tukey HSD test was used to compare subsets of the group. In the only group with a dissimilar number of responders, T tests were used for comparison.
Sixty-four of 139 (46%) surveys were correctly completed and returned. Students rated the most important and influential parts of their education as experiences in years 3 and 4 of medical school. The most highly rated group of teachers were resident physicians (mean rating = 1.64, F (df = 343) = 12.55, p < .0001) during years 3 and 4 of medical school, followed by full time clinical faculty in years 3 and 4 (mean = 1.78), full time basic science faculty in years 1 and 2 (mean = 1.98), community physicians in years 3 and 4 (mean = 2.15), and teaching assistants in years 1 and 2 (mean = 2.75). Students rated the preservation of teaching efforts in years 1 and 2 (mean = 3.06), developing objective structured clinical examinations (mean = 3.21), and administering "board type" end of course examinations (mean = 3.42), as the lowest priority items for receiving educational resources. Coordination of the basic science and clinical years of medical school (mean = 2.03), problem based learning (mean = 2.08) and preserving teaching effort of years 3 and 4 clinical faculty (mean = 2.09) were the highest priorities for receiving resources. Open-ended comments indicated years 1 and 2 should be condensed and coordinated with years 3 and 4, making learning more clinically oriented.
Students at the end of their medical school education at the University of Wisconsin rate the clinical portions of their training as most important to their medical education and residents as their most important teachers. When asked how best to change medical education, their most common responses were to 1) make years 1 and 2 more clinically oriented, both by including patient care earlier and more often during those years, 2) take the repetitiveness out of the years 1 and 2 curriculum and 3) prepare students for years 3 and 4 with transitional classes.
确定即将毕业的医学生如何看待教学环境、教学材料和教师对其教育的重要性或影响,以及他们将如何根据自身经历改变课程设置并分配教育资源。
向威斯康星大学麦迪逊分校的139名即将毕业的医学生提供5美元报酬,以完成并返还调查问卷。学生们被要求对四十多个教育环境、教学材料、教师的重要性或影响进行评分(1 = 最重要或最有影响力,5 = 最不重要或最没有影响力),并在教育资源变得更加有限时,对课程的哪些方面应予以强调或保留进行评分。同时也允许开放式回答。对评分进行分析,确定均值和标准差。采用单因素方差分析来确定各组之间是否存在差异。当存在统计学显著差异时,使用Tukey HSD检验来比较组内子集。在唯一一组回答者数量不同的组中,使用T检验进行比较。
139份调查问卷中有64份(46%)被正确完成并返还。学生们将医学院3年级和4年级的经历评为其教育中最重要和最有影响力的部分。评分最高的教师群体是医学院3年级和4年级的住院医师(平均评分 = 1.64,F(自由度 = 343)= 12.55,p <.0001),其次是3年级和4年级的全职临床教师(平均 = 1.78)、1年级和2年级的全职基础科学教师(平均 = 1.98)、3年级和4年级的社区医生(平均 = 2.15)以及1年级和2年级的助教(平均 = 2.75)。学生们将1年级和2年级的教学工作保留(平均 = 3.06)、开展客观结构化临床考试(平均 = 3.21)以及进行“委员会式”课程结束考试(平均 = 3.42)评为获得教育资源的最不优先项目。医学院基础科学和临床学年的协调(平均 = 2.03)、基于问题的学习(平均 = 2.08)以及保留3年级和4年级临床教师的教学工作(平均 = 2.09)是获得资源的最高优先事项。开放式评论表明,1年级和2年级应该压缩并与3年级和4年级进行协调,使学习更以临床为导向。
威斯康星大学医学院即将毕业的学生将其培训的临床部分视为对其医学教育最重要的部分,将住院医师视为最重要的教师。当被问及如何最好地改变医学教育时,他们最常见的回答是:1)通过在1年级和2年级更早、更频繁地纳入患者护理,使这两年更以临床为导向;2)去除1年级和2年级课程中的重复性内容;3)通过过渡课程为3年级和4年级的学生做好准备。