학부 교육과정이 학생의 SDL에 미치는 영향 (Acad Med, 2003)

학부 교육과정이 학생의 SDL에 미치는 영향 (Acad Med, 2003)

Effect of an Undergraduate Medical Curriculum on Students’ Self-Directed Learning 

Bart J. Harvey MD, PhD, Arthur I. Rothman, EdD, and Richard C. Frecker, MD, PhD

1992년, U of Toronto는 전통적인 강의중심의 교육과정을 소그룹의, 문제중심의, SDL을 장려하는 교육과정으로 개편하였다. 개편한 교육과정은 Barrows가 묘사한 "학생이 경험을 통해 자극받고, 그들이 배우는 내용이 미래에 그들이 감당할 책임과 어떻게 연결되는지 깨닫고, 높은 수준의 학습동기를 유지하고, 전문가적 태도의 중요성을 깨닫는" 것을 목표하였다. 우리는 교육과정 변화가 학생의 SDL에 어떻게 영향을 주는지 보고자 했다.

In 1992, at least in part to address this curricular goal and to enhance students’ self-directed learning (SDL), the Uni- versity of Toronto Faculty of Medicine revised its conventional, lecture-based medical curriculum into a “hybrid,” replacing much of the curriculum time devoted to large-group didactic lectures with small-group, problem-based, and SDL opportunities. The resulting curric- ular changes were designed and implemented to achieve the ideals Barrows describes: “That students would be stimulated by the experience, would see the relevance of what they were learning to their future responsibilities, would maintain a high degree of motivation for learning, and would begin to under- stand the importance of responsible pro- fessional attitudes.”4 We undertook this study to begin to learn whether the curricular revision enhanced students’ SDL (and, ultimately, their abilities as effective lifelong learners)."

총 280명의 학생이 참여하였으며, 각각 학년에서 70명 무작위 선택. 이 숫자를 선택한 이유는 60%응답자가 0.80의 study power와 5% difference를 제공하기 때문이다.

Participants A total of 280 students, 70 from each of the four years of the undergraduate med- ical curriculum, were randomly selected fromthe school’s population of 700. We chose this number because calculations showed that 60 respondents per class (85% response rate) would provide a study power of .80 to detect ( .05) a 5% difference among the four years.23"

네 가지 SDL 요소에 따라서 Rayn은 간략한 두 파트로 된 설문지를 개발하여 SDL의 중요도와 자기주도적 학습자로서의 능력을 평가하게끔 했다.

Guided by these four SDL components, Ryan6 developed and administered a brief, two-part questionnaire to assess students’ perceptions concerning the importance of SDL and their abilities as self-directed learners."

두 개의 가장 널리 사용되는 SDL 척도는 SDLRS와 OCLI이다. 타당도와 신뢰도에 대한 여러 연구가 되어있다.

The two most widely recognized, extensively used, and validated instruments for measuring SDL capability and readiness13–15 are Guglielmino’s Self- Directed Learning Readiness Scale (SDLRS)16 and Oddi’s Continuing Learning Inventory (OCLI).17,18 Several assessments of the reliability and valid- ity of the OCLI and SDLRS have been conducted,14 including dissertations re- porting positive associations between instrument scores and SDL activity."

Ryan의 설문지는 SDL의 네 가지 요소에 대한 것이며 그 요소들에 대해서 중요도와 능력을 0부터 6까지 응답하게 되어있다. SDLR은 58개의 명제로 되어 있으며 5점 척도로 응답하게 되어있다. OCLI는 24개의 명ㅈ제로 되어있으며 7점 척도로 응답하게 되어있다.

Ryan’s questionnaire asks respondents to consider the four identified components of SDL and rate each, from low (0) to high (6), on its importance and their ability with the component.6 The SDLRS contains 58 statements (e.g., “I learn several new things on my own each year”) with five-point responses, ranging from “Almost never true of me; I hardly ever feel this way” to “Almost always true of me; there are very few times when I don’t feel this way.” Total scores range from 58 (least ready for SDL) to 290 (most ready).16 The OCLI contains 24 statements (e.g., “I work more effectively if I have freedom to regulate myself”) with seven- point responses, ranging from “Strongly Disagree” to “Strongly Agree.” Total scores range from 24 (least characteris- tic of self-directed learners) to 168 (most characteristic).17,18 Brockett and Hiemstra,14 in their review of the use and validity of the SDLRS and OCLI, concluded that both are well-accepted measures of SDL."

여학생과 남학생은 SDL 점수가 비슷했다. SDLRS와 OCLI Ryan ability 점수는 나이가 높아짐에 따라 높아졌으며, 의예과 이전에 교육 수준이 높을수록 높았다. 그러나 여러 요인을 포함한 MLR 분석에서는 premedical education만이 유의한 요인으로 남았다.

