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A framework for reinitiating global academic exchange in the context of the COVID-19 pandemic. 新冠肺炎大流行背景下重启全球学术交流框架。
IF 3.1 Q2 Medicine Pub Date : 2022-09-09 DOI: 10.5116/ijme.62fa.0af4
Caitrin M Kelly, Fatma Some, Daniel A Guiles, Matthew Turissini, Adrian Gardner, Debra K Litzelman
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引用次数: 0
Comparing achievements of medical graduates in an alternative unique pre-medical track vs regular medical track. 比较另类独特的医学预科课程与常规医学课程的医学毕业生的成就。
IF 3.1 Q2 Medicine Pub Date : 2022-09-02 DOI: 10.5116/ijme.62f6.10b6
Shimon Amar, Elena Chernin, Gabriel Schreiber, Michael Friger, Angel Porgador

Objectives: To evaluate the association between the achievements of medical students and whether they were admitted via the pre-medical track or the regular direct track.

Methods: We performed a comparative retrospective data study using data from a three-year experimental cohort in a six-year medical school. We analyzed the academic achievements of all students admitted at one Israeli medical school between 2013-2015, either directly to the six-year program or via a pre-medical track. We compared averages of both yearly final grades and final medical examinations grades between the two groups. Descriptive statistics were calculated and differences between groups were evaluated using multivariate analysis.

Results: Of the 324 students included in the study, 65 (20.1%) were enrolled in all three cohorts of the pre-medical track. Age and Gender distribution were nearly similar for both tracks. For the first two cohorts, the average final grades of year one of pre-medical students were significantly higher than those of regular direct track (F=(3,167) 6.10, p=0.001), but the opposite was true for the third cohort (F=(3,110)2.38, p=0.073). No further statistically significant differences were found neither between the groups in their final exams grades nor between choosing a MD/PhD optional track and admission pathway.

Conclusions: Our results suggest promising achievements with the pre-medical admission pathway. This should encourage further discussion about the significant potential human resources lost by current admission processes and may question the effectiveness of six-year programs in medical schools.

目的:评价医学生的学业成绩与是否通过医学预科或常规直接入学的关系。方法:我们使用一所六年制医学院三年实验队列的数据进行了一项比较回顾性数据研究。我们分析了2013-2015年间被一所以色列医学院录取的所有学生的学术成就,这些学生要么直接进入6年制课程,要么通过医学预科课程进入。我们比较了两组的年度期末成绩和期末体检成绩的平均值。计算描述性统计数据,并采用多变量分析评估组间差异。结果:在纳入研究的324名学生中,65名(20.1%)参加了医学预科课程的所有三个队列。年龄和性别分布在两个轨道上几乎相似。在前两个队列中,医学预科学生第一年的平均期末成绩显著高于常规直接跟踪的学生(F=(3167) 6.10, p=0.001),而在第三个队列中则相反(F=(3110)2.38, p=0.073)。两组学生在期末考试成绩上,以及在选择医学博士/博士选修课程和录取途径上,都没有发现进一步的统计学显著差异。结论:我们的研究结果表明,医学前入学途径取得了可喜的成果。这应该鼓励进一步讨论当前录取程序所损失的大量潜在人力资源,并可能质疑医学院6年课程的有效性。
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引用次数: 1
Virtual global health in graduate medical education: a systematic review. 研究生医学教育中的虚拟全球健康:系统综述。
IF 3.1 Q2 Medicine Pub Date : 2022-08-31 DOI: 10.5116/ijme.62eb.94fa
Lisa Umphrey, Nora Lenhard, Suet Kam Lam, Nathaniel E Hayward, Shaina Hecht, Priya Agrawal, Amy Chambliss, Jessica Evert, Heather Haq, Stephanie M Lauden, George Paasi, Mary Schleicher, Megan Song McHenry

Objectives: To synthesize recent virtual global health education activities for graduate medical trainees, document gaps in the literature, suggest future study, and inform best practice recommendations for global health educators.

