How undergraduate clinical learning climates differ: a multi-method case study
How undergraduate clinical learning climates differ: a multi-method case study
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DOI：
10.1111/j.1365-2923.2008.03149.x
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发表时间：
2008-10-01
影响因子：
6
通讯作者：
Scherpbier, Albert J. J. A.
中科院分区：
文献类型：
--
作者：
Boor, Klarke;Scheele, Fedde;Scherpbier, Albert J. J. A.
临床学习氛围影响医学本科生的行为、满意度和成功。大多数研究主要使用定量方法（如问卷）描述临床学习环境的各个方面。本研究旨在阐明医学生对临床学习气氛的看法，以及哪些因素及其相互作用解释了临床学习气氛的差异。妇产科的12个部门分发了研究生院教育环境测量（PHEEM），一个可靠的问卷测量临床学习环境，医学生。经过分析（使用方差分析和事后检验），14名医学生从最高和最低得分的部门参加了半结构化的采访。我们使用内容分析方法分析了转录的录音。研究人员同意编码和专家组达成共识的主题analysis.RESULTS我们发现一个显着的差异部门之间的PHEEM分数。访谈表明，部门和医学生的特点决定了临床学习气氛。就部门而言，“合法性”、“见习安排”和“注重个人发展”是主要的主题。对于医学生来说，“最初的主动性”、“持续发展”和“实习疲劳”是主要的主题。参与的数量和性质发挥了核心作用，在所有themes.CONCLUSIONS临床学习气候之间的差异似乎与不同的方法，部门之间的参与。参与取决于部门和学生的特点，以及他们之间的互动。这些结果为如何形成有利的临床学习氛围提供了有价值的线索。
CONTEXT The clinical learning climate affects undergraduate medical students' behaviour, satisfaction and success. Most studies predominantly describe aspects of the clinical learning climate using quantitative methodologies, such as questionnaires. This study aimed to illuminate medical students' perceptions of the clinical learning climate, and which factors and their interactions explain differences in clinical learning climates.METHODS We carried out a multi-method case study. Twelve departments of obstetrics and gynaecology distributed the Postgraduate Hospital Educational Environment Measure (PHEEM), a reliable questionnaire measuring the clinical learning environment, among medical students. After analysis (using ANOVA and post hoc tests), 14 medical students from the highest- and lowest-scoring departments participated in semi-structured interviews. We analysed the transcribed recordings using a content analysis approach. Researchers agreed on coding and an expert group reached consensus on the themes of the analysis.RESULTS We found a significant difference between departments in PHEEM scores. The interviews indicated that department and medical student characteristics determine the clinical learning climate. For departments, 'legitimacy', 'clerkship arrangements' and 'focus on personal development' were the main themes. For medical students, 'initial initiatives', 'continuing development' and 'clerkship fatigue' were the principal themes. The amount and nature of participation played a central role in all themes.CONCLUSIONS Differences between clinical learning climates appear to be related to differing approaches to participation among departments. Participation depends on characteristics of both departments and students, and the interactions among them. The outcomes give valuable clues to how a favourable clinical learning climate is shaped.