Women and men had similar SDL scores. SDLRS, OCLI, and Ryanability scores increased significantly by age (data not shown) and highest level of premedical education achieved (under- graduate only, masters, or doctoral). However, only premedical education re- mained significant in a multivariate lin- ear regression including both factors."

SDLRS, OCLI, Ryan importance 점수가 학년간 유의하게 달랐지만, 지속적인 경향은 Ryan importance에서만 확인되었다. 

Although a significant between-yeardifference was found for the SDLRS(p .028), OCLI (p .011), andRyanimportance (p .021), a significanttrend by year was only evident forRyanimportance scores (p .007). Thistrend, however, indicated a decrease inperceived SDL importance by curricularyear."

SDL이 학년 간 차이가 컸지만, 교육과정을 진행함에 따라서 지속되는 경향은 없었고 1학년이 가장 높고, 2학년에서 가장 낮은 경향이 있었다.

Although significant interyear SDL differences were found, SDL scores did not follow a trend consistent with progression through the curriculum, with the first and second years having consis- tently the highest and lowest scores, respectively."

우리는 네 개의 SDLRS 문항이 학년에 따라 경향성을 갖는 것을 확인하였다. 그러나 이 모든 문항이 학년이 올라가면서 SDL이 감소하는 것으로 나타났다.

we found four, albeit different, SDLRS items suggesting a trend by curricular year. These, however, all indicated decreasing SDL into senior years."

본 연구 결과가 교육과정이 SDL을 촉진하지 않는다는 것을 보여주나 다른 해석도 봐야 한다.

Although the results of our study suggest that the curriculum does not foster students’ SDL, alternative explanations should be considered."

평가도구들은 SDL 변화를 보여주기에 충분히 민감한가? 두 가지를 보면 그러하다. (1) 모든 세 가지 평가도구가 유사한 결과를 보여준다. 즉, SDL이 premedical education 수준이 높을수록 높아지는 것이다. (2) 세 척도의 유사성이 우연히 나타났을 가능성은 낮다. 또한 응답률이 거의 일정했으므로 응답 편향의 가능성도 낮다.

the instruments sufficiently sensitive to detect SDL progress? Two factors sug- gest that they are: (1) all three instru- ments provide similar findings, with each able to detect the significant in- creasing trend in SDL associated with higher levels of premedical education; and (2) the similarity of results for each of the three measures of SDL ability (i.e., SDLRS, OCLI, and Ryanability) suggests that the significant results ob- served are unlikely to have occurred by chance (i.e., as a result of the multiple comparisons conducted). Further, re- sponse bias is not a likely explanation for the study’s inability to detect a year- by-year SDL trend because the response rates across the four years were uni- formly high—in excess of 85%."

추가적으로 고려할 점은, 이것이 단면연구라는 점이다. 

An additional consideration, how- ever, is the study’s cross-sectional design. Although this design is more efficient than a longitudinal approach, actual changes in SDL are not measured in the same groups of students over time. Instead, the cross-sectional design assumes the comparability of the four classes. Although the admission proce- dures and curriculum were similar for each of the four years, the failure to detect SDL progress over the curriculum could be the result of unmeasured differences between two or more of the classes. 

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Acad Med. 2003 Dec;78(12):1259-65.

Effect of an undergraduate medical curriculum on students' self-directed learning.

Harvey BJ1, Rothman AI, Frecker RC.

Author information

• 1Department of Public Health Sciences, Institute of Medical Science, Ontario Institute for Studies in Education, Toronto, Canada.

Abstract

PURPOSE:

Lifelong, self-directed learning (SDL) has been identified as an important ability for medical graduates. To evaluate the effect of the University of Toronto Faculty of Medicine's revised undergraduate medical curriculum on students' SDL, a cross-sectional study was conducted.

METHOD:

A questionnaire package was mailed to 280 randomly selected students, 70 from each of the four years of the curriculum. The package contained the two most widely recognized, extensively used, and validated instruments of SDL (Guglielmino's 58-item Self-Directed LearningReadiness Scale and Oddi's 24-item Continuous Learning Inventory) and Ryan's two-part Self-Assessment Questionnaire. An identification number and sociodemographic questions were included with the questionnaires. Data analysis was completed using chi-square for differences of proportions, analysis of variance for differences between means, and linear regression for trends.

RESULTS:

A total of 250 (89.3%) complete questionnaire packages were returned. No significant trend in SDL was evident by curriculum year, and similar SDL levels were observed for women and men. However, a significant positive trend in SDL was found with the highest level of premedicaleducation achieved (undergraduate only, masters, or doctoral). Further, students' perceptions concerning the importance of SDL decreased according to year in the curriculum.

CONCLUSION:

This study found no evidence that students' self-reported SDL is positively influenced by the current undergraduate medicalcurriculum at the University of Toronto Faculty of Medicine.

PMID:

 

14660430

 

[PubMed - indexed for MEDLINE]