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A Pilot Study on Burnout in Medical Students (BuMS) over an Academic Year 医学生一学年倦怠的初步研究
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-08-04 DOI: 10.3390/ime2030016
Frederick J. Ashby, W. Dodd, Emily W. Helm, Daniel Stribling, L. Spiryda, C. Heldermon, Yuxing Xia
Background: Physician burnout is increasingly recognized as a problem in physician well-being and may negatively affect patient care outcomes. Burnout can begin at any point of training or practice, potentially as early as the first year of medical school. Thus, there is a need to characterize possible burnout in medical students as the first step to optimizing strategies for mitigation. Traditionally, burnout has been studied using survey-based variables; however, identifying novel physiological and molecular biomarkers could allow for the expansion of screening and intervention strategies. Methods: In this pilot prospective cohort study, we followed a group of preclinical 1st and 2nd year medical students (n = 9) at the University of Florida over one academic year of medical school. We collected survey responses (Maslach Burnout Inventory [MBI], Patient Health Questionnaire-9 [PHQ-9], and Perceived Stress Scale [PSS]) and measured a panel of candidate physiological biomarkers of burnout (Inflammatory Cytokine Panel, Heart Rate Variability [HRV], and Leukocyte Telomere Length). Results: In the study participants, MBI composite scores and PHQ-9 scores showed a statistically significant increase over the course of an academic year, indicating higher levels of medical student burnout. Additionally, respondents reported a statistically significant decrease in time devoted to exercise, and we measured a significant increase in body mass index (BMI) during the academic year. PSS scores showed an upward trend which was not statistically significant. Likewise, average leukocyte telomere length trended downward, but the change was not statistically significant. There were no measured changes in the serum concentration of pro-inflammatory cytokines, and time-domain heart rate variability metrics did not differ significantly between timepoints. Conclusions: This pilot study supports the notion that burnout can begin early in medical school and is detectable via survey instruments in first-year and second-year medical students even with a small sample size. Additionally, leukocyte telomere length could potentially be a useful biomarker of burnout with supporting data, but we did not observe any statistically significant changes in inflammatory cytokines or heart rate variability. Further investigation into these potential biomarkers with larger cohort sizes is required to fully characterize their clinical utility.
背景:医生职业倦怠越来越被认为是医生健康的一个问题,并可能对病人的护理结果产生负面影响。职业倦怠可以在培训或实践的任何时候开始,可能早在医学院的第一年就开始了。因此,有必要表征医学生可能的职业倦怠,作为优化缓解策略的第一步。传统上,倦怠研究使用基于调查的变量;然而,识别新的生理和分子生物标志物可以扩大筛查和干预策略。方法:在这项前瞻性队列研究中,我们跟踪了一组佛罗里达大学医学院一学年的临床前一年级和二年级医学生(n = 9)。我们收集了调查反馈(Maslach倦怠量表[MBI]、患者健康问卷-9 [PHQ-9]和感知压力量表[PSS]),并测量了倦怠的一组候选生理生物标志物(炎症细胞因子面板、心率变异性[HRV]和白细胞端粒长度)。结果:在研究参与者中,MBI综合得分和PHQ-9得分在一学年的过程中显示出统计学上显著的增加,表明医学生的职业倦怠水平较高。此外,受访者报告说,在统计上,用于锻炼的时间显著减少,我们测量到,在学年期间,身体质量指数(BMI)显著增加。PSS评分呈上升趋势,但无统计学意义。同样,白细胞端粒平均长度呈下降趋势,但变化无统计学意义。血清促炎细胞因子浓度没有测量到变化,时域心率变异性指标在时间点之间没有显着差异。结论:本初步研究支持了倦怠可以在医学院早期开始的观点,并且即使样本量很小,也可以通过调查工具在一年级和二年级医学生中检测到。此外,白细胞端粒长度可能是有支持数据的有用的倦怠生物标志物,但我们没有观察到炎症细胞因子或心率变异性的任何统计学显著变化。需要对这些潜在的生物标志物进行更大规模的进一步研究,以充分表征其临床应用。
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引用次数: 0
Beyond travel restrictions: exploring alternative infection control measures for Japanese medical students. 超越旅行限制:探索日本医学生的替代感染控制措施。
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-07-31 DOI: 10.5116/ijme.64b8.db07
Yudai Kaneda, Miyuka Kushibe
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引用次数: 0
Effect of shift-based scheduling on student learning, satisfaction and capacity in obstetrics and gynecology rotations. 轮班制对妇产科轮转学生学习、满意度和能力的影响。
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-07-28 DOI: 10.5116/ijme.64b4.f880
Erin Nelson

