PDF(Pubmed)
Abstract：
Background Choosing a medical specialty is an important decision. A combination of factors influenced this decision. Student characteristics and examination performances can influence this decision. With the transition of the United States Medical Licensing Examination (USMLE) Step 1 becoming pass/fail, it is important to analyze the specialty decision process. Objective The purpose of this multimethod study is to assess when in the curriculum students choose a specialty, what factors influence their decision, and the impact of USMLE Step 1 scores on a student\'s assessment of competitiveness. Methods In February 2022, a survey was prepared and approved by the University of Nevada, Las Vegas (UNLV) Institutional Review Board (IRB). The survey contained multiple-choice questions and a free-response section. The survey was sent to the Class of 2022 and 2023 students at Kirk Kerkorian School of Medicine who follow a Longitudinal Integrated Clerkship. Descriptive statistics and one-sample t-tests were calculated. Results A total of 89 students completed the survey: 42 out of 60 students (70%) from the Class of 2022 and 47 out of 61 students (77%) from the Class of 2023. This study found that 78.8% of longitudinal interleaved clerkship (LInC) students committed to their specialty during the second half of the clinical year. The effects of positive and negative experiences during clerkships were most significantly different (p < 0.001). Conclusion The majority of LInC students arrive at their decision by the latter half of the clinical year. A variety of factors help students arrive at their decision. Our findings suggest that the pass/fail grading system will make it more difficult for students to assess their personal competitiveness.
摘要：
背景选择医学专业是一个重要的决定。综合因素影响了这一决定。学生特征和考试表现会影响这一决定。随着美国医学执照考试（USMLE）步骤1的过渡成为通过/失败，分析专业决策过程很重要。目的这项多方法研究的目的是评估学生在课程中选择专业的时间，哪些因素影响他们的决定，以及USMLE步骤1分数对学生竞争力评估的影响。方法2022年2月，内华达大学编制并批准了一项调查，拉斯维加斯（UNLV）机构审查委员会（IRB）。调查包含多项选择题和自由回答部分。该调查已发送给KirkKerkorian医学院的2022和2023级学生，他们遵循纵向综合文员制度。计算描述性统计和单样本t检验。结果共有89名学生完成了调查：2022级60名学生中有42名（70％），2023级61名学生中有47名（77％）。这项研究发现，在临床年的下半年，有78.8％的纵向交错文员（LInC）学生致力于他们的专业。在担任职员期间，积极和消极经历的影响差异最大（p<0.001）。结论大多数LInC学生在临床年的下半年就做出了决定。各种因素帮助学生做出决定。我们的发现表明，及格/不及格评分系统将使学生更难评估自己的个人竞争力。
