A multicenter cross-sectional study in China revealing the intrinsic relationship between medical students' grade and their perceptions of the learning environment

作者全名："Huang, Runzhi; Qian, Weijin; Xie, Sujie; Cheng, Mei; Gong, Meiqiong; Xian, Shuyuan; Jin, Minghao; Zhang, Mengyi; Tang, Jieling; Lu, Bingnan; Yang, Yiting; Liu, Zhenglin; Qu, Mingyu; Ma, Haonan; Wu, Xinru; Yin, Huabin; Wang, Xiaonan; Liu, Xin; Wang, Yue; Chen, Wenfang; Lin, Min; Zhang, Chongyou; Du, Erbin; Lin, Qing; Huang, Zongqiang; Zhang, Jie; Zhang, Guoyang; Liu, Yifan; Chen, Yu; Liu, Jun; Ji, Shizhao"

作者地址："[Huang, Runzhi; Xie, Sujie; Xian, Shuyuan; Ji, Shizhao] Naval Med Univ, Affiliated Hosp 1, Dept Burn Surg, 168 Changhai Rd, Shanghai 200433, Peoples R China; [Huang, Runzhi; Xie, Sujie; Xian, Shuyuan; Ji, Shizhao] Chinese Acad Med Sci, Res Unit Key Tech Treatment burns & Combined Burns, Shanghai 200433, Peoples R China; [Qian, Weijin; Jin, Minghao; Zhang, Mengyi; Tang, Jieling; Lu, Bingnan; Yang, Yiting; Liu, Zhenglin; Qu, Mingyu; Ma, Haonan; Wu, Xinru; Liu, Yifan] Shanghai Jiao Tong Univ, Sch Med, Shanghai 200025, Peoples R China; [Cheng, Mei] Naval Med Univ, Affiliated Hosp 1, Dept Nephrol, Shanghai 200433, Peoples R China; [Gong, Meiqiong] Shanghai Open Univ, Off Educ Adm, Shanghai 200444, Peoples R China; [Yin, Huabin] Shanghai Jiao Tong Univ, Sch Med, Shanghai Gen Hosp, Dept Orthoped, 100 Haining Rd, Shanghai 200072, Peoples R China; [Wang, Xiaonan] Capital Med Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, 10 Xitoutiao, Beijing 100069, Peoples R China; [Liu, Xin] Naval Med Univ, Affiliated Hosp 2, Dept Rheumatol & Immunol, Shanghai, Peoples R China; [Wang, Yue] Air Force Med Univ, Sch Publ Hlth, Dept Hlth Stat, 169,Changle West Rd, Xian 710032, Peoples R China; [Chen, Wenfang] Jinggangshan Univ, Fac Med, 28 Xueyuan Rd, Jian 343009, Peoples R China; [Lin, Min] Chongqing Med Univ, Mental Hlth Educ & Consultat Ctr, 61 Daxuecheng Middle Rd, Chongqing 401331, Peoples R China; [Zhang, Chongyou] Harbin Med Univ, Basic Med Coll, 157 Baojian Rd, Harbin 150081, Heilongjiang, Peoples R China; [Du, Erbin] Mudanjiang Med Univ, Clin Med Coll 1, 66 Tongxiang St, Mudanjiang 157011, Peoples R China; [Lin, Qing] Fujian Med Univ, Sch Basic Med Sci, Dept Human Anat, Lab Clin Appl Anat, 1 Xuefu North Rd, Fuzhou 350122, Peoples R China; [Huang, Zongqiang] Zhengzhou Univ, Affiliated Hosp 1, Dept Orthoped, 1 Jianshe East Rd, Zhengzhou 450052, Peoples R China; [Zhang, Jie] Tongji Univ, Sch Med, Shanghai Matern & Infant Hosp 1, Dept Gynecol, 2699 West GaoKe Rd, Shanghai 201204, Peoples R China; [Zhang, Guoyang] Maastricht Univ, Sch Hlth Profess Educ, Maastricht, Netherlands; [Chen, Yu] Naval Med Univ, Affiliated Hosp 1, Dept Orthopaed, 168 Changhai Rd, Shanghai 200433, Peoples R China; [Liu, Jun] Tongji Univ, Shanghai Pulm Hosp, Dept Anesthesiol, 507 Zheng Min Rd, Shanghai 200433, Peoples R China"