Objectives: Determine how a shift- based schedule to accommodate more students affects learning, performance, and satisfaction with the Obstetrics and Gynecology (OBG) rotation.

Methods: The study was conducted among third year OBG medical students with a triangular convergent cross-sectional approach. A new shift-based schedule was implemented. After each rotation, an online survey was conducted using a convenience sampling. Student scores on the National Board of Medical Examiner (NBME) OBG subject exam were analyzed using paired t test. Survey data was analyzed using two sample t test. The relationship between survey responses and exam score findings were described. Data from shift-schedule students was compared to traditional schedule students from the prior academic year.

Results: A statistically significant improvement was seen for average NBME score for shift-schedule students during the beginning portion (groups 1-3) of the academic year (M=80, SD=6.9) compared to traditional (M=75.7, SD=7.3) [t (145) =3.69, p =.001]. A similar pattern was not seen in subsequent groups (groups 4-6). Shift-schedule students also showed a statistically significant improvement in their perception of learning (t (183) =-2.54, p =.012). Parallel results were seen for belonging, manageable workload, time to study, and engaging meaningfully. Using this model, we increased rotation capacity from 24 to 30 students per group (20%).

Conclusions: Shift based scheduling allows 20% increase in capacity. Exam scores and student learning outcomes were similar or better than traditional schedule controls.

