4년 교육과정에 걸친 의과대학생의 호기심 (Med Teach, 2017)

4년 교육과정에 걸친 의과대학생의 호기심 (Med Teach, 2017)

Describing medical student curiosity across a four year curriculum: An exploratory study

Robert Sternszusa, Alenoush Saroyanb and Yvonne Steinertc 

aDepartment of Pediatrics and Centre for Medical Education, McGill University, Montreal, Quebec, Canada; bDepartment of Education and Counseling Psychology, McGill University, Montreal, Quebec, Canada; cDepartment of Family Medicine and Centre for Medical Education, McGill University, Montreal, Quebec, Canada

도입

Introduction

지적 호기심은 내재적이고 안정된 기준선 특성 (즉 특성 호기심)과 다양한 상황 의존적 상태 (즉, 국가 호기심)로 구성된 탐색적 행동으로 이끄는 지식에 대한 욕구로 정의 될 수있다 (Berlyne 1954, Berlyne 1960, Naylor 1981 ; Pluck & Johnson 2011; Reio et al., 2006). 의학 및 의학 교육 분야에서의 중요성은 약 15 년 전 내부자 인 Faith T. Fitzgerald에 의해 강조되었습니다. 그녀는 호기심이 의학에서 인본주의적 실천의 핵심에 있으며 "어떤 경우에는, 돌보는 것caring과 같다"라고 하였다 (Fitzgerald 1999, p.70).

Intellectual curiosity can be defined as a desire for knowledge that leads to exploratory behavior, consisting of an inherent and stable baseline trait (i.e. trait curiosity) and a variable context-dependent state (i.e. state curiosity) (Berlyne 1954; Berlyne 1960; Naylor 1981; Pluck & Johnson 2011; Reio et al. 2006). In medicine and medical education, its importance was highlighted by internist Faith T. Fitzgerald more than 15 years ago, when she argued that curiosity is at the core of the humanistic practice of medicine and is “the same, in some cases, as caring” (Fitzgerald 1999, p. 70).

그 이후 호기심이 지적 발견, 문제 해결, 자기 감시, 평생 학습에 결정적인 역할을한다고 가정 한 의학 교육자들 사이에서 호기심의 중요성에 대한 관심이 커졌습니다 (Kasman 2004; Epstein 외 2008; Curry & 몽고메리 2010, Dyche & Epstein 2011, 로마 2011, Nanda 2012, Kanter 2012, Whitehead & Kuper 2012, Ellaway 2014).

Since that time, interest in the importance of curiosity has grown amongst medical educators who have hypothesized that curiosity plays a critical role in intellectual discovery, problem solving, self-monitoring, and lifelong learning (Kasman 2004; Epstein et al. 2008; Curry & Montgomery 2010; Dyche & Epstein 2011; Roman 2011; Nanda 2012; Kanter 2012; Whitehead & Kuper 2012; Ellaway 2014).

피츠제랄드 박사는 호기심의 중요성을 강조한 것 외에도 "의학 교육 자체가 호기심의 표현을 억제한다"고 주장하면서 "의사의 호기심이 위험하다"고 경고했다 (Fitzgerald 1999, p.71).

In addition to highlighting the importance of curiosity, Dr. Fitzgerald also warned that, “curiosity in physicians is at risk,” arguing that, “medical education itself suppresses the expression of curiosity” (Fitzgerald 1999, p. 71).

최근에는 "고의적이고deliberate 집중적이며focused 지속적인sustained 지적 탐구의 개발이 (...) 의학 교육에서 배우고 가르치는 핵심 부분이되어야한다고 주장 해왔다"(Ellaway 2014, 113 쪽).

More recently, it has been argued that the “development of deliberate, focused, and sustained [intellectual] curiosity should ( …) be a core part of learning and teaching in medical education” (Ellaway 2014, p. 113).

호기심은 의학 교육에서 중요한 주제 인 것처럼 보이지만,이 구조에 대한 이해를 높이기위한 경험적 연구는 거의 없습니다. "호기심", "의학", "교육", "학생", "대학", "성인 학습"및 "학업 성과"와 같은 주요 검색어를 사용하여 PubMed 및 Scopus 데이터베이스를 검색 한 결과, 의학교육에서 호기심에 관한 연구는 세 가지 뿐이었다.

While curiosity appears to be an important topic in medical education, there has been little empirical research to advance our understanding of this construct. A search of the PubMed and Scopus databases using key search terms “curiosity,”“medicine,”“education,”“student,”“university,” “adult learning” and “academic performance” yielded only three published studies on curiosity in medical education.