通信作者："Ji, SZ (通讯作者)，Naval Med Univ, Affiliated Hosp 1, Dept Burn Surg, 168 Changhai Rd, Shanghai 200433, Peoples R China.; Ji, SZ (通讯作者)，Chinese Acad Med Sci, Res Unit Key Tech Treatment burns & Combined Burns, Shanghai 200433, Peoples R China.; Liu, YF (通讯作者)，Shanghai Jiao Tong Univ, Sch Med, Shanghai 200025, Peoples R China.; Yin, HB (通讯作者)，Shanghai Jiao Tong Univ, Sch Med, Shanghai Gen Hosp, Dept Orthoped, 100 Haining Rd, Shanghai 200072, Peoples R China.; Wang, XA (通讯作者)，Capital Med Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, 10 Xitoutiao, Beijing 100069, Peoples R China.; Liu, X (通讯作者)，Naval Med Univ, Affiliated Hosp 2, Dept Rheumatol & Immunol, Shanghai, Peoples R China.; Wang, Y (通讯作者)，Air Force Med Univ, Sch Publ Hlth, Dept Hlth Stat, 169,Changle West Rd, Xian 710032, Peoples R China.; Chen, WF (通讯作者)，Jinggangshan Univ, Fac Med, 28 Xueyuan Rd, Jian 343009, Peoples R China.; Lin, M (通讯作者)，Chongqing Med Univ, Mental Hlth Educ & Consultat Ctr, 61 Daxuecheng Middle Rd, Chongqing 401331, Peoples R China.; Zhang, CY (通讯作者)，Harbin Med Univ, Basic Med Coll, 157 Baojian Rd, Harbin 150081, Heilongjiang, Peoples R China.; Du, ER (通讯作者)，Mudanjiang Med Univ, Clin Med Coll 1, 66 Tongxiang St, Mudanjiang 157011, Peoples R China.; Lin, Q (通讯作者)，Fujian Med Univ, Sch Basic Med Sci, Dept Human Anat, Lab Clin Appl Anat, 1 Xuefu North Rd, Fuzhou 350122, Peoples R China.; Huang, ZQ (通讯作者)，Zhengzhou Univ, Affiliated Hosp 1, Dept Orthoped, 1 Jianshe East Rd, Zhengzhou 450052, Peoples R China.; Zhang, J (通讯作者)，Tongji Univ, Sch Med, Shanghai Matern & Infant Hosp 1, Dept Gynecol, 2699 West GaoKe Rd, Shanghai 201204, Peoples R China.; Zhang, GY (通讯作者)，Maastricht Univ, Sch Hlth Profess Educ, Maastricht, Netherlands.; Chen, Y (通讯作者)，Naval Med Univ, Affiliated Hosp 1, Dept Orthopaed, 168 Changhai Rd, Shanghai 200433, Peoples R China.; Liu, J (通讯作者)，Tongji Univ, Shanghai Pulm Hosp, Dept Anesthesiol, 507 Zheng Min Rd, Shanghai 200433, Peoples R China."

来源：BMC MEDICAL EDUCATION

ESI学科分类：SOCIAL SCIENCES, GENERAL

WOS号：WOS:001282876300002

JCR分区：Q1

影响因子：3.6

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Medical school learning environment; Johns Hopkins learning environment scale; Perception; Student's grade; Nomogram; Intervention; Cross-sectional study

摘要："Background Medical school learning environment (MSLE) has a holistic impact on students' psychosomatic health, academic achievements, and personal development. Students in different grades perceive MSLE in different ways. Thus, it is essential to investigate the specific role of student's grade in the perception of MSLE. Methods Using the Johns Hopkins Learning Environment Scale (JHLES) as a quantification instrument for the perception level of MSLE, 10,901 medical students in 12 universities in China were categorized into low or high JHLES group according to their questionnaires. We investigated the relationship between student's grade and JHLES category by univariate analysis employing Pearson Chi-square test and Welch's ANOVA. Then multivariable logistic regression analysis confirmed the predictive efficacy of student's grade. A nomogram concerning the prediction of low JHLES score probability in medical students was also constructed. Results A significant difference between two JHLES categories among students in different grades was observed (p < 0.001), with the proportion of the high JHLES group dominating in grade 1, 5, and the graduate subgroups (p < 0.001). The mean JHLES score declined especially in the third and fourth graders compared to freshmen (p < 0.001), while the mean score among the fifth graders had a remarkable rebound from the third graders (p < 0.001). Most imperatively, identified by multivariable logistic regression analysis, students in grade 3 (OR = 1.470, 95% CI = 1.265-1.709, p < 0.001) and 4 (OR = 1.578, 95% CI = 1.326-1.878, p < 0.001) perceived more negatively than freshmen. The constructed nomogram provided a promising prediction model for student's low JHLES score probability, with accuracy, accordance, and discrimination (area under the curve (AUC) = 0.627). Conclusion The student's grade was a significant influencing factor in medical students' perception of MSLE. The perceptions among the third and fourth graders got worse, probably due to the worrying changes in various aspects of MSLE during that period. The relevant and appropriate interventions to improve medical students' perceptions are urgently needed."

基金机构："National Natural Science Foundation of China [81930057, 81772076, 81971836]; CAMS Innovation Fund for Medical Sciences [2019-I2M-5-076]; Deep Blue Talent Project of Naval Medical University, 234 Academic Climbing Programme of Changhai hospital and Achievements Supportive Fund [2018-CGPZ-B03]; Shanghai Rising-Star Program [23YF1458400]"

基金资助正文："This study was supported in part by the National Natural Science Foundation of China (81930057, 81772076, 81971836), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-076), Deep Blue Talent Project of Naval Medical University, 234 Academic Climbing Programme of Changhai hospital and Achievements Supportive Fund (2018-CGPZ-B03); Shanghai Rising-Star Program (Sailing Special Program) (No. 23YF1458400). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."