目的:确定以轮班为基础的时间表如何适应更多的学生影响妇产科(OBG)轮转的学习、表现和满意度。方法:采用三角收敛横断面入路对OBG三年级医学生进行研究。实行了新的轮班制。每次轮换后,使用方便的抽样方式进行在线调查。采用配对t检验对全国医学检验委员会(NBME) OBG科目考试学生成绩进行分析。调查数据采用两样本t检验进行分析。描述了调查结果与考试成绩之间的关系。将倒班制学生的数据与上一学年的传统制学生的数据进行比较。结果:倒班制学生在学年开始部分(1-3组)的平均NBME分数(M=80, SD=6.9)与传统学生(M=75.7, SD=7.3)相比有统计学意义上的显著改善[t (145) =3.69, p =.001]。在随后的各组(4-6组)中没有发现类似的模式。倒班制学生的学习知觉也有统计学上的显著改善(t (183) =-2.54, p = 0.012)。在归属感、可管理的工作量、学习时间和有意义的参与方面也有类似的结果。使用这个模型,我们将每组24名学生的轮换能力提高到30名(20%)。结论:基于班次的调度允许20%的容量增加。考试成绩和学生的学习成果与传统的时间表控制相似或更好。
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引用次数: 0
How Can Curricular Elements Affect the Motivation to Study? 课程要素如何影响学习动机?
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-07-26 DOI: 10.3390/ime2030015
Catherine Bopp, Aline Salzmann, Silke Ohlmeier, Melanie Caspar, E. Schmok, Sara Volz-Willems, Johannes Jäger, Fabian Dupont
(1) Background: This qualitative study aimed to identify and describe course components which affect a student’s motivation to learn within a blended-learning competency-based curriculum. (2) Methods: The data were gathered via two consecutive semi-structured group interviews. The participants were purposefully sampled from medical students attending the Family Medicine (FM) class at Saarland University (UdS) in Winter 2020. The two interviews were transcribed verbatim and inductively analysed using content analysis. (3) Results: Three categories of curricular components that affected motivation were inductively formed: (a) the provision of structure (curriculum design), where providing external learning milestones to self-regulated learning positively influenced an interviewee’s learning motivation; (b) the provision of interpersonal interactions and emotional relatedness by staff, where constructive feedback and enthusiasm from a teacher facilitated intrinsic motivation and real-life examples helped the students to remember content more easily; and (c) perceived gain in self-efficacy, where a participant’s motivation to learn a particular subject area was especially high if it appeared to be highly relevant to practice or exams and the applicability of the knowledge gained was readily apparent. (4) Conclusions: It is important for educators to be aware of how they influence a student’s motivation. This study may help to provide an orientation on what to avoid and what to include in a curriculum design project to purposefully foster motivation in students.
(1)背景:本定性研究旨在识别和描述在基于混合学习能力的课程中影响学生学习动机的课程组成部分。(2)方法:采用连续两次半结构化的小组访谈收集数据。参与者是有目的地从2020年冬季萨尔大学(UdS)家庭医学(FM)班的医学生中抽取的。对两次访谈进行逐字记录,并采用内容分析法进行归纳分析。(3)研究结果表明:影响学习动机的课程成分可归纳为三类:(a)提供结构(课程设计),其中为自我调节学习提供外部学习里程碑对被调查者的学习动机有积极影响;(b)教职员提供人际互动和情感联系,其中教师的建设性反馈和热情促进了内在动机,而现实生活中的例子有助于学生更容易地记住内容;(c)自我效能感的感知增益,即参与者学习某一特定学科领域的动机特别高,如果该学科领域与实践或考试高度相关,并且所获得的知识的适用性很明显。(4)结论:对于教育者来说,意识到他们如何影响学生的动机是很重要的。本研究可能有助于提供一个方向,在课程设计项目中应避免什么和包括什么,以有目的地培养学生的动机。
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引用次数: 0
Examining factors that drive health-related students to seek help for psychological challenges. 研究促使健康相关学生寻求心理帮助的因素。
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-07-24 DOI: 10.5116/ijme.64a7.bffb
Nidwaree Sojindamanee, Sirichai Hongsanguansri, Somboon Hataiyusuk, Nareemarn Neelapaichit, Karn Suttapanit, Ponjit Jithavech, Komsan Kiatrungrit

Objectives: This study aims to find the prevalence of mental health problems and the rates of seeking mental health care among health-related students, as well as identifying factors associated with seeking mental health care.

Methods: A cross-sectional online survey was conducted among students from the Faculty of Medicine at a university in the 2021 academic year. A total of 832 students voluntarily completed an online survey measuring mental health problems and factors influencing mental health care seeking. Descriptive and analytic statistics including t-test, Pearson's chi-square test, and binary logistic regression analysis, were used to analyze the data.

Results: Among the participants, 46.80% (n = 389) reported experiencing mental health problems, but only 16.97% (n = 66) of them sought mental health care. Binary logistic regression analysis revealed that female (OR = 2.63 (1.08 - 6.43)) and LGBTQ (OR = 4.26 (1.36 - 13.37)) students, and those with a positive attitude toward professionals (OR = 1.10 (1.02 - 0.19)), were more likely to seek formal mental health care than those who did not.

Conclusions: The study findings indicate that mental health problems are prevalent among health-related students, yet formal mental health care uptake is low. To address this issue, mental health screening programs, improved knowledge and attitudes about mental health care, and mental health training for academic staffs who work with health-related students are necessary. Future studies should explore interventions to increase the uptake of mental health services among health-related students.