결론적으로,이 세 연구는 의료 전문가가 호기심을 의학에 중요하다고 생각하고 호기심이 강한 의대생이 더 깊은 학습 전략을 채택하고 있음을 보여줍니다. 그러나 연구는 state 와 trait 호기심이 의학 교육에 어떤 영향을 미치는지, 그리고 이 잠재적 영향이 퍼포먼스에 어떤 영향을 미칠 수 있는지에 대해 조사하지 않았습니다.

In sum, these three studies illustrate that healthcare professionals perceive curiosity as important to medicine and that medical students with high trait curiosity employ deeper learning strategies. Studies have not explored the influence of medical education on state and trait intellectual curiosity or how this potential influence may affect performance.

그러나 고등교육에서는 검증 된 도구를 사용하여 state and trait 지적 호기심이 연구되고 측정, 탐구되었다 (Naylor 1981; Reio et al., 2006). 연구 결과는 학습자의 state 호기심이 자극받을 수 있음을 보여 주며 (Loewenstein 1994; Reio & Wiswell 2000, Reio & Callahan 2004, Pluck & Johnson 2011), state and trait 호기심은 교실 및 직장 학습 및 성과를 긍정적으로 예측합니다 (Chamoiro-Premuzic 2006, Arteche et al., 2009, von Stumm et al., 2011). 종합적으로 말하자면, 이러한 연구들은 지적 호기심이 교육을 통해 성인들에게 촉진 될 수 있으며, 그렇게하면 학습자들에게 유익한 효과가 있음을 암시합니다.

These relationships, however, have been explored in higher education, where both state and trait intellectual curiosity have been studied and measured using validated instruments (Naylor 1981; Reio et al. 2006). Findings show that learner state curiosity can be stimulated (Loewenstein 1994; Reio & Wiswell 2000; Reio & Callahan 2004; Pluck & Johnson 2011), and that both state and trait curiosity are positively predictive of classroom and workplace learning and performance (Chamoiro-Premuzic et al. 2006; Arteche et al. 2009; von Stumm et al. 2011). Taken together, these studies suggest that intellectual curiosity can be promoted in adults through education and that doing so will have beneficial effects on learners.

방법

Methods

연구 설계와 성과 척도

Study design and outcome measure

To quantify and describe curiosity across all 4 years of a medical school at a single university, we employed cross-sectional design. State and trait intellectual curiosity was measured using the Melbourne Curiosity Inventory (MCI). This instrument has been previously used in studies carried out in other contexts, including higher education, which shares similarities to medical education (Naylor 1981; Reio & Wiswell 2000; Reio et al. 2006). This self-report measure uses distinct state and trait subscales, each consisting of 20 positively worded items, rated on a four-point Likert-type scale. Items assess thoughts and feelings about learning, exploring, problem solving, and questioning. The trait subscale focuses on the individual in general, whereas the state subscale asks respondents to focus on the current situation. The maximum score for each subscale is 80 and each subscale can be scored separately.

참여자와 세팅

Participants and setting

The undergraduate medical program at McGill University has parallel admission streams for students with and without a prior university degree. The curriculum follows the Canadian accreditation model and is delivered over 4 years. The emphasis in the first two years is on the basic sciences and clinical skills (pre-clerkship), with an early longitudinal exposure to the clinical setting. The final 2 years are devoted to experiential learning and the delivery of supervised clinical care in hospital and community practice settings (clerkship). The admissions website lists intellectual curiosity as one of the attributes desired in a potential medical student; however, curiosity is not listed as one of the core values of the undergraduate medical education program.

자료 수집

Data collection

Exceptionally, a subset of third-year medical students completed the questionnaire on two separate occasions in order to allow us to monitor the test–retest reliability of the tool in our context.

자료 분석

Data analysis

Data analysis occurred in two steps: 

(1) examining the appropriateness of the MCI as measure of curiosity in our context and 

(2) describing medical student curiosity across years of training.

MCI의 적절성

Appropriateness of the MCI

Given that the MCI had never been used in a medical education context, we monitored the performance of the tool prior to analyzing our data. 

• Using our entire dataset, we assessed the scale and subscale characteristics by calculating Cronbach’s alpha coefficients in order to determine the internal consistency of the instrument in the medical education context. 

• In addition, we conducted a test–retest analysis on the MCI subscales with a subset of the third-year medical class to confirm that the trait subscale would be more reliable on repeated measures than the state subscale, as the construct definitions would predict.

