不同实习阶段医学生的动机与教学满意度关系分析

Relation Analyses Between Motivation and Teaching Satisfaction of Medical Students in Different Practice Period

目的：了解不同实习阶段医学生实习动机与其对实习医院教学满意度之间的关系,为提升实习教学质量提供依据。方法：应用自编问卷,调查某军医大学学员实习前期和后期的实习动机、对医院各方面风气、各项教学工作、带教老师的满意度。结果：（1）实习前、后期不同动机的实习生在校期间成绩有统计学差异（χ~2=13.409,26.743,P〈0.05）,成绩优秀的学生实习动机中等的比例最高（16.6%,34.0%）;（2）实习前、后期不同动机的实习生对所在医院医疗风气、教学风气、实习生学风的评价均有差异（χ~2=25.204,52.998,39.777,54.067,18.277,44.914;P〈0.05）,动机较强的学员评价为很好的比例从实习前期的59.6%、61.4%、62.9%分别下降为实习后期的27.9%、27.9、26.5%;（3）实习前期对所在医院教学管理机构和管理制度、带教老师安排、食宿条件、各项教研活动、岗前教育与出入科教育、带教老师带教水平、带教方法的满意度有统计学差异（χ~2=11.998,6.726,12.201,11.500,12.502,9.921,7.862;P〈0.05）,动机较强的实习生满意度均较高（71.4%,71.1%,50.7%,37.1%,36.8%,77.4%,59.3%）;实习后期对教学条件、各项教研活动、岗前教育与出入科教育、带教老师带教方法的满意度有统计学差异（χ~2=10.643,16.304,18.796,16.223;P〈0.05）,动机较强的实习生不满意的比例较高（62.5%,74.3%,80.1%,69.9%）。结论：实习期间是医学生动机、思想波动的过程;动机与在校成绩并无明显关系,与实习前期对医院的评价相关;实习前期医学生满意度受医院外在硬件条件的影响,后期受教学软件影响较大。

Objective：To analyze the relations between motivation and teaching satisfaction of medical students in different practice period and offer gists to promote practice teaching quality.Methods：Using self-made questionnaires,we surveyed some Military Medical Undergraduates on their practice motivations,satisfactions with all the aspects of hospital culture,the teaching work and the teachers in prophase and anaphase period.Results：（1） The grades showed statistical significance with different motivations in both prophase and anaphase period（χ~2=13.409,26.743;P〈0.05）,and the percentage of moderate motivation in those with excellent grades was the highest（16.6%,34.0%）.（2）The appraisals of students with different motivations for hospitals’ medical culture,teaching culture and the interns’ learning culture showed statistical significance in both prophase and anaphase period（χ~2=25.204,52.998,39.777,54.067,18.277,44.914;P〈0.05）,and the percentage of ＂very good＂ among those with high motivation dropped respectively from 59.6%,61.4%,62.9%in prophase period to 27.9%,27.9,26.5%in anaphase period.（3）The satisfaction with teaching management system and mechanism,the arrangement of teachers,accommodations,teaching and research activities,pre-job education and access to education,teaching levels of teachers,teaching methods of teachers among different motivations showed statistical significance in prophase period（χ~2=11.998,6.726,12.201,11.500,12.502,9.921,7.862;P〈0.05）,and the percentage in those with high motivation was higher（71.4%,71.1%,50.7%,37.1%,36.8%,77.4%,59.3%）.The satisfaction with teaching conditions,teaching and research activities,pre-job education and access to education,teaching methods of teachers among different motivations showed statistical significance in anaphase period（χ~2=10.643,16.304,18.796,16.223;P〈0.05）,and the percentage of dissatisfaction among those with high motivation was higher（62.5%,74.3%,80.1%,69.9%）.Conclusion：Practice period is a wave process of motivation and thoughts of medical students.The motivation has nothing with the school grades but with the appraisals for hospitals in prophase period.The teaching satisfaction is influenced by hospital external hardware in prophase but by instructional software in anaphase period.