目的:本研究旨在了解健康相关学生心理健康问题的患病率、寻求心理健康护理的比例,以及寻求心理健康护理的相关因素。方法:对某大学医学院2021学年学生进行横断面在线调查。共有832名学生自愿完成了一项在线调查,测量了心理健康问题和影响心理保健寻求的因素。采用描述性统计和分析性统计,包括t检验、Pearson卡方检验和二元logistic回归分析。结果:在参与者中,46.80% (n = 389)报告有精神健康问题,但只有16.97% (n = 66)的人寻求精神卫生保健。二元logistic回归分析显示,女性学生(OR = 2.63(1.08 ~ 6.43))、LGBTQ学生(OR = 4.26(1.36 ~ 13.37))以及对专业人员持积极态度的学生(OR = 1.10(1.02 ~ 0.19))寻求正规心理健康服务的可能性高于未寻求专业人员服务的学生。结论:研究结果表明,心理健康问题在与健康相关的学生中普遍存在,但正规心理卫生保健的使用率较低。为了解决这一问题,有必要开展心理健康筛查项目,提高对心理健康护理的认识和态度,并对与健康相关的学生打交道的学术人员进行心理健康培训。未来的研究应探索干预措施,以增加健康相关学生对心理健康服务的接受。
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引用次数: 0
Exploring Factors and Challenges Influencing Nursing Interns’ Training Experiences in Emergency Departments in Saudi Arabia 探讨影响沙特阿拉伯急诊科护理实习生培训经验的因素和挑战
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-07-04 DOI: 10.3390/ime2030013
Reem Alotaibi, Rawan Alkhaldi, Abeer Adel Turkistani, Manar Musallam Alfaqih, Lena Saeed Alzaidi, Zainab Shabab Alosaimi, Manar Hamed Almutairi, Abdulellah Al Thobaity
This study aims to investigate nursing interns’ training experiences in emergency departments (EDs) in Saudi Arabia and explore the factors influencing their experiences. A descriptive research design was employed utilizing a survey distributed to nursing interns who completed their ED rotation within the last three months. The data were analyzed using SPSS version 27, and principal component analysis (PCA) was conducted to identify the challenges encountered by the interns. This study analyzed the responses of 126 nursing internship students in various regions of Saudi Arabia to assess their training experiences in emergency departments. The principal component analysis revealed two significant factors: (1) “Emergency Department Training and Skill Development”, which focused on challenges faced during training, and (2) “Integrated Emergency Department Training and Competence Development”, which provided a holistic view of nursing internship students’ experiences and preparedness for their careers. The results indicated moderately below-average challenges and a moderately positive overall training experience. The findings suggest a need to address these challenges to improve the training experience and better prepare nursing internship students for careers in emergency departments. This study recommends enhancing the nursing curricula alignment with practical training objectives, focusing on technical and interpersonal skills development. A supportive learning environment in emergency departments is crucial, including effective communication and collaboration. Diverse clinical experiences and reflection on training can guide students in exploring potential career paths in emergency departments or other specialized nursing areas.
本研究旨在调查沙特阿拉伯急诊科护理实习生的培训经历,并探讨影响其经历的因素。采用描述性研究设计,对在过去三个月内完成急诊科轮转的护理实习生进行调查。数据分析采用SPSS 27版,采用主成分分析(PCA)识别实习生面临的挑战。本研究分析了沙特阿拉伯不同地区126名护理实习学生的反馈,以评估他们在急诊科的培训经历。主成分分析显示两个显著因子:(1)“急诊科培训与技能发展”,重点关注培训过程中面临的挑战;(2)“急诊科综合培训与能力发展”,提供了护理实习学生经历和职业准备的整体观点。结果表明,挑战程度略低于平均水平,整体训练体验略积极。研究结果表明,需要解决这些挑战,以改善培训体验,更好地为急诊部门的护理实习学生做好准备。本研究建议加强护理课程与实际培训目标的一致性,注重技术和人际交往能力的发展。急诊科的支持性学习环境至关重要,包括有效的沟通和协作。丰富的临床经验和对培训的反思可以指导学生探索急诊科或其他专业护理领域潜在的职业道路。
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引用次数: 2
Self-Regulated Video-Based Learning for Cultivating Surgical Skills: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 自我调节的基于视频的外科技能培养:随机对照试验的系统回顾和荟萃分析
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-07-04 DOI: 10.3390/ime2030014
N. Pakkasjärvi, S. Anand, H. Anttila, K. Pyhältö