호기심에 대한 서술적 분석

Descriptive analysis of curiosity

Demographic data and curiosity scores were analyzed in a descriptive fashion, and means and standard deviations on each of the MCI subscales were determined. A Mixed Models ANOVA, with the MCI subscale as the repeated factor and year of training as the between-subjects factor, was used to compare mean state and trait curiosity scores within and across years of training.

Results

인구통계학 자료

Demographic data

Of the 751 students enrolled at McGill University for the 2014–2015 academic year, 402 completed the inventory, resulting in a response rate of 53.5%.

A summary of the demographic data by year of trainingis presented in Table 1. 

MCI의 적절성

Appropriateness of the MCI

Cronbach’s alphas for the 20-item trait and 20-item state curiosity subscales were calculated and determined to be 0.90 and 0.94, respectively. In addition, test–retest on a subsample of 26 third year medical students revealed a high correlation on the trait subscale, r ¼0.84. The state subscale was more unreliable than the trait subscale on test-retest analysis, r ¼0.69, which is consistent with the context-dependent construct definition of state curiosity and supports the assumption that the two subscales are measuring different dimensions of curiosity in our participants.

Descriptive analysis of curiosity

Examination of the descriptive statistics (as shown in Table 2 and Figure 1) reveal that trait curiosity is relatively stable across years whereas there is more variability in state curiosity, which is consistently lower than trait curiosity in each year, and particularly low in the year-2 student sample.

고찰

Discussion

교육 심리학에서는 호기심이 단일 구조로 연구 된 것이 아니라 오히려 다차원적인 구조로 연구되었다 (Langevin, 1971). 그러한 차원 중 하나는 지적 호기심이며, 여러 차례 렌즈에서 볼 수 있습니다. 즉, 호기심은 일시적이고 맥락의존적인 동기부여상태 또는 안정된 성격 특성으로서의 동기부여 상태로 묘사되어왔다(Langevin 1971, Reio et al. 2006). 우리 연구 결과는 의과대학생의 state and trait 지적 호기심이 의학 교육에서의 연구와 실천의 관심대상이 될 수 있음을 시사합니다.

In educational psychology, curiosity has not been studied as a unitary construct, but rather as a construct with multiple dimensions (Langevin 1971). One such dimension is intellectual curiosity, which in turn has been viewed from multiple lenses. Namely, it has been described as a motivational state that is transient and context dependent and/or a more stable personality trait (Langevin 1971; Reio et al. 2006). Our study findings suggest that both state and trait medical student intellectual curiosity may be of interest to research and practice in medical education.

형질 호기심과 관련하여 고등학생 2 명 (M = 56.1, SD = 8.5, M = 56.0)의 문헌에서 이전에보고 된 점수와 비교할 때 우리 연구 참가자의 호기심은 매우 높았다 (M = 64.9, SD = 8.5) , SD = 8.1), 두 명의 대학생 (M = 57.9 ~ 57.9, SD = 8.8, M = 55.6, SD = 9.9) (Naylor 1981). 이 연구의 횡단면 설계가 인과 관계를 추론하는 능력을 제한하지만,이 결과는 의과 대학이 높은 trait 호기심을 가진 학생들을 선발 할 가능성을 시사한다. 교육 심리학에 관한 연구에 따르면 trait 호기심은 학업 성취와 관련이 있습니다. (Chamoiro-Premuzic 외 2006, Arteche 외 2009, von Stumm 외. 2011).

With regard to trait curiosity, participants in our study scored highly (M¼64.9, SD¼8.5) when compared with scores previously reported in the literature for two samples of high school students (M¼56.1, SD¼8.5; and M¼56.0, SD¼8.1) and two samples of university students (M¼57.9 to 57.9, SD¼8.8; and M¼55.6, SD¼9.9) (Naylor 1981). Although the cross-sectional design of this study limits our ability to infer causality, this result suggests the possibility that medical schools may be selecting for students with high trait curiosity. Studies in educational psychology have shown that trait curiosity is positively associated with academic achievement; it is possible that medical schools are selecting for curiosity by prioritizing academic achievement in their admissions processes (Chamoiro-Premuzic et al. 2006; Arteche et al. 2009; von Stumm et al. 2011).

