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首页> 外文期刊>BMC Medical Education >Medical Students' and Residents' preferred site characteristics and preceptor behaviours for learning in the ambulatory setting: a cross-sectional survey
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Medical Students' and Residents' preferred site characteristics and preceptor behaviours for learning in the ambulatory setting: a cross-sectional survey

机译：医学生和居民在非卧床环境中学习时偏爱的场所特征和感受器行为：横断面调查

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Background Medical training is increasingly occurring in the ambulatory setting for final year medical students and residents. This study looks to identify if gender, school, level of training, or speciality affects learner's (final year medical students and residents) preferred site characteristics and preceptor behaviours for learning in the ambulatory setting. Methods All final year medical students and residents at the five medical schools in Ontario (N = 3471) were surveyed about the site characteristics and preceptor behaviours most enhancing their learning in the ambulatory setting. Preferred site characteristics and preceptor behaviours were rank ordered. Factor analysis grouped the site characteristics and preceptor behaviours into themes which were then correlated with gender, school, level of training, and speciality. Results Having an adequate number and variety of patients while being supervised by enthusiastic preceptors who give feedback and are willing to discuss their reasoning processes and delegate responsibility are site characteristics and preceptor behaviours valued by almost all learners. Some teaching strategies recently suggested to improve efficiency in the ambulatory teaching setting, such as structuring the interview for the student and teaching and reviewing the case in front of the patient, were found not to be valued by learners. There was a striking degree of similarity in what was valued by all learners but there were also some educationally significant differences, particularly between learners at different levels and in different specialities. Key findings between the different levels include preceptor interaction being most important for medical students as opposed to residents who most value issues pertaining to patient logistics. Learning resources are less valued early and late in training. Teaching and having the case reviewed in front of the patient becomes increasingly less valued as learners advance in their training. As one approaches the end of ones' training office management instruction becomes increasingly valued. Differences between specialities pertain most to the type of practice residents will ultimately end up in (ie: office based specialties particularly valuing instruction in office management and health care system interaction). Conclusions Preceptors need to be aware of, and make efforts to provide, teaching strategies such as feedback and discussing clinical reasoning, that learners have identified as being helpful for learning. If strategies identified as not being valued for learning, such as teaching in front of the patient, must continue it will be important to explore the barriers they present to learning. Although what all learners want from their preceptors and clinic settings to enhance their learning is remarkably similar, being aware of the educationally significant differences, particularly for learners at different levels and in different specialities, will enhance teaching in the ambulatory setting.
机译：背景技术在最后一年的医学生和住院医师的非住院治疗中，医学培训越来越多。这项研究旨在确定性别，学校，培训水平或专业是否会影响学习者（最终的医学生和住院医师）的首选场所特征和在门诊环境中学习的感受器行为。方法对安大略省五所医学院（N = 3471）的所有最后一年的医学生和居民进行调查，以了解他们在非卧床环境中最能促进他们学习的场所特征和感受器行为。优选的位点特征和受体行为按等级排序。因子分析将场所特征和受体行为分为主题，然后与性别，学校，培训水平和专业相关。结果在热情的主持人的监督下，有足够数量和种类的病人接受反馈，并愿意讨论他们的推理过程和委托责任是几乎所有学习者都重视的现场特征和主持人的行为。最近发现一些教学策略建议提高门诊教学环境的效率，例如为学生安排面试以及在患者面前进行教学和复习案例，这些方法并未被学习者重视。所有学习者所看重的事物之间都具有惊人的相似性，但在教育上也存在显着差异，尤其是不同级别和不同专业的学习者之间。不同级别之间的主要发现包括，与医学生相比，受体相互作用最重要，而居民最重视与患者后勤相关的问题。在培训的早期和晚期，学习资源的价值较低。随着学习者培训的提高，在患者面前进行教学和病例审查的价值越来越低。随着人们的临近，培训办公室的管理指导越来越受到重视。专业之间的差异与居民的执业类型最相关（即：基于办公室的专业，尤其是重视办公室管理和医疗保健系统互动方面的指导）。结论导师需要意识到并努力提供教学策略，例如反馈和讨论临床推理，这些学习策略已被学习者认为对学习有所帮助。如果必须继续采取被认为对学习无价值的策略，例如在患者面前进行教学，那么探索它们为学习带来的障碍就很重要。尽管所有学习者都希望从其主管和诊所环境中获得什么来增强他们的学习，这是非常相似的，但是意识到教育上的显着差异，特别是对于不同级别和不同专业的学习者，将提高非住院环境中的教学。

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