In recent decades, there has been a shift towards competency-based approaches in surgical training. The effectiveness of video-based learning (VBL) in enhancing surgical skills, particularly in the context of self-regulated learning (SR-VBL), was assessed in this study. While VBL is cost-effective, flexible, and can improve proficiency in technical skills prior to clinical practice, it is resource-challenging. SR-VBL includes many of VBL’s benefits but has utility in individual and distance settings due to its autarkic nature. This study identified and analyzed contemporary literature on SR-VBL using PRISMA guidelines, focusing on original randomized controlled studies published in international peer-reviewed journals during the COVID-19 pandemic in 2020–2022. Seven studies with 462 participants were included, with three eligible for the meta-analysis. The results showed that self-regulated video-based learning contributes to the learning of technical skills and can be applied to learners of all levels across surgical specialties. The meta-analysis revealed that improvements in validated outcome assessment scores (OSATS) were at least equal to traditional methods with a statistically significant result, though the effect was modest. Therefore, contemporary surgical training could incorporate SR-VBL for technical training to help surgeons of all levels in surgical self-assessment.
近几十年来,在外科培训中已经有了向基于能力的方法的转变。本研究评估了基于视频的学习(VBL)在提高手术技能方面的有效性,特别是在自我调节学习(SR-VBL)的背景下。虽然VBL具有成本效益,灵活性,并且可以在临床实践之前提高技术技能的熟练程度,但它具有资源挑战性。SR-VBL包括许多VBL的优点,但由于其自给自足的性质,在个人和远程环境中具有实用性。本研究使用PRISMA指南对SR-VBL的当代文献进行了识别和分析,重点研究了2020-2022年COVID-19大流行期间发表在国际同行评审期刊上的原始随机对照研究。纳入了7项462名参与者的研究,其中3项符合荟萃分析的条件。结果表明,自我调节的基于视频的学习有助于技术技能的学习,可以应用于外科专业的各级学习者。荟萃分析显示,有效结果评估分数(OSATS)的改善至少与传统方法相同,结果具有统计学意义,尽管效果不大。因此,当代外科培训可纳入SR-VBL进行技术培训,帮助各级外科医生进行手术自我评估。
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引用次数: 0
The importance of crafting a good introduction to scholarly research: strategies for creating an effective and impactful opening statement. 撰写一个好的学术研究导言的重要性:创建一个有效和有影响力的开场白的策略。
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-06-29 DOI: 10.5116/ijme.6499.82af
Mohsen Tavakol, David O'Brien
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引用次数: 0
Tutors Matter: The Relationship between Medical Students’ Satisfaction from Their Tutor and Their Overall Satisfaction from Clinical Rotations 导师重要:医学生对导师满意度与临床轮转整体满意度的关系
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-06-22 DOI: 10.3390/ime2030012
N. Dickman, B. Hijazi, A. Samson, Lea Even
Background and Aim: Medical students are required to complete a number of clinical rotations in hospital departments, affiliated with the Azrieli Faculty of Medicine, under the supervision of a department tutor. Our experience shows that departments receiving good scores typically also receive good feedback for their tutor. Accordingly, our aim was to assess the tutor contribution to students’ overall satisfaction from clinical rotations in hospital departments across northern Israel. Methods: Here, we recorded the students’ reported satisfaction with tutors as well as the satisfaction with clinical rotations in different departments of Galilee Medical Center (GMC) in Naharia, and Baruch Padeh Medical Center in Poria. The students’ reported satisfaction was assessed numerically and verbally using questionnaires over a period of three years. Results: We find that the students reported satisfaction with a clinical rotation is positively and significantly correlated with the student satisfaction with the tutor, and less with other factors such as hospital organization and department facilities, geographical distance from home, working hours, etc. Conclusion: Our findings suggest that medical schools can increase students’ satisfaction through investment in good tutors.
背景和目的:医学生必须在阿兹列利医学院附属医院部门完成一些临床轮转,并在部门导师的监督下完成。我们的经验表明,获得高分的院系通常也会得到对其导师的良好反馈。因此,我们的目的是评估导师对以色列北部医院部门临床轮转学生总体满意度的贡献。方法:在Naharia加利利医疗中心(GMC)和Poria巴鲁克帕德医疗中心(Baruch Padeh Medical Center)的不同科室,我们记录了学生对导师的满意度和对临床轮转的满意度。在三年的时间里,学生们报告的满意度通过数字和口头调查问卷进行了评估。结果:学生轮转满意度与导师满意度呈显著正相关,与医院组织机构、科室设施、离家距离、工作时间等因素呈显著正相关。结论:本研究结果表明,医学院可以通过对优秀导师的投入来提高学生的满意度。
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引用次数: 0
Psychological need fulfillment in virtual teaching: insights of residents and faculty. 虚拟教学中的心理需求满足:住院医师与教师的见解。
IF 3.1 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2023-06-22 DOI: 10.5116/ijme.6488.2625
Oksana Babenko, Shannon Gentilini, Nathan Turner, Olga Szafran, Sudha Koppula

