中国医学生感官学习风格与经验学习风格的关系

为探讨不同学习风格之间的关系,应用感官学习风格量表(the Visual,Aural,Read/Write,Kinesthetic questionnaire,VARK)和经验学习风格量表(kolb learning styles inventory,KLSI),调查我国11所医学院校17460名学生。结果显示,我国医学生感官学习风格不同倾向重数的经验学习风格类型不同(χ2=19.270,P=0.023),四重风格的医学生属于吸收型的百分比相对最高(14.6%);感官学习风格不同强度的医学生经验学习风格类型未见统计学差异(χ2=8.719,P=0.464);感官学习风格不同分布类型的医学生经验学习风格类型有统计学差异(χ2=184.824,P<0.001):VA型感官风格的医学生属于发散型经验风格的百分比相对最高(77.5%),R和RK型感官风格的医学生属于吸收型的百分比相对最高(17.7%和16.9%),AK和VAK型的医学生属于集中型的百分比相对最高(3.9%和3.7%),VK和K型医学生属于调节型的百分比相对最高(6.5%和5.6%)。     

Factors associated with medical students' career choices regarding internal medicine

Karen E. Hauer, MD; Steven J. Durning, MD; Walter N. Kernan, MD; Mark J. Fagan, MD; Matthew Mintz, MD; Patricia S. O’Sullivan, EdD; Michael Battistone, MD; Thomas DeFer, MD; Michael Elnicki, MD; Heather Harrell, MD; Shalini Reddy, MD; Christy K. Boscardin, PhD; Mark D. Schwartz, MD

JAMA. 2008;300(10):1154-1164.

Context  Shortfalls in the US physician workforce are anticipated as the population ages and medical students' interest in careers in internal medicine (IM) has declined (particularly general IM, the primary specialty serving older adults). The factors influencing current students' career choices regarding IM are unclear.

Objectives  To describe medical students' career decision making regarding IM and to identify modifiable factors related to this decision making.

Design, Setting, and Participants  Web-based cross-sectional survey of 1177 fourth-year medical students (82% response rate) at 11 US medical schools in spring 2007.

Main Outcome Measures  Demographics, debt, educational experiences, and number who chose or considered IM careers were measured. Factor analysis was performed to assess influences on career chosen. Logistic regression analysis was conducted to assess independent association of variables with IM career choice.

Results  Of 1177 respondents, 274 (23.2%) planned careers in IM, including 24 (2.0%) in general IM. Only 228 (19.4%) responded that their core IM clerkship made a career in general IM seem more attractive, whereas 574 (48.8%) responded that it made a career in subspecialty IM more attractive. Three factors influenced career choice regarding IM: educational experiences in IM, the nature of patient care in IM, and lifestyle. Students were more likely to pursue careers in IM if they were male (odds ratio [OR] 1.75; 95% confidence interval [CI], 1.20-2.56), were attending a private school (OR, 1.88; 95% CI, 1.26-2.83), were favorably impressed with their educational experience in IM (OR, 4.57; 95% CI, 3.01-6.93), reported favorable feelings about caring for IM patients (OR, 8.72; 95% CI, 6.03-12.62), or reported a favorable impression of internists' lifestyle (OR, 2.00; 95% CI, 1.39-2.87).

Conclusions  Medical students valued the teaching during IM clerkships but expressed serious reservations about IM as a career. Students who reported more favorable impressions of the patients cared for by internists, the IM practice environment, and internists' lifestyle were more likely to pursue a career in IM.

     

医科大学生职业决策自我效能与应付方式的关系研究

目的:探讨医科大学生职业决策自我效能与应付方式的关系,为制定提高大学生职业决策自我效能的针对性干预措施提供理论依据?方法:采用大学生职业决策自我效能量表和应付方式问卷对659名医科大学在校本科生进行调查?结果:①医科大学生职业决策自我效能处于中等水平,且存在性别差异,男大学生的职业决策自我效能高于女大学生(P < 0.05)?②总的职业决策自我效能及其各维度与应付方式中的解决问题因子存在显著的正相关(P < 0.05);职业决策自我效能及其各维度与自责?幻想?退避这三种消极应付方式均存在显著负相关(P < 0.05);职业决策自我效能的自我评价?问题解决维度与应付方式的合理化因子存在负相关(P < 0.05)?③高职业决策自我效能者多采用积极的应付方式,而低职业决策自我效能者多使用消极的应付方式?结论:医科大学生职业决策自我效能与应付方式间存在一定关系,应注重大学生积极应付能力的培养?     