또는, 의과 대학은 인터뷰 과정을 통해 지적 호기심이 높은 사람을 뽑을 수도 있습니다. 호주 국립 대학 (Australian National University)의 멀티 미니 인터뷰 스테이션은 호기심이 높은 사람을 선발하기 위해 고안되었다. 호기심은 여러 이해관계자들로부터 의사의 가장 중요한 특성 중 하나로 선정되었습니다 (Harris & Owen 2007). 또한이 연구가 진행된 대학을 비롯한 여러 캐나다 대학의 입학 시험 웹 사이트는 잠재적 인 후보자가 찾는 특성으로 지적 호기심을 포함하고 있다.

Alternatively, it is possible that medical schools are selecting for intellectual curiosity through their interview process. At the Australian National University, a multi-mini interview station was designed to try and select for curiosity, which was listed as one of the most important attributes in a practicing physician by their stakeholders (Harris & Owen 2007). In addition, the admissions websites at several Canadian universities, including the university in which this study was conducted, list intellectual curiosity as an attribute that they look for in potential candidates.

우리가 trait 호기심을 바탕으로 선발할 가능성도 있지만, 이번 결과는 교육 과정 그 자체도 의대생의 지적 호기심에 영향을 미칠 수 있다고 제안합니다.

While it is possible that we are selecting for trait curiosity, our findings suggest that the educational process itself may be influencing medical students’ state intellectual curiosity.

우리는 trait를 불변이라고 생각하는 경향이 있지만, 심리학 문헌에 따르면 어떤 성격 state의 장기변화는 결국 trait에 영향을 줄 수 있다는 증거가있다 (Roberts et al., 2006; Roberts & Jackson 2008).

although we tend to think of traits as immutable, there is evidence in the psychology literature to suggest that a prolonged change in the state of a characteristic can eventually influence trait (Roberts et al. 2006; Roberts & Jackson 2008).

우리의 데이터는 의과 대학이 trait 호기심을 바탕으로 선발할지 모르지만, 의대학생의 state 호기심에 대해 이상적인 서포트를 하고있지는 않을 수 있다는 예비 증거를 제시합니다. 반드시 다른 대학에 일반화되지는 않을지라도, 호기심에 대한 의학 교육의 영향은 더 많은 탐구가됩니다. 알버트 아인슈타인 (Albert Einstein)은 "호기심이 공식 교육에서 살아남는 것이 기적이다"라고 말한 적이있다.

Our data suggest that medical schools may be selecting for trait curiosity and provide preliminary evidence that the state curiosity of our medical students finding may not be optimally supported. Although this may not necessarily generalize to other universities, the influence of medical education on curiosity merits further exploration. Albert Einstein once said that, “it is a miracle that curiosity survives formal education;”

Norman G. 2012. On competence, curiosity and creativity. Adv Health Sci Educ Theory Pract. 17:611–613.

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Med Teach. 2017 Apr;39(4):377-382. doi: 10.1080/0142159X.2017.1290793. Epub 2017 Feb 19.

Describing medical student curiosity across a four year curriculum: An exploratory study.

Sternszus R1, Saroyan A2, Steinert Y3.

Author information

1

a Department of Pediatrics and Centre for Medical Education , McGill University , Montreal , Quebec , Canada.

2

b Department of Education and Counseling Psychology , McGill University , Montreal , Quebec , Canada.

3

c Department of Family Medicine and Centre for Medical Education , McGill University , Montreal , Quebec , Canada.

Abstract

BACKGROUND:

Intellectual curiosity can be defined as a desire for knowledge that leads to exploratory behavior and consists of an inherent and stable trait (i.e. trait curiosity) and a variable context-dependent state (i.e. state curiosity). Although intellectual curiosity has been considered an important aspect of medical education and practice, its relationship to medical education has not been empirically investigated. The purpose of this exploratory study was to describe medical students' intellectual curiosity across a four-year undergraduate program.

METHODS:

We employed a cross-sectional design in which medical students, across a four-year undergraduate program at McGill University, completed the Melbourne Curiosity Inventory as a measure of their state and trait intellectual curiosity. A Mixed Models ANOVA was used to compare students across year of training.

RESULTS:

Four hundred and two out of 751 students completed the inventory (53.5%). Trait curiosity was significantly higher than state curiosity (M = 64.5, SD = 8.5 versus M = 58.5, SD = 11.6) overall, and within each year of training.

CONCLUSIONS:

This study is the first to describe state and trait intellectual curiosity in undergraduate medical education. Findings suggest that medical students' state curiosity may not be optimally supported and highlight avenues for further research.

PMID:

 

28379089

 

DOI:

 

10.1080/0142159X.2017.1290793