社区融合式实践学习效果及影响因素分析

Analysis of the effect and influencing factors of community integrated practice learning

目的为满足新医科背景对医学生培养需求,研究社区实习生实践能力的现状及影响因素,为医学生实践教学提供参考。方法采用方便抽样法,使用实践能力评估量表,2022年3月至5月,选取江西省上饶市及周边地区社区卫生服务机构中的实习生作为观察组,将尚未进入临床实习的医学生作为对照组进行问卷调查。结果调研共发放问卷468份,回收有效问卷436份,有效回收率为93.16%,其中社区实践学习组224名,对照组212名。实践学习组临床学习、临床任务、实践能力得分高于对照组,教学环境低于对照组,差异有统计学意义(P<0.05)。多因素线性回归分析显示,男生、本科、省会城市、参加实践教学技能培训次数(>4次)、带教老师工作年限(>10年)、单位承担实践教学年限(>10年)和总体教学效果自评好均进入回归方程,并能解释总变异的26.5%。结论社区实习的医学生实践能力得到显著提升,医学生实践能力受到性别、所在城市、培训经历等多种因素影响。

Objective To meet the training needs of medical students in the new medical background,to investigate the current situation and influencing factors of community interns’practical abilities,and to provide reference for practical teaching of medical students.Methods Convenient sampling method and practical ability assessment scale were adopted.From March to May 2022,interns in community health service institutions in Shangrao and surrounding areas were selected as the observation group,and medical students who had not yet entered clinical practice were selected as the control group for questionnaire survey.Results A total of 468 questionnaires were sent out,and 436 were effectively collected,with an effective recovery rate of 93.16%,including 224 in the community practice learning group and 212 in the control group.The scores of clinical learning,clinical task,and practical ability in the practice learning group were higher than those in the control group,and the teaching environment was lower than that in the control group,with statistical significance(P<0.05).Multivariate linear regression analysis showed that male students,undergraduate students,provincial capital cities,the number of practical teaching skills training(>four times),the working years of teaching teachers(>10 years),the years of practical teaching units(>10 years),and the overall teaching effect were all included in the regression equation,and could explain 26.5%of the total variation.Conclusion The practical ability of medical students in community practice has been significantly improved,and the practical ability of medical students is affected by gender,city where they live,training experience and other factors.