Methods: We systematically reviewed articles published on virtual global health education activities from 2012-2021 by searching MEDLINE, EMBASE, Cochrane Library, ERIC, Scopus, Web of Science, and ProQuest Dissertations & Theses A&I. We performed bibliography review and search of conference and organization websites. We included articles about primarily virtual activities targeting for health professional trainees. We collected and qualitatively analyzed descriptive data about activity type, evaluation, audience, and drivers or barriers. Heterogeneity of included articles did not lend to formal quality evaluation.

Results: Forty articles describing 69 virtual activities met inclusion criteria. 55% of countries hosting activities were high-income countries. Most activities targeted students (57%), with the majority (53%) targeting trainees in both low- to middle- and high-income settings. Common activity drivers were course content, organization, peer interactions, and online flexibility. Common challenges included student engagement, technology, the internet, time zones, and scheduling. Articles reported unanticipated benefits of activities, including wide reach; real-world impact; improved partnerships; and identification of global health practice gaps.

Conclusions: This is the first review to synthesize virtual global health education activities for graduate medical trainees. Our review identified important drivers and challenges to these activities, the need for future study on activity preferences, and considerations for learners and educators in low- to middle-income countries. These findings may guide global health educators in their planning and implementation of virtual activities.

目的:综合最近针对医学研究生的虚拟全球健康教育活动,记录文献中的空白,提出未来的研究建议,并为全球健康教育者提供最佳实践建议。方法:通过检索MEDLINE、EMBASE、Cochrane Library、ERIC、Scopus、Web of Science和ProQuest dissert&theses A&I,系统回顾了2012-2021年间发表的关于虚拟全球健康教育活动的文章。我们对会议和组织网站进行了参考文献审查和搜索。我们收录了主要针对卫生专业受训人员的虚拟活动的文章。我们收集并定性分析了有关活动类型、评估、受众和驱动因素或障碍的描述性数据。纳入文章的异质性不利于正式的质量评估。结果:40篇描述69个虚拟活动的文章符合纳入标准。55%的活动主办国为高收入国家。大多数活动针对学生(57%),大多数(53%)针对中低收入和高收入环境中的受训人员。常见的活动驱动因素是课程内容、组织、同伴互动和在线灵活性。常见的挑战包括学生参与、技术、互联网、时区和日程安排。文章报道了活动的意想不到的好处,包括广泛的影响;现实世界的影响;改善合作关系;确定全球卫生实践差距。结论:本文首次综述了针对医学研究生的虚拟全球健康教育活动。我们的综述确定了这些活动的重要驱动因素和挑战,未来研究活动偏好的必要性,以及中低收入国家学习者和教育工作者的考虑因素。这些发现可以指导全球卫生教育工作者规划和实施虚拟活动。
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引用次数: 7
Transfer of anatomy during surgical clerkships: an exploratory study of a student-staff partnership. 外科实习期间解剖学的转移:学生与工作人员合作的探索性研究。
IF 3.1 Q2 Medicine Pub Date : 2022-08-31 DOI: 10.5116/ijme.62eb.850a
Josefin Ivarson, André Hermansson, Björn Meister, Hugo Zeberg, Klara Bolander Laksov, Wilhelmina Ekström

Objectives: This qualitative study aims to explore how fourth-year medical students on the surgery course perceived a clinical anatomy workshop organised by near-peer student teachers in partnership with faculty.

Methods: Forty-seven medical students participated in a workshop on clinical anatomy in the dissection laboratory. A voluntary response sampling method was used. The students' perceptions of the workshop were explored through a thematic content analysis of transcribed, semi-structured group interviews and written comments.

Results: A majority of the students had not revisited the dissection laboratory since their second year, and all students described the workshop as a unique opportunity to vertically integrate anatomical knowledge. Four main themes were identified as most valuable for the students' learning experience, namely that the workshop 1) was taught by knowledgeable and friendly near-peer tutors (NPTs), 2) consisted of highly relevant anatomical content, 3) offered a hands-on experience of cadavers in the dissection laboratory, and 4) was taught in a focused session in the middle of the surgery course.

