本文關(guān)鍵詞：醫(yī)學(xué)生第一年學(xué)業(yè)成績(jī)影響因素的隊(duì)列研究　出處：《南方醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

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【摘要】：背景 大學(xué)第一年是大學(xué)生發(fā)展最為關(guān)鍵性的一年,大學(xué)學(xué)習(xí)成功在很大程度上取決于新生第一年經(jīng)歷。第一年對(duì)于培養(yǎng)大學(xué)學(xué)習(xí)的興趣、掌握醫(yī)學(xué)基礎(chǔ)知識(shí)、形成積極的態(tài)度和獲取自信心、以及建立人際關(guān)系等起著至關(guān)重要的作用,而這些因素對(duì)學(xué)生學(xué)業(yè)成績(jī)和學(xué)業(yè)的完成有著重要的影響。有研究表明,新生的學(xué)業(yè)表現(xiàn)和學(xué)業(yè)的完成主要是受學(xué)生對(duì)大學(xué)環(huán)境適應(yīng)程度的影響,而學(xué)生的個(gè)體特質(zhì)與各種大學(xué)環(huán)境之間的互動(dòng)關(guān)系是復(fù)雜多樣的。要闡明這種關(guān)系,就需要結(jié)合影響因素的背景特征和社會(huì)心理的理論模型,應(yīng)用合適的統(tǒng)計(jì)模型,分析各影響因素是如何相互作用進(jìn)而影響學(xué)業(yè)成績(jī),探討可能的影響機(jī)制。 既往有關(guān)醫(yī)學(xué)生學(xué)業(yè)成績(jī)影響因素的文獻(xiàn)主要來(lái)源于美國(guó)和歐洲等發(fā)達(dá)國(guó)家。近十年來(lái),中國(guó)高等教育快速發(fā)展,中國(guó)的醫(yī)學(xué)生招生規(guī)模擴(kuò)大,也對(duì)醫(yī)學(xué)生的教育質(zhì)量提出了更高的要求。盡管如此,仍然很少文獻(xiàn)對(duì)中國(guó)醫(yī)學(xué)生學(xué)業(yè)成績(jī)影響因素及其機(jī)制進(jìn)行深入系統(tǒng)的分析。中國(guó)的大學(xué)生在文化背景、人口學(xué)特征和社會(huì)經(jīng)濟(jì)地位等各方面特質(zhì)均與國(guó)外的大學(xué)生有所不同。因而,在中國(guó),有必要開(kāi)展專門(mén)針對(duì)中國(guó)醫(yī)學(xué)生的學(xué)業(yè)成績(jī)與其影響因素關(guān)系的研究,并對(duì)影響機(jī)制做全面綜合的分析。本研究擬針對(duì)一所醫(yī)科大學(xué)的醫(yī)學(xué)生進(jìn)行第一年學(xué)業(yè)成績(jī)影響因素的隨訪調(diào)查,并提出相應(yīng)的統(tǒng)計(jì)模型探討學(xué)業(yè)成績(jī)的影響因素及其機(jī)制,為同類研究提供方法學(xué)參考,同時(shí)也為促進(jìn)醫(yī)學(xué)生學(xué)業(yè)成績(jī)和幫助大學(xué)生順利完成學(xué)業(yè)提供參考依據(jù)。 方法 2.1研究對(duì)象和數(shù)據(jù)來(lái)源 在2011年8月對(duì)來(lái)自南方醫(yī)科大學(xué)28個(gè)醫(yī)學(xué)專業(yè)的1820名醫(yī)學(xué)生進(jìn)行新生調(diào)查,調(diào)查方法是將調(diào)查表隨錄取通知書(shū)郵寄給新生,新生報(bào)到時(shí)回收問(wèn)卷,回收率為71%。一年之后對(duì)28個(gè)專業(yè)中6個(gè)專業(yè)的1105名醫(yī)學(xué)生進(jìn)行隨訪調(diào)查,現(xiàn)場(chǎng)發(fā)放及回收問(wèn)卷,回收率為87%。將兩次調(diào)查按準(zhǔn)考證號(hào)進(jìn)行樣本匹配,匹配后的樣本量是519。本研究的調(diào)查表是在美國(guó)教育委員會(huì)研制的大學(xué)新生調(diào)查表和第一年調(diào)查表的基礎(chǔ)上漢化,調(diào)查內(nèi)容涵蓋了大學(xué)生的綜合特征,包括人口學(xué)特征、學(xué)業(yè)和社交方面的能力評(píng)估、價(jià)值目標(biāo)期望及行為習(xí)慣等心理和行為方面的發(fā)展變化特征。除了人口學(xué)特征部分因素,調(diào)查表的其他條目均采用Likert計(jì)分方式,分為3-7個(gè)等級(jí)。大學(xué)生的高考成績(jī)和大學(xué)第一年各科成績(jī)均從教務(wù)處獲取。 2.2統(tǒng)計(jì)分析方法 進(jìn)行探索性因子分析和驗(yàn)證性因子分析,通過(guò)Cronbach's alpha系數(shù)、組合信度、因子分析獲得的因子載荷、平均方差抽取量、聚合效度和區(qū)別效度等指標(biāo)對(duì)調(diào)查表的信效度進(jìn)行評(píng)價(jià)。由于調(diào)查的條目多為有序分類數(shù)據(jù),為獲得更準(zhǔn)確的評(píng)價(jià)指標(biāo),故采用基于多項(xiàng)相關(guān)系數(shù)的方法進(jìn)行相應(yīng)的因子分析和評(píng)價(jià)指標(biāo)的計(jì)算。