| With the progression of social system and educational system reformation, thestudent resource environment, human cultural environment and social environmentwhich the medical practice education confronted has been earthshakingly changed.The influencing factors affecting practice education were much different from before.Confronting the problem generally raised by teachers who worked in the practiceeducation domain that interns were more and more difficult to handle, measures mustbe taken to effectively cope with the new problems. But, it was not objective toformulate strategy merely based on feedback opinions from teachers. We must get thefirst-hand data based on the personally experience of interns, making clear theinherent reasons, thus taking measures to archieve a etiological treatment. So, thegoal of this paper was to gain objective cognition of the influencing factors affectingcurrent practice education based on the personal experience of interns throughquestionnaire investigation on the 2002nd ocassion's undergraduates of the NanfangMedical College who had just finished practice education, and to provide evidencefor directly formulating educational reforming measures and scientifically impel thepractice education reformation.Investigation ObjectThe object of our questionnaire investigation is the 2002nd ocassion'sundergraduates of the Southern medical university, the total sample size is 309.Research method When students turned back to campus at the end of the 9th term, representativesof each practice educational hospital were convened together for a symposium. Allrepresentatives were asked to exemplify influencing factors affecting practiceeducation based on their own experience and reception frankly. The questionnaireadministrator summarized all the representatives' opinions to achieve primarycollection of the influencing factors affecting current practice education.According to the influencing factors of practice education primary defined, aquestionnaire was designed by the administrator. This questionnaire included all theprimary collected influencing factors and further designed questions and answer itemsto ascertain the influencing scope, severity and duration of each factor did to themedical practice education.The questionnaire investigation was carried out at beginning of the 10th termwhen all the interns came back to campus just a winter holiday after practiceeducation. All questionnaire tables were collected for data collection as an EXCELdatabase concerning medical practice education influencing factors and thenstatistical analysis by the SPSS12.0 software(Chinese version) just after they werefinished.The contents of our investigation included:①Investigating the influencing scope,severity and duration of each factor did in the medical interns' crowd;②Analyzingthe time-effect or extent-effect characteristic of each influencing factor.③Single-factor and multiple-factors analysis(multiple linear regression) among therelationship of the influencing factors and general subjective quantization score ofinterns' practice education achievement, or the mid-term examination results whichreflect interns' objective practice education achievement, to ascertain both thesubjective and objective definitive influencing factors of current medical practiceeducation. Result:The influencing factors affecting current medical practice education included:"the problems of teachers who execute the practice education", "the relative shortageof teaching resource in some hospitals responsible for practice education", "theshortage of exercising chance in medical operations", "too much group activitiesnothing to do with medical practice education", "work seeking", "love problem", "toomuch private social activity" and "preparing for graduate and civil servant entranceexamination".The quantization score of interns' subjective practice education achievement was81.84±9.40. Meanwhile, the teachers' average score was 79.09±11.05 and theinfluencing proportionality of teachers' problems did in interns' population was 62.11％.The influencing scopes of each influencing factor were sequenced from big tosmall as below: "the problems of teachers who execute the practice education"＞"preparing for graduate entrance examination"＞"the shortage of exercising chancein medical operations"＞"too much private social activity"＞"work seeking"＞"loveproblem"＞"the relative shortage of teaching resource in some hospitals responsiblefor practice education"＞"preparing for civil servant entrance examination".Corresponding negative influencing scopes of each influencing factor did in the2002nd ocassion's undergraduates population were as high as below respectively:62.11％, 59.29％, 46.32％, 41.05％, 40.35％, 34.74％, 25.26％, 14.04％and 8.77％.When sequenced by duration from long to short, influencing factors were listedas below: "preparing for graduate entrance examination"＞"work seeking"＞"preparing for civil servant entrance examination"＞"too much group activitynothing to do with practice education". Corresponding time these factors occupied the practice education was as long as below respectively: 3.51±1.80months,1.31±1.01 months, 1.28±0.46months and 9.53±6.75days.When sequenced by average severity of negative influencing effect, theinfluencing factors were listed from severe to weak as below: "preparing for graduateentrance examination"＞"the problems of teachers who execute the practiceeducation"＞"work seeking"＞"preparing for civil servant entrance examination"＞"too much group activities nothing to do with medical practice education".In these factors, "teachers' score", "preparing for graduate entranceexamination", "group activities nothing to do with medical practice education" and"private social activity" presented a time-effect or extent-effect characteristic. Thehigher the teacher' s score was, the better the subjective effect of the interns'medical practice. On the contrary, the more time wasted in preparing for the graduateentrance examination, group activities and private social activities, the worse thesubjective effect of the interns' medical practice was.Single-factor and multiple-factors analysis demonstrated that teachers' scoreswere the only factor affecting subjective effect of medical practice education (p=0.000). The higher the score was, the better the subjective effect of the interns'medical practice. The subjective effect of medical practice was not affected by certaintheoretical scores such as internal medicine, surgery and diagnostics.The objective influencing factors affecting medical practice education included:"preparing for graduate entrance examination", "the teaching resource status ofhospitals responsible for practice education", "the exercising chance of medicaloperations" and score of part theoretical courses such as surgery and diagnostics. Thetime taken to prepare for graduate entrance examination was negatively correlatedwith the score of mid-term examination of practice education. The more time wastedfor examination preparation, the more severe the negative impact on practice education. In the other hand, other factors such as "the teaching resource status ofhospitals responsible for practice education" and "the exercising chance of medicaloperations" were positive correlated with the score of mid-term examination ofpractice education. The richer teaching resource of hospitals, the more chances foroperation practice, the better the effect of medical practice, otherwise, the effect ofmedical practice was hard to be guaranteed.Conclusion:Through questionnaire investigation on the 2002nd ocassion's undergraduate andsuccedent statistical analysis, the results demonstrated:(1) Main influencing factors affecting current medical practice education included:"work seeking", "preparing for graduate and civil servant entrance examination", "theproblems of teachers who execute the practice education", "too much private socialactivity", "too much group activities nothing to do with medical practice education","love problem", "the relative shortage of teaching resource in some hospitalsresponsible for practice education" and "the shortage of exercising chance in medicaloperations".(2) The only subjective factor influencing interns' practice education effect wasthe teachers' problems, while the objective factors included: "preparing for graduateentrance examination", "the teaching resource status of hospitals responsible forpractice education", "the exercising chance of medical operations" and score of parttheoretical courses such as surgery and diagnostics.(3) Interns preparing for graduate entrance examination has become a fairlyuniverse phenomenon. This problem occupied much time ought to be used formedical practice, which cast severe negative impact on medical practice education.The problem must be paid attention.(4) The phenomena of practice teaching source and exercising chance shortage were existed in some practice teaching hospitals. The constitution of practice teachinghospitals ought to be optimized.(5) The negative impact of "work seeking" problem has been reduced in someextent through drawing the practice time in advance.Aggregate analysis revealed that the rudimentary reason for influencing factorsaffecting current medical practice education was the conflict between the expandedstudents recruiting scale and limited work availability. In order to resolve thisproblem absolutely, an adequate students recruiting scale adapting for talent marketrequirement must be established. Or, medical students' employment should bedirected to community or countryside to increase work availability.
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