Conclusions:  This study shows how hands-on workshops in clinical anatomy, developed in student-staff partnerships and taught by NPTs, can enable senior medical students to recall and vertically integrate anatomical knowledge during surgical clerkships. The results have implications for curriculum design, giving voice to senior students' wishes for spaced repetition and vertical integration of pre-clinical anatomy knowledge during their clinical training. Moreover, this study may inspire other students and faculty to develop similar near-peer teaching activities through student-staff partnerships.

目的:本定性研究旨在探讨外科课程的四年级医学生如何感知由同侪学生教师与教师合作组织的临床解剖学研讨会。方法:47名医科学生参加解剖实验室的临床解剖学研讨会。采用自愿回答抽样方法。学生们对研讨会的看法是通过对转录、半结构化的小组访谈和书面评论的主题内容分析来探讨的。结果:大多数学生自二年级以来没有再访问解剖实验室,所有学生都将研讨会描述为垂直整合解剖知识的独特机会。四个主要的主题被认为是最有价值的学生的学习经验,即工作坊1)由知识渊博和友好的近同伴导师(NPTs)教授,2)由高度相关的解剖学内容组成,3)提供解剖实验室的尸体实践经验,4)在手术课程的中间集中讲授。结论:本研究表明,由npt教授的临床解剖学实践工作坊,在学生与教师的合作中开发,可以使高年级医学生在外科实习期间回忆和垂直整合解剖学知识。研究结果对课程设计具有启示意义,表达了高年级学生在临床训练中对临床前解剖学知识的间隔重复和垂直整合的愿望。此外,本研究可能会启发其他学生和教师通过师生合作伙伴关系开展类似的近同伴教学活动。
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引用次数: 2
Effect of COVID-19 Pandemic on Medical Students—A Single Center Study COVID-19大流行对医学生的影响——一项单中心研究
IF 3.1 Q2 Medicine Pub Date : 2022-08-31 DOI: 10.3390/ime1010004
Maria Poluch, R. Ries, Monjur Ahmed
Background: The COVID-19 pandemic caused medical education to shift unprecedentedly, leading medical schools to switch to virtual platforms and modify student-patient interactions. On top of educational changes, medical students adapted to their support network, finances, and mental and physical health changes. Objective: To understand the holistic impact of COVID-19 on medical students and medical education and identify how to distribute resources during future educational disruptions in a large medical university in the United States. Methods: An anonymous online survey was distributed to medical students at Sidney Kimmel Medical College, Philadelphia, in February 2021. Participants self-reported the impact of the COVID-19 pandemic on their medical education, family life, financial burden, mental health, and physical health. Results: 168 out of 1088 students at Sidney Kimmel Medical College completed the survey, with 58% (98/168) of the