Timing and motivation in pediatric career choices

A total of 257 third-year residents in pediatrics, internal medicine, and family practice were asked about their career goals for the year following their residency and in five years, and information was obtained from them about their motives for career choices. The authors specifically examined the following: humanitarian interests; intellectual motivation; service motives; and practical, personal, and financial considerations. The characteristics of the residency training program which may have influenced their career choices were also examined. A majority of the 214 pediatric residents said they had not considered going into pediatrics on entry to medical school. Of these residents, 109 planned academic pursuits for the following year, while only 81 of the 109 anticipated an academic career within five years. Intellectual stimulation, geographic location, and an "opportunity to clarify goals" were the three most frequently mentioned factors in choosing positions for the following year.     

医学检验专业大学生职业生涯规划的探索与实践

大学生职业生涯规划对大学生的生活、学习、就业以及成长具有十分重要的意义.通过分析大学生职业生涯规划教育的现状,提出了一系列加强医学检验专业大学生职业生涯规划的具体指标,以便建立完善的医学检验专业大学生职业生涯规划体系,促进就业.     

Primary medical care in a paediatric accident and emergency department.

The characteristics of a random sample of 853 children who attended the accident and emergency department of the Royal Belfast Hospital for Sick Children were studied prospectively to determine the extent to which the department was being used to provide primary medical care. Direct parent referrals accounted for 69% of all attendances with a further 21% referred by the family doctor. Parental preference and accessibility were the main reasons given for choosing to attend the department with the latter significantly higher among out-of-hours attendances. However, only 37 of the 585 parent referrals had made an attempt to contact the family doctor. Overall, 33.9% of children were felt to be inappropriate attenders, i.e. were neither accident nor emergency cases, and the proportion was highest among the parent-referred groups. The present financial restraints facing the National Health Service make it uneconomical to provide primary medical care at both hospital and community level. However, the level of demand for the accident and emergency department, together with the attitudes of those who attend, make it unlikely that a more rational use of resources will be achieved in the foreseeable future.     

高中生防御方式与父母教养方式的相关分析

目的:探讨高中生防御方式与父母教养方式之间的关系。方法:采用防御方式问卷(DSQ)和父母教养方式评价量表(EMBU)对596名中学生施以团体测验。结果:男、女学生除中间型防御机制差异显著性外,不成熟防御机制、成熟防御机制及掩饰因子均无显著差异(P>0.05);男生在投射、潜意显现、抱怨、分裂、伴无能之全能、同一化和期望因子分上明显高于女生,女生在退缩、反作用形成、理想化因子上明显高于男生,且有统计学意义(P<0.05～P<0.01)。父母教养方式在惩罚、严厉、过分干涉、偏爱被试、拒绝、否认、过度保护及过干涉、过保护、偏爱被试上的平均得分男生均显著高于女生,且有统计学意义(P<0.05～P<0.01)。防御方式的部分因子和父母教养方式中的部分因子存在显著相关,且有性别上的差异。结论:父母的教养方式对子女的防御方式有重要影响。     

高等医学院校学生学习适应性的测量与影响因素分析

目的 测量医学院校学生学习适应性现状及其影响因素,修订符合医学生特有语境的学习适应性量表。方法 采用分层抽样的方法,抽取哈尔滨医科大学1180名医学生进行问卷调查。应用SPSS22.0进行数据分析,采用内部一致性信度检验,验证修订完毕的医学生学习适应性量表的信度;利用主成份分析法的探索性因子分析提取出5个公因子;应用Logistic回归分析医学生学习适应性的影响因素。结果 修订完毕的医学生学习适应性量表（Cronbach’s Alpha=0.914）包含27个测量条目;量表包含：自主学习、信息利用、环境抉择、压力应对和目标倾向”五个维度。医学生学习适应性处于中等水平（3.28±0.52）,影响因素包括：职务[OR=1.496, 95%CI（1.114~2.009）]、成绩水平[OR=1.638, 95%CI（1.386~1.936）]、学习现状满意度[OR=2.160, 95%CI（1.745~2.673）]、专业满意度[OR=1.369, 95%CI（1.092~1.718）]、专业兴趣度[OR=1.426, 95%CI（1.186~1.715）]和就业前景[OR=1.526, 95%CI（1.251~1.862）]。结论 医学生学习适应性量表信效度良好,医学生学习适应性受诸多因素影响。