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Active learning of medical students in Taiwan: a realist evaluation

机译：台湾医学生的积极学习：现实主义评估

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BACKGROUND:Active learning is defined as any instructional method that engages students in the learning process. Cultural differences in learning patterns can play an important role in engagement with active learning. We aimed to examine process models of active learning to understand what works, for whom and why.METHODS:Forty-eight sixth- and seventh-year medical students with experience of active learning methods were purposively selected to participate in ten group interviews. Interactions around active learning were analysed using a realist evaluation framework to unpack the 'context-mechanism-outcome' (CMO) configurations.RESULTS:Three core CMO configurations, including cultural, training and individual domains, were identified. In the cultural context of a strong hierarchical culture, the mechanisms of fear prompted students to be silent (outcome) and dare not give their opinions. In the training context of teacher-student familiarity alongside teachers' guidance, the mechanisms of learning motivation, self-regulation and enthusiasm were triggered, prompting positive learning outcomes and competencies (outcome). In the individual context of learning how to learn actively at an early stage within the medical learning environment, the mechanisms of internalisation, professional identity and stress resulted in recognising active learning and advanced preparation (outcomes).CONCLUSIONS:We identified three CMO configurations of Taiwanese medical students' active learning. The connections among hierarchical culture, fear, teachers' guidance, motivation, the medical environment and professional identity have been shown to affect the complex interactions of learning outcomes. Fear derived from a hierarchical culture is a concern as it is a significant and specific contextual factor, often sparking fear with negative outcomes.
机译：背景：主动学习被定义为参与学习过程中的任何教学方法。学习模式的文化差异可以在与积极学习的参与中发挥重要作用。我们旨在审查积极学习的流程模型，了解有关的作用，为谁以及为什么。方法：有四十八个六年和七年的医学生，具有积极学习方法经验的医学学生被任意地选择参加十个集团访谈。通过现实主义评估框架分析了主动学习的交互，以解压缩“上下文 - 机制 - 结果”（CMO）配置。结果：确定了三个核心CMO配置，包括文化，培训和个人域。在强大的等级文化的文化背景下，恐惧机制促使学生保持沉默（结果），敢于没有提出意见。在教师学生熟悉的培训背景下，触发了学习动机，自我监管和热情的机制，促使积极的学习结果和能力（结果）。在学习如何在医学学习环境中的早期阶段学习的个体背景下，内心的机制，专业认同和压力导致认识到积极学习和高级准备（结果）.Conclusions：我们确定了三个CMO配置的台湾人医学生的积极学习。已经表明了分层文化，恐惧，教师的指导，动机，动机，医疗环境和专业认同之间的联系影响了学习结果的复杂相互作用。来自分层文化的恐惧是一个关注，因为它是一个重要和特异性的语境因素，通常引发恐惧与消极结果引发。

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