respondents identifying as female. The class breakdown was as follows: 38% (63/168) first years, 18% (31/168) second years, 21% (36/168) third years, 20% (34/168) fourth years, and 2% (4/168) were considered “other” (including research year, Master’s program). A total of 28% of respondents reported developing new mental illness, with second years having the highest incidence at 39%. In total, 42% said the pandemic affected a previous mental health condition. Further, 96% of third and fourth years reported COVID-19 affected their clinical rotations. In total, 68% of first years reported their entrance to medical school was severely affected. Moreover, 13% reported losing a family member due to COVID-19, and 7% reported personal sickness due to COVID-19. Additionally, 16% reported incurring a financial burden due to the pandemic. Conclusion: COVID-19 impacted the well-being of students by affecting their mental health and financial burdens. Clinical rotations and medical school entrance were the most problematic aspects. In the future setting of major educational disruptions, this study provides a starting point for where to focus resources, mental health support, financial support, and academic flexibility.
背景:新冠肺炎大流行导致医学教育发生了前所未有的转变,导致医学院转向虚拟平台,并修改了学生与患者的互动。除了教育方面的变化,医学生还适应了他们的支持网络、经济状况以及心理和身体健康方面的变化。目的:了解新冠肺炎疫情对美国一所大型医科大学医学生和医学教育的整体影响,并确定在未来教育中断期间如何分配资源。方法:于2021年2月对费城Sidney Kimmel医学院的医学生进行匿名在线调查。参与者自我报告了2019冠状病毒病大流行对其医学教育、家庭生活、经济负担、心理健康和身体健康的影响。结果:悉尼金梅尔医学院1088名学生中有168人完成了调查,其中58%(98/168)的受访者为女性。年级分类如下:第一年占38%(63/168),第二年占18%(31/168),第三年占21%(36/168),第四年占20%(34/168),2%(4/168)被认为是“其他”(包括研究年,硕士课程)。总共有28%的受访者报告出现了新的精神疾病,第二年的发病率最高,为39%。总共有42%的人表示,疫情影响了他们之前的精神健康状况。此外,96%的第三和第四年报告的COVID-19影响了他们的临床轮换。总共有68%的一年级新生报告说,他们进入医学院时受到了严重影响。此外,13%的人报告因COVID-19失去了一位家庭成员,7%的人报告因COVID-19生病。此外,16%的人报告因大流行而造成财政负担。结论:COVID-19通过影响学生的心理健康和经济负担来影响学生的幸福感。临床轮转和医学院入学是最成问题的方面。在未来重大教育中断的背景下,本研究为在哪里集中资源、心理健康支持、财政支持和学术灵活性提供了一个起点。
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引用次数: 1
A qualitative study of factors promoting EBM learning among medical students in Japan. 促进日本医学生循证医学学习因素的质性研究。
IF 3.1 Q2 Medicine Pub Date : 2022-08-26 DOI: 10.5116/ijme.62eb.7c19
Yoshihiro Kataoka, Takami Maeno, Takashi Inaba, Sayaka Ninn, Masatsune Suzuki, Tetsuhiro Maeno

