叙述小组讨论对医学生解释能力的影响:一项前瞻性观察研究

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摘要

背景:临床决策主要是基于知识的感知,在不确定性条件下的解释。口译能力是否可以提高尚不清楚。我们评估了叙述小组讨论课程(NGDC)对一年级医学生解释能力的影响。目的:评价本课程对一年级医学生的影响:a)他们的解释能力;b)他们对学习文学和核心科目的态度。方法:采用一份为期一学期的课程前后问卷,在两个连续的班级中,作者评估了参与者在分析四个复杂段落时的解释能力和理解深度。结果:在235名学生中,146名(62%)回答了两份问卷。参与者的解释能力显著提高(P=0.003)。91名参与者(38%)在四篇文章中的至少一篇中提高了理解水平,37名参与者(25%)在两篇文章中提高了理解水平。多因素分析显示,口译能力的提高与年龄较小(P=0.034, CI 95%=0.64-0.98, OR=0.79)、积极的课程前态度和动机(P<0.001, CI 95%=1.43-3.05, OR=2.09)以及缺乏先前的文献背景(P=0.064, CI 95%=0.17-1.05, OR=0.43)有关。结论:我们的数据表明NGDC可以提高和完善解释能力。需要进一步的研究来确定这种变化的短期和长期影响,以及它是否可以转化为更好的临床决策。
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The influence of narrated group discussions on the interpretational ability of medical students: a prospective observational study
Background: Clinical decision making is predominantly knowledge-based perception, interpretation under terms of uncertainty. It is unclear whether interpretational ability can be improved. We evaluated the effect of a narrated group-discussions course (NGDC) on the interpretational ability of first-year medical students. Objective: To evaluate the effect of our course on first year medical students in respect to: a) their interpretational abilities b) their attitude towards studying literature and the core subjects. Method: Using a pre-post questionnaire, of a semester-long course, among two consecutive classes, the authors evaluated the participant’s interpretational ability and depth of understanding when analyzing four complex passages. Results: Out of 235 students, 146 (62%) responded to both questionnaires. There was a significant increase in the participant’s interpretational ability (P=0.003). ninety one participants (38%) improved their level of understanding in at least one out of the four passages, and 37 participants (25%) improved in two passages. A multivariate analysis revealed that the improvement in the interpretational ability was associated with younger age (P=0.034, CI 95%=0.64-0.98, OR=0.79), positive pre-course attitude and motivation (P<0.001, CI 95%=1.43-3.05, OR=2.09), and lack of a prior literature background (P=0.064, CI 95%=0.17-1.05, OR=0.43). Conclusion: Our data suggests that NGDC may improve and refine interpretational ability. Further studies are required to establish the short- and long-term impact of this change and whether it can be translated into better clinical decision making.
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