目的 从临床医学专业学生视角分析X大学本科临床医学教育可能存在的不足,为其提升本科临床医学教育质量及临床医学生专业满意度提供参考。方法 2019年6月,采用问卷调查方法对X大学2014级临床医学专业181名学生(以下简称医学生)专业教育的感知教育质量(以下简称为感知质量)与满意度进行分析。利用因子分析将感知质量包含的具体指标降维得到公因子,并计算相应的因子评分。将各公因子分别命名为“临床阶段课程、教师与实习”“临床阶段考核与医院氛围”“临床前阶段课程”“临床前阶段教师”“临床前阶段考核”“基于问题学习(problem-based learning,PBL)”,此即为感知质量的6个维度。采用均数描述学生专业满意度及其对感知质量总体与各维度评价的现状,并基于均数对感知质量各维度进行降序排序;利用多重线性回归分析感知质量各维度对专业满意度的影响,并基于标准回归系数对感知教育质量各维度进行降序排序。结果 医学生专业满意度评分为3.56分,感知质量整体评分为3.65分,感知质量各维度评分最高的为“临床阶段课程、教师与实习”(3.89分),最低的为“临床前阶段课程”(3.24分)。回归分析显示,R²值为0.528,感知教育质量各维度对专业满意度均存在正向影响,差异均具有统计学意义(均P <0.05),其中,标准回归系数最高的为“临床前阶段课程”(0.438)。结论 X大学医学生对临床阶段教育质量的评价优于临床前阶段,其中,“临床前阶段课程”的评价最低。然而,临床前阶段感知质量对专业满意度的影响力大于临床阶段,其中,首位影响因素是“临床前阶段课程”。X大学应当切实关注学生需求,听取学生的意见,重点关注临床前阶段课程质量的提升,例如在PBL教学、科研训练、课程整合等方面采取改进措施。

Objective To analyzes the possible shortcomings of undergraduate clinical medical education in X university from the perspective of clinical medical students, so as to provide reference for improving the quality of undergraduate clinical medical education and the major satisfaction of clinical medical students. Methods In June 2019, a questionnaire survey was used to analyze the perceived quality and satisfaction of 181 students majoring in clinical medicine in 2014 of X university. Factor analysis is used to reduce the dimension of specific indicators included in perceived quality to obtain common factors, and the corresponding factor scores are calculated. The common factors are named “clinical stage courses, teachers and practice”, “clinical stage assessment and hospital atmosphere”, “pre-clinical stage courses,”, “pre-clinical stage teachers”, “pre-clinical stage assessment” and “problem-based learning (PBL)”, which are the six dimensions of perceived quality. The mean is used to describe the current situation of students' major satisfaction and its evaluation of the overall and various dimensions of perceived quality, and the dimensions of perceived quality are ranked in descending order based on the mean; Multiple linear regression is used to analyze the impact of each dimension of perceived quality on major satisfaction, and the dimensions of perceived education quality are ranked in descending order based on the standard regression coefficient. Results The major satisfaction score of medical students is 3.56, and the overall score of perceived quality is 3.65. The highest score of each dimension of perceived quality is “clinical stage courses, teachers and practice” (3.89), and the lowest is “pre-clinical stage courses” (3.24). Regression analysis showed that R² was 0.528, and all dimensions of perceived education quality had a statistically significant positive impact on major satisfaction (all P<0.05). Among them, the “pre-clinical courses” (0.438) had the highest standard regression coefficient. Conclusions Clinical medical students of X university evaluated the quality of education in clinical stage better than that in pre-clinical stage, and “pre-clinical stage courses” had the lowest evaluation. Regression analysis showed that the influence of perceived quality of education on student satisfaction in pre-clinical stage was greater than that in clinical stage, and the first influencing factor was “pre-clinical stage courses”. X university should pay attention to the needs of students, listen to their opinions, focus on the improvement of the quality of pre-clinical courses, and take improvement measures in PBL teaching, scientific research training and curriculum integration.