Objectives: To identify the elements needed to facilitate undergraduate EBM learning among Japanese medical students.

Methods: We conducted a qualitative study based on individual semi-structured interviews. Participants were physicians working at universities, teaching hospitals, or clinics who teach EBM to medical students. Purposive sampling was used to recruit participants via email through the researchers' acquaintances. Six physicians agreed to participate in the study and were interviewed individually from October 2019 to January 2020. The interviewees were asked about their own EBM learning and teaching experiences, what they kept in mind when teaching EBM to medical students, and what they felt was needed to improve current undergraduate EBM education. Interviews were recorded. Transcripts were analysed using thematic analysis.

Results: Thematic analysis extracted five themes: finding foreground questions, observing role models, active learning, understanding patient backgrounds, and understanding the reason for learning EBM. To promote EBM education for medical students, it is first necessary for students to actively participate in clinical practice and identify foreground questions by observing their supervisors practicing EBM. In addition to acquiring skills in information retrieval and critical appraisal, understanding a patient's background leads to understanding the significance of learning EBM, which improves students' motivation to learn EBM.

Conclusions: This study identified five themes that promote undergraduate EBM education. Curriculum development incorporating these elements would improve EBM education in Japan and other countries.

目的:确定促进日本医科学生本科循证医学学习所需的要素。方法:基于个体半结构化访谈进行定性研究。参与者是在大学、教学医院或诊所工作的医生,他们向医科学生教授循证医学。有目的的抽样是通过研究人员的熟人通过电子邮件招募参与者。6名医生同意参加这项研究,并在2019年10月至2020年1月期间接受了单独采访。受访者被问及他们自己的循证医学学习和教学经历,他们在向医学生教授循证医学时记住了什么,以及他们认为需要改进当前的本科循证医学教育。采访被记录下来。使用主题分析对转录本进行分析。结果:主题分析提取了发现前景问题、观察榜样、主动学习、了解患者背景、理解学习循证医学的原因五个主题。推进医学生循证医学教育,首先需要学生积极参与临床实践,通过观察导师实践循证医学,发现前景问题。除了获得信息检索和批判性评价的技能外,了解患者的背景还可以了解学习循证医学的意义,从而提高学生学习循证医学的动机。结论:本研究确定了促进本科循证医学教育的五个主题。结合这些要素的课程开发将改善日本和其他国家的循证医学教育。
{"title":"A qualitative study of factors promoting EBM learning among medical students in Japan.","authors":"Yoshihiro Kataoka,&nbsp;Takami Maeno,&nbsp;Takashi Inaba,&nbsp;Sayaka Ninn,&nbsp;Masatsune Suzuki,&nbsp;Tetsuhiro Maeno","doi":"10.5116/ijme.62eb.7c19","DOIUrl":"https://doi.org/10.5116/ijme.62eb.7c19","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the elements needed to facilitate undergraduate EBM learning among Japanese medical students.</p><p><strong>Methods: </strong>We conducted a qualitative study based on individual semi-structured interviews. Participants were physicians working at universities, teaching hospitals, or clinics who teach EBM to medical students. Purposive sampling was used to recruit participants via email through the researchers' acquaintances. Six physicians agreed to participate in the study and were interviewed individually from October 2019 to January 2020. The interviewees were asked about their own EBM learning and teaching experiences, what they kept in mind when teaching EBM to medical students, and what they felt was needed to improve current undergraduate EBM education. Interviews were recorded. Transcripts were analysed using thematic analysis.</p><p><strong>Results: </strong>Thematic analysis extracted five themes: finding foreground questions, observing role models, active learning, understanding patient backgrounds, and understanding the reason for learning EBM. To promote EBM education for medical students, it is first necessary for students to actively participate in clinical practice and identify foreground questions by observing their supervisors practicing EBM. In addition to acquiring skills in information retrieval and critical appraisal, understanding a patient's background leads to understanding the significance of learning EBM, which improves students' motivation to learn EBM.</p><p><strong>Conclusions: </strong>This study identified five themes that promote undergraduate EBM education. Curriculum development incorporating these elements would improve EBM education in Japan and other countries.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10717569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Do incoming residents vary in measures of emotional status even prior to residency training? 在住院医师培训之前,新住院医师的情绪状态是否会有所不同?
IF 3.1 Q2 Medicine Pub Date : 2022-07-29 DOI: 10.5116/ijme.62cb.f308
Jeanne L Jacoby, Amy B Smith, Robert D Barraco, Marna Rayl Greenberg, Elaine A Donoghue, Bryan G Kane, Jennifer E Macfarlan, Lauren M Crowley, Kevin R Weaver, Joann Farrell Quinn

Objectives: To determine whether Empathy, Emotional Intelligence, and Burnout scores differ by specialty in incoming residents.

Methods: This is a single-site, prospective, cross-sectional study. Three validated survey instruments, the Jefferson Scale of Physician Empathy, Maslach Burnout Inventory, and Emotional and Social Competency Inventory, were written into a survey platform as a single 125-question Qualtrics survey. Over three academic years, 2015-2017, 229 incoming residents across all specialties were emailed the survey link during orientation. Residents were grouped by incoming specialty with anonymity assured. A total of 229 responses were included, with 121 (52.8%) identifying as female. Statistical analysis was performed using the Analysis of Variance or Kruskal-Wallis test, Chi-Square or Fisher's Exact test, and Independent Samples t-test or Mann Whitney U test. A Bonferroni correction was applied for pairwise comparisons.

