Effect of national curriculum reform on medical students’ preparedness for practice: a prospective cohort study from undergraduate to postgraduate periods

BMC Medical Education

Research

Shiuan-Ruey Yu¹  Liang-Shiou Ou²  Chien-Da Huang³  Ji-Tseng Fang⁴  Hsu-Min Tseng⁵  Chung-Hsien Chaou⁶  Shou-De Ma⁷ 

[1] Chang Gung University College of Medicine, Taoyuan, Taiwan;Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan;Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan;Chang Gung University College of Medicine, Taoyuan, Taiwan;Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan;Tungs’ Taichung Memorial Hospital, Taichung, Taiwan;

关键词: Preparedness for practice;    Undergraduate medical education;    Burnout;    Longitudinal cohort study;    Transition;    Questionnaire;    Mixed model;   

DOI  :  10.1186/s12909-022-03909-3

 received in 2022-09-14, accepted in 2022-11-21,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundIn recent years, a national curriculum reform was implemented in undergraduate medical education in Taiwan to reduce clinical rotation training from 3 years to 2 years. The last generation of the old curriculum and the first generation of the new curriculum both graduated in 2019. This study aimed to compare the learning outcomes of the medical students in these two curriculum groups in terms of preparedness for practice during the transition from undergraduate to postgraduate study.MethodsThis was a 3-year prospective, longitudinal, comparative cohort study between 2017 and 2020. Medical students from both the 7-year and 6-year curriculum groups received biannual questionnaire surveys starting 18 months before graduation and running until 11 months after graduation. The measurement tools were the Preparedness for Hospital Practice Questionnaire (PHPQ) and Copenhagen Burnout Inventory (CBI). Personal demographic information was also collected. Linear mixed models were used to determine the effect of curriculum change on learners’ preparedness and burnout levels.ResultsA total of 130 medical students from the two cohorts provided 563 measurements during the study period. Compared to their counterparts following the old curriculum, the participants following the new curriculum showed a lower level of preparedness when first entering clinical rotation (p = 0.027) and just after graduating (p = 0.049), especially in the domains of clinical confidence (p = 0.021) and patient management p = 0.015). The multivariate linear mixed model revealed gradual increases in preparedness and burnout in serial measurements in both curriculum groups. Students following the new curriculum, which involved a shortened clinical rotation, showed a slightly lower overall preparedness (p = 0.035) and the same level of burnout (p = 0.692) after adjustment. The factor of year of change did not show a significant effect on either preparedness (p = 0.258) or burnout (p = 0.457).ConclusionShortened clinical rotation training for medical undergraduates is associated with a decrease in preparedness for practice during the transition from undergraduate to postgraduate study. Clinical confidence and patient management are the main domains affected.

【 授权许可】

CC BY   
© The Author(s) 2022

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