采用多水平線性模型分析第一年學(xué)業(yè)成績(jī)?cè)趥�(gè)體水平和專業(yè)水平上的影響因素。建模的思路是先建立只包含截距項(xiàng)的隨機(jī)效應(yīng)方差分析模型,若截距項(xiàng)的隨機(jī)效應(yīng)方差顯著,則建立含影響因素的多水平線性模型,此模型中檢驗(yàn)隨機(jī)效應(yīng)系數(shù)方差的顯著性,若不顯著則建立固定效應(yīng)模型,截距項(xiàng)為隨機(jī)效應(yīng),影響因素為固定效應(yīng)。采用路徑分析建立各因素對(duì)大學(xué)第一年成績(jī)直接與間接影響的因果路徑模型,其中應(yīng)用多元回歸模型篩選路徑(P0.05),此多元回歸是用路徑模型建立的,允許自變量間兩兩相關(guān)。所建的路徑模型進(jìn)一步刪除路徑系數(shù)不顯著的路徑(P0.05)。計(jì)算路徑模型中每個(gè)自變量所解釋因變量的變異。為檢驗(yàn)路徑模型是否有性別差異,對(duì)路徑模型進(jìn)行群組路徑分析。應(yīng)用的統(tǒng)計(jì)分析軟件包括SPSS19.0, AMOS17.0, R3.0.2和SAS9.2,雙側(cè)P0.05認(rèn)為結(jié)果有統(tǒng)計(jì)學(xué)意義。 結(jié)果 對(duì)醫(yī)學(xué)生入學(xué)前后學(xué)業(yè)相關(guān)特征因素的比較發(fā)現(xiàn),入學(xué)一年后醫(yī)學(xué)生在學(xué)習(xí)和社交目標(biāo)期望以及自我效能等心理特征方面的評(píng)估均顯著低于入學(xué)前的水平(P0.05)。另外,與高中相比,醫(yī)學(xué)生花更多的時(shí)間在自習(xí)和課外活動(dòng)上。 多水平線性模型的分析結(jié)果顯示,人口學(xué)特征因素對(duì)醫(yī)學(xué)生的成績(jī)有著顯著的影響,女醫(yī)學(xué)生第一年的成績(jī)高于男醫(yī)學(xué)生(b=2.44,P0.001),大學(xué)成績(jī)與父母收入呈負(fù)相關(guān)關(guān)系(b=-0.30,P=0.049),往屆生的大學(xué)成績(jī)低于應(yīng)屆生(b=-1.55,P=0.001)。當(dāng)控制了人口學(xué)因素后,醫(yī)學(xué)生的高考成績(jī)對(duì)大學(xué)第一年的成績(jī)有顯著的影響,具體表現(xiàn)在：同一個(gè)專業(yè)內(nèi),高考成績(jī)?cè)礁叩尼t(yī)學(xué)生其大學(xué)成績(jī)也越高(b=1.24,P0.001),而對(duì)于不同的專業(yè)來(lái)說(shuō),高考平均分高的專業(yè)其大學(xué)第一年的成績(jī)也高(b=3.04,P=0.022)。 心理行為路徑模型的分析結(jié)果表明,醫(yī)學(xué)生的學(xué)習(xí)自我效能(b=0.10,P=0.013)、課程參與(b=0.12,P=0.004)、花時(shí)間做作業(yè)或自習(xí)(b=0.15,P0.001)均能直接地正向影響第一年大學(xué)成績(jī)。以往成績(jī)、入學(xué)前的自信及大學(xué)學(xué)習(xí)活動(dòng)的參與均與大學(xué)成績(jī)有關(guān),而這些因素是通過(guò)提高學(xué)習(xí)自我效能來(lái)正向影響大學(xué)成績(jī)。高考成績(jī)(b=0.20,P0.001)、入學(xué)前的自我效能(b=0.32,P0.001；b=0.124,P=0.016)、師生互動(dòng)(b=0.17,P0.001)、增加做作業(yè)或自習(xí)時(shí)間(b=0.14,P0.001)能提高大學(xué)學(xué)習(xí)方面的自信,從而提高大學(xué)學(xué)業(yè)成績(jī)。 動(dòng)機(jī)成就的路徑模型分析結(jié)果發(fā)現(xiàn),學(xué)習(xí)經(jīng)驗(yàn)(b=0.10,P=0.011)、職業(yè)目標(biāo)(b=0.12,P=0.003)和學(xué)術(shù)目標(biāo)(b=0.09,P=0.034)對(duì)大學(xué)第一年成績(jī)有正向影響。目標(biāo)動(dòng)機(jī)在背景特征、大學(xué)環(huán)境和學(xué)業(yè)成績(jī)之間起著正向調(diào)節(jié)作用。老師的支持和關(guān)注能正向影響醫(yī)學(xué)生的目標(biāo)定位(b=0.11, P=0.01;b6=0.15, P0.001),從而間接地正向影響醫(yī)學(xué)生的第一年成績(jī)。高中和大學(xué)的學(xué)習(xí)經(jīng)驗(yàn)的發(fā)展與學(xué)術(shù)目標(biāo)之間的影響關(guān)系是相互的,即高考成績(jī)能正向預(yù)測(cè)學(xué)術(shù)目標(biāo)(b=0.12,P=0.007),而學(xué)術(shù)目標(biāo)能促進(jìn)學(xué)習(xí)經(jīng)驗(yàn)的增長(zhǎng)(b=0.16,P0.001),學(xué)習(xí)經(jīng)驗(yàn)又正向預(yù)測(cè)后續(xù)的學(xué)術(shù)目標(biāo)(b=0.16,P0.001),這種相互影響關(guān)系最終能正向影響著醫(yī)學(xué)生的學(xué)業(yè)成績(jī)。