Results: Family Medicine had a higher median Jefferson Scale of Physician Empathy score (127) compared to Emergency Medicine (115), (U=767.7, p=0.0330). Maslach Burnout Inventory depersonalization and personal accomplishment subcategory scores showed a significant difference between specialties when omnibus tests were performed, but pairwise comparisons with emergency medicine residents showed no differences. Differences were found in the Maslach Burnout Inventory categories of Depersonalization (χ2(8, N=229) =15.93, p=0.0434) and Personal Accomplishment level (χ2(8, N=229) =20.80, p=0.0077) between specialties.

Conclusions: Differences in measures of well-being exist across specialties, even prior to the start of residency training. The implication for educators of residency training is that some incoming residents, regardless of specialty, already exhibit troublesome features of burnout, and resources to effectively deal with these residents should be developed and utilized.

目的:了解新住院医师共情、情绪智力和倦怠得分是否因专科而异。方法:这是一项单点、前瞻性、横断面研究。三个有效的调查工具,杰弗逊医生共情量表,马斯拉克倦怠量表,以及情绪和社会能力量表,被写入一个调查平台,作为一个单一的125个问题的质量调查。在2015-2017年的三个学年里,所有专业的229名新住院医生在迎新期间通过电子邮件发送了调查链接。住院医生按照即将到来的专业进行分组,并保证匿名。共纳入229份回复,其中121份(52.8%)为女性。采用方差分析或Kruskal-Wallis检验、卡方检验或Fisher精确检验、独立样本t检验或Mann Whitney U检验进行统计分析。两两比较采用Bonferroni校正。结果:家庭医学医师共情杰弗逊量表得分中位数(127)高于急诊医学(115),差异有统计学意义(U=767.7, p=0.0330)。Maslach倦怠量表去人格化和个人成就子类别得分在综合测试中显示出不同专业间的显著差异,但在急诊科住院医师间两两比较无显著差异。Maslach倦怠量表中人格解体类别(χ2(8, N=229) =15.93, p=0.0434)和个人成就感水平(χ2(8, N=229) =20.80, p=0.0077)在各专业间存在差异。结论:即使在住院医师培训开始之前,不同专业的幸福感指标也存在差异。对住院医师培训教育者的启示是,一些新来的住院医师,无论专业如何,已经表现出倦怠的麻烦特征,应该开发和利用有效处理这些住院医师的资源。
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引用次数: 2
Psychometric properties of a French version of the Jefferson Scale of Empathy. 法语版杰弗逊共情量表的心理测量特性。
IF 3.1 Q2 Medicine Pub Date : 2022-07-29 DOI: 10.5116/ijme.62d2.8497
Mariem Ghardallou, Chekib Zedini, Jihene Sahli, Thouraya Ajmi, Hedi Khairi, Ali Mtiraoui

Objective: To assess the reliability and construct validity of a French version of the Jefferson Scale of Empathy-Students.

Methods: A cross-sectional study was performed among undergraduate medical students in Tunisia. A total of 833 students completed a French version of the JSE-S using convenience sampling. To identify the internal consistency aspect of the reliability, Cronbach's alpha coefficient was computed. Moreover, to assess the construct validity, the sample was randomly divided into two groups. Data from the first group (n=415) were subjected to exploratory factor analysis (EFA), with principal axing factoring (PAF) and oblimin rotation, to re-examine the underlying factor structure of the scale. Data from the second group (n=419) were used for confirmatory factor analysis (CFA) to confirm its latent variable structure. Some goodness-of-fit indices were used to assess the hypothesized model. Gender groups were compared using a t-test to check the known-group validity.

Results: Reliability analysis reported an acceptable level of internal consistency, with an overall Cronbach's alpha of 0.78 (95% CI [0.75,0.80]). EFA identified a two-factor structure, accounting for 27.4% of the total variance. The two-factor model produced good fit indices when item correlated errors were considered (χ2/df = 1.95, GFI = 0.92, CFI = 0.90, PCFI = 0.79, PGFI = 0.73 and RMSEA = 0.04). Female students had a statistically significant higher empathy scores than male students (t (830) = - 4.16, p < .001).