Objective: To explore benefits and challenges experienced by residents and faculty when teaching in virtual settings.

Methods: This was a qualitative descriptive study employing one-on-one semi-structured interviews with 10 residents and 12 faculty in the Department of Family Medicine at the University of Alberta, Canada, from May 2021 to May 2022. Participants were recruited via social media, resident and department events and email lists. Interview transcripts were analyzed descriptively and thematically employing the Self-Determination Theory (SDT) framework to map the identified benefits and challenges as facilitators and barriers to fulfilling teacher's basic psychological needs for autonomy, competence, and relatedness in virtual settings.

Results: Resident and faculty participants used virtual technology not only to deliver education, but also leveraged various platform features to support their needs in virtual settings. The emerging themes within benefits and challenges of virtual teaching were amenable to mapping onto three basic psychological needs of the SDT framework - autonomy (e.g., increased accessibility; lack of control over teaching environment), competence (e.g., increased self-confidence; technological limitations hindering skill development), and relatedness (e.g., timely exchange of information; difficulty with professional identity formation).

Conclusions: Despite the inherent challenges, teaching in virtual settings can support teachers' psychological needs. Recommendations for the future delivery and facilitation of virtual learning include: giving high priority to engagement and active participation; nurturing autonomy and greater individual responsibility for learning; and creating an environment of emotional support. The SDT-informed strategies shown to be effective in in-person teaching need to be examined for their applicability in virtual settings.

目的:探讨住院医师和教师在虚拟环境中教学时所经历的好处和挑战。方法:这是一项定性描述性研究,采用一对一半结构化访谈,于2021年5月至2022年5月对加拿大阿尔伯塔大学家庭医学系的10名住院医生和12名教师进行访谈。参与者是通过社交媒体、住院医师和院系活动以及电子邮件列表招募的。采用自我决定理论(SDT)框架对访谈记录进行了描述性和主题性分析,以绘制出在虚拟环境中作为满足教师自主性、能力和相关性基本心理需求的促进因素和障碍的已识别的利益和挑战。结果:住院医师和教师参与者不仅使用虚拟技术来提供教育,而且还利用各种平台功能来支持他们在虚拟环境中的需求。虚拟教学的好处和挑战中出现的主题符合SDT框架的三个基本心理需求-自主性(例如,增加可访问性;缺乏对教学环境的控制)、能力(例如,自信心增强;阻碍技能发展的技术限制)和相关性(例如,及时交换信息;难以形成职业认同)。结论:尽管存在固有的挑战,但虚拟环境下的教学可以支持教师的心理需求。关于未来提供和促进虚拟学习的建议包括:高度重视参与和积极参与;培养自主性和更大的个人学习责任感;创造一个情感支持的环境。基于sdt的策略在面对面教学中被证明是有效的,需要对其在虚拟环境中的适用性进行检验。
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引用次数: 0
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International Journal of Medical Education
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