另外,醫(yī)學(xué)生入學(xué)前的學(xué)習(xí)動(dòng)機(jī)態(tài)度,如學(xué)術(shù)目標(biāo)(b=0.41,P0.001)和職業(yè)目標(biāo)(b=0.32,P0.001)以及自我效能(b=0.32,P0.001),均能正向預(yù)測(cè)大學(xué)期間的學(xué)習(xí)動(dòng)機(jī)態(tài)度。 人口學(xué)特征如性別和家庭情況在大學(xué)成績(jī)影響機(jī)制中也起調(diào)節(jié)作用：女生更積極地上課和參與課程學(xué)習(xí)(b=0.18,P0.001),而男生更主動(dòng)與老師交流(b=-0.15,P0.001)；父母教育水平越高的學(xué)生其社交自我效能越高,也越可能參與師生互動(dòng)(b=0.12,P=0.004)。這些正向調(diào)節(jié)關(guān)系均有利于提高學(xué)業(yè)成績(jī)。 大學(xué)成績(jī)影響因素模型中,所有因素共同解釋大學(xué)成績(jī)32%的變異。其中,性別、父母教育水平、專業(yè)等因素共同解釋了9%的變異,高考成績(jī)解釋了9%的變異,大學(xué)參與(課程參與、做作業(yè)或自習(xí)、師生互動(dòng)如參與課題活動(dòng)或與老師交流)解釋6%的變異,學(xué)術(shù)和職業(yè)方面的目標(biāo)則解釋了4%的變異,學(xué)習(xí)和社交方面的自我效能解釋了2%的變異,老師的支持和關(guān)心及大學(xué)學(xué)習(xí)經(jīng)驗(yàn)的發(fā)展共同解釋了2%的變異。 結(jié)論 本研究采用多水平模型和路徑分析對(duì)大學(xué)生學(xué)業(yè)影響因素進(jìn)行研究。多水平模型通過(guò)將第一年成績(jī)的隨機(jī)誤差項(xiàng)分解到專業(yè)水平和個(gè)體水平上,一方面能有效估計(jì)個(gè)體效應(yīng)和專業(yè)效應(yīng),有利于解釋變異來(lái)源。另一方面,在控制了專業(yè)水平上的隨機(jī)效應(yīng)后(截距),分析適用于各專業(yè)的個(gè)體固定效應(yīng),即消除了專業(yè)影響,把個(gè)體效應(yīng)推廣到更多的醫(yī)學(xué)專業(yè)上,使結(jié)論具有普遍性。路徑分析模型則通過(guò)構(gòu)建影響因素與結(jié)果變量之間的因果關(guān)系圖,能有效且簡(jiǎn)便地驗(yàn)證社會(huì)心理理論上構(gòu)建的模型,在實(shí)證分析的角度對(duì)理論模型進(jìn)一步的改進(jìn)和完善。 大學(xué)第一年是大學(xué)生從高中到大學(xué)的過(guò)渡時(shí)期,他們?cè)诖藭r(shí)期經(jīng)歷著個(gè)人認(rèn)知、行為習(xí)慣、學(xué)習(xí)環(huán)境和學(xué)習(xí)模式的轉(zhuǎn)折變化,本研究發(fā)現(xiàn)大學(xué)生在目標(biāo)期望和自我效能等心理因素方面均相對(duì)于入學(xué)前顯著降低,而花在自習(xí)的時(shí)間顯著增加,這提示學(xué)校相關(guān)部門(mén)應(yīng)關(guān)注醫(yī)學(xué)生在這些方面的變化,適當(dāng)采取積極的措施調(diào)節(jié)學(xué)生的心理落差或緩解其學(xué)習(xí)壓力,幫助其更好地適應(yīng)大學(xué)的學(xué)習(xí)生活。 高考成績(jī)是大學(xué)成績(jī)的顯著影響因素,但其預(yù)測(cè)效度并不是很高(解釋了不足10%的大學(xué)成績(jī)變異),提示高考方案有待完善,從而能更有效地篩選出優(yōu)秀的醫(yī)科學(xué)生。除了高考成績(jī),本研究還發(fā)現(xiàn)社會(huì)人口學(xué)特征因素、專業(yè)因素和心理因素等均對(duì)大學(xué)學(xué)業(yè)成績(jī)產(chǎn)生顯著影響,這些因素在大學(xué)生學(xué)業(yè)成績(jī)影響機(jī)制研究以及制定促進(jìn)學(xué)業(yè)的相關(guān)措施時(shí)需要認(rèn)真考慮。心理行為路徑模型和動(dòng)機(jī)成就的路徑模型表明,大學(xué)生的學(xué)業(yè)成績(jī)的影響機(jī)制中最主要的成分是學(xué)生的個(gè)人特征(如背景特征和動(dòng)機(jī)態(tài)度特征等)與大學(xué)環(huán)境(師生關(guān)系和大學(xué)參與)之間的調(diào)節(jié)適應(yīng)關(guān)系,從大學(xué)入學(xué)初到大學(xué)第一年中,個(gè)人特征和大學(xué)環(huán)境相互地正向調(diào)節(jié)將有利于大學(xué)生提高學(xué)業(yè)成績(jī)。有關(guān)學(xué)業(yè)成績(jī)的影響因素中,心理因素如自我效能和學(xué)習(xí)動(dòng)機(jī)在大學(xué)環(huán)境中起著關(guān)鍵的調(diào)節(jié)作用,而影響學(xué)業(yè)成績(jī)主要的大學(xué)環(huán)境因素包括,大學(xué)學(xué)習(xí)活動(dòng)的參與,如課程參與、積極做作業(yè)與自習(xí)、學(xué)習(xí)經(jīng)驗(yàn)積累等,及人際關(guān)系的建立,如師生關(guān)系等。另外,本研究還發(fā)現(xiàn)第一年學(xué)業(yè)成績(jī)較低的人群：男生、往屆生、父母收入較高的、父母教育水平較低的及醫(yī)學(xué)邊緣專業(yè)的學(xué)生。然而,大學(xué)學(xué)業(yè)成績(jī)的人群差別是短期的還是長(zhǎng)期的,仍需進(jìn)一步探討。