Conclusions: The findings support the construct validity and reliability of a French version of the JSE for medical students. This instrument appears to be useful for investigating empathy among French-speaking populations.

目的:评价法语版杰弗逊共情学生量表的信度和结构效度。方法:对突尼斯医科本科学生进行横断面调查。共有833名学生使用方便抽样的方法完成了法语版的JSE-S。为了确定信度的内部一致性方面,计算了Cronbach's alpha系数。此外,为了评估构念效度,样本被随机分为两组。第一组(n=415)的数据进行探索性因子分析(EFA),采用委托保理(PAF)和oblimin轮换,重新检查量表的潜在因子结构。第二组数据(n=419)用于验证性因子分析(CFA)以确定其潜在变量结构。一些拟合优度指标被用来评估假设模型。性别组间比较采用t检验检验已知组效度。结果:信度分析报告了可接受的内部一致性水平,总体Cronbach's α为0.78 (95% CI[0.75,0.80])。EFA确定了一个双因素结构,占总方差的27.4%。考虑项目相关误差后,双因素模型拟合指标较好(χ2/df = 1.95, GFI = 0.92, CFI = 0.90, PCFI = 0.79, PGFI = 0.73, RMSEA = 0.04)。女生的共情得分显著高于男生(t (830) = - 4.16, p < .001)。结论:本研究结果支持法语版医学生自我评价量表的结构效度和信度。这个工具似乎对调查法语人群的同理心很有用。
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引用次数: 0
Medical students' confidence and competence with prescribing in ST-elevation myocardial infarction: a mixed-methods study. 医科学生对 ST 段抬高型心肌梗死处方的信心和能力:一项混合方法研究。
IF 1.6 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2022-07-29 DOI: 10.5116/ijme.62c2.c33c
Teeranan Angkananard, Panida Issarasenarak, Pawita Teerawattananon, Maneekarn Kosulawath, Varunrut Samrejphol, Kamolnetr Okanurak

Objectives: To explore factors associated with prescribing confidence and competence of final-year medical students for prescribing antiplatelet and fibrinolytic agents in ST-segment elevation myocardial infarction (STEMI).

Methods: The study was conducted among final-year medical students with a triangular convergent mixed-methods approach. First, an online survey was conducted using a voluntary sampling method with concurrent in-depth interviews performed. The survey data was analysed using descriptive statistics and paired t-tests, while survey factors were compared using the chi-squared or Fisher's exact test. The interview data were coded and analysed thematically. The relations between the qualitative and quantitative findings were finally described.

Results: Totally 92 validly replied to the questionnaire, and 20 participated in the interviews. The quantitative analysis indicated that they had high competence in the diagnosis of STEMI and prescribing antiplatelet and fibrinolytic agents. The mean confidence score of prescribing for both was medium and was significantly lower in fibrinolytic agents. (M=3.3, SD=1.1 vs. M=2.8, SD=1.0, t(91)=5.39, p<0.01). Their experience, knowledge, and mentoring were accounted for, considering the prescribing confidence factors in both approaches. Besides, providing guidelines and standing orders were derived from the interview data.

Conclusions: This study has demonstrated that final-year medical students have a high ability to diagnose and prescribe essential medications in STEMI but tend to have low confidence in prescribing fibrinolytic agents. Experiential learning, mentorship and providing guidelines can help them, especially in emergency settings to prescribe confidently and safely. Further multicenter studies on undergraduate and graduate medical students' confidence and perspective of prescribing are required, especially for high-alert medications.

