TY - JOUR
T1 - A multicenter cross-sectional study in China revealing the intrinsic relationship between medical students' grade and their perceptions of the learning environment
AU - Huang, Runzhi
AU - Qian, Weijin
AU - Xie, Sujie
AU - Cheng, Mei
AU - Gong, Meiqiong
AU - Xian, Shuyuan
AU - Jin, Minghao
AU - Zhang, Mengyi
AU - Tang, Jieling
AU - Lu, Bingnan
AU - Yang, Yiting
AU - Liu, Zhenglin
AU - Qu, Mingyu
AU - Ma, Haonan
AU - Wu, Xinru
AU - Yin, Huabin
AU - Wang, Xiaonan
AU - Liu, Xin
AU - Wang, Yue
AU - Chen, Wenfang
AU - Lin, Min
AU - Zhang, Chongyou
AU - Du, Erbin
AU - Lin, Qing
AU - Huang, Zongqiang
AU - Zhang, Jie
AU - Zhang, Guoyang
AU - Liu, Yifan
AU - Chen, Yu
AU - Liu, Jun
AU - Ji, Shizhao
PY - 2024/8/1
Y1 - 2024/8/1
N2 - 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.
AB - 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.
KW - Medical school learning environment
KW - Johns Hopkins learning environment scale
KW - Perception
KW - Student's grade
KW - Nomogram
KW - Intervention
KW - Cross-sectional study
KW - EDUCATIONAL ENVIRONMENT
KW - ACADEMIC-PERFORMANCE
KW - SCHOOL
KW - ASSOCIATION
KW - TRANSITION
KW - RESIDENTS
KW - STRESS
U2 - 10.1186/s12909-024-05538-4
DO - 10.1186/s12909-024-05538-4
M3 - Article
SN - 1472-6920
VL - 24
JO - BMC Medical Education
JF - BMC Medical Education
IS - 1
M1 - 832
ER -