目的探讨与应届医学生在 ST 段抬高型心肌梗死(STEMI)中开具抗血小板和纤溶药物处方的信心和能力相关的因素:本研究采用三角聚合混合方法在医学专业毕业班学生中开展。首先,采用自愿抽样法进行在线调查,同时进行深度访谈。调查数据采用描述性统计和配对 t 检验进行分析,调查因素则采用卡方检验或费雪精确检验进行比较。对访谈数据进行了编码和专题分析。最后描述了定性和定量结果之间的关系:共有 92 人有效回答了问卷,20 人参加了访谈。定量分析显示,他们在诊断 STEMI 和开具抗血小板及纤维蛋白溶解药物处方方面具有很高的能力。开具抗血小板药物和纤维蛋白溶解药物处方的平均信心分数为中等,而开具纤维蛋白溶解药物处方的平均信心分数明显较低。(M=3.3, SD=1.1 vs. M=2.8, SD=1.0, t(91)=5.39, p结论:本研究表明,应届医学生诊断和处方 STEMI 必要药物的能力较高,但对处方纤溶药物的信心不足。经验学习、导师指导和提供指南可以帮助他们,尤其是在急诊环境中自信、安全地开药。需要进一步开展多中心研究,了解医科本科生和研究生对处方的信心和看法,尤其是对高警戒药物的处方。
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引用次数: 0
A pedagogical model to enhance nurses' ability to support patient learning: an educational design research study. 一种提高护士支持病人学习能力的教学模式:一项教育设计研究。
IF 3.1 Q2 Medicine Pub Date : 2022-07-29 DOI: 10.5116/ijme.62c2.b9c4
Lena Engqvist Boman, Kay Sundberg, Lena-Marie Petersson, Malin Backman, Charlotte Silén

Objectives: To design, apply, evaluate, and analyse a pedagogical model to enhance nurses' ability to create pedagogical encounters to support patients' learning.

Methods: The study relies on an educational design research approach. A pedagogical model based on learning theories was designed, applied, evaluated, and analysed in a specialist nursing programme in cancer care. All students (n=28) who attended the programme accepted to participate in the evaluation of the model. Their perception of the learning activities was evaluated in a questionnaire, and 16 (57%) students responded. The students' learning was assessed in written assignments, including all students. Descriptive statistics, content analysis and theoretical reasoning, were used to analyse data and interpret the usefulness and shortcomings of the model.

Results: The most appreciated learning activities were to study learning theories, observe pedagogical encounters, act as a critical friend, and document one's own pedagogical encounters. The written assignments about observing and performing their own pedagogical encounters with patients showed students' increased awareness of how to support patients' learning. The clinical supervisors' lack of pedagogical knowledge inhibited the feedback on students' performances.

Conclusions: The theoretical analysis of the evaluation identified strengths and needs for further development. The strengths tend to be the ongoing learning process created by learning activities supporting students to continuously study, experience, and apply their knowledge. Nurse supervisors and other stakeholders at the clinics are suggested to be involved in improving the design and require pedagogical competence. Further research should include observational and interview studies related to students' performance in pedagogical encounters.

目的:设计、应用、评估和分析一种教学模式,以提高护士创造教学体验以支持患者学习的能力。方法:本研究采用教育设计研究方法。一个基于学习理论的教学模型被设计、应用、评估和分析在癌症护理的专业护理方案中。所有参加课程的学生(n=28)接受参与模型的评估。他们对学习活动的看法在问卷中进行了评估,有16名(57%)学生做出了回应。所有学生的学习情况都以书面作业的形式进行评估。使用描述性统计、内容分析和理论推理来分析数据并解释模型的有用性和缺点。结果:最受欢迎的学习活动是研究学习理论、观察教学遭遇、充当批判性朋友和记录自己的教学遭遇。关于观察和执行自己与患者的教学接触的书面作业表明,学生们对如何支持患者学习的意识有所提高。临床督导缺乏教学知识,抑制了对学生表现的反馈。结论:通过理论分析,确定了评价的优势和需要进一步发展的地方。优势往往是通过支持学生不断学习、体验和应用知识的学习活动所创造的持续学习过程。建议诊所的护士主管和其他利益相关者参与改进设计,并要求具备教学能力。进一步的研究应包括与学生在教学遭遇中的表现有关的观察和访谈研究。
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International Journal of Medical Education
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