[Abstract]:Background The first year of the university is the most critical year for college students to develop , and the success of university learning depends on the first year ' s experience . The first year has an important role in cultivating the interest of university study , mastering the basic knowledge of medicine , forming positive attitude and acquiring self - confidence , and establishing interpersonal relationship . In recent ten years , China ' s higher education has been developing rapidly , the expansion of Chinese medical students ' enrollment scale and the higher demand for medical students ' educational quality . method 2.1 Study objects and data sources A survey of 1820 medical students from 28 medical specialties in the Southern Medical University was conducted in August 2011 . The survey was conducted by mail the questionnaire to the freshmen , and the recovery rate was 71 % . After one year , the questionnaire was carried out on the basis of the college freshmen questionnaire and the first year questionnaire developed by the American Education Commission . The survey contents covered the comprehensive characteristics of college students , including demographic characteristics , academic and social competence assessment , value goal expectation and behavioral habits . The questionnaire was divided into 3 - 7 grades . The college entrance examination and the first year ' s first year ' s achievements were obtained from the teaching affairs . 2.2 Statistical Analysis Methods In order to obtain more accurate evaluation indexes , a multi - level linear model based on multiple correlation coefficients is used to analyze the influence factors of individual level and professional level . Results Compared with high school , medical students spend more time on self - study and extra - curricular activities compared with high school . The results of the multi - level linear model show that the demographic characteristics have significant influence on the students ' achievement . The first year ' s achievement of female medical students is higher than that of male medical students ( b = 2.44 , P = 0.049 ) , and the university ' s achievement is lower than that of the college students ( b = - 1.55 , P = 0.001 ) . After controlling the demographic factors , the college entrance examination scores of medical students have significant influence on the first year ' s achievement , especially in the same profession , the higher the students with higher entrance examination scores ( b = 1.24 , P0.001 ) , and for the different majors , the higher the average score of the college entrance examination is also higher ( b = 3.04 , P = 0 . 022 ) . The results showed that the self - efficacy of medical students ( b = 0.10 , P = 0 . 013 ) , the participation of curriculum ( b = 0.12 , P = 0.004 ) , time - making or self - learning ( b = 0.15 , P0.001 ) were positively related to university achievements . ( b = 0.12 , P = 0.003 ) and academic goals ( b = 0.09 , P = 0.034 ) . The demographic characteristics , such as gender and family , also play an important role in the mechanism of university achievement impact : female students are more active in class and participation in the course study ( b = 0.18 , P 0.001 ) , while the higher the students are with the teacher ( b = - 0.15 , P 0.001 ) ; the higher the parent education level , the higher the social self - efficacy of the students , the more likely to participate in the interaction of teachers and students ( b = 0.12 , P = 0.004 ) . These positive regulation relationships contribute to the improvement of academic performance . In the model of college achievement influence factors , all the factors jointly explain the variation of 32 % of university scores . Among them , 9 % variation is explained by sex , parents ' education level , professional and other factors . The results of college entrance examination account for 9 % variation , university participation ( course participation , homework or self - learning , teacher - student interaction such as participation subject activity or interaction with teachers ) explains 4 % variation , learning and social self - efficacy explains 2 % variation , teacher ' s support and concern and the development of university learning experience together explain 2 % variation . Conclusion Multi - level model and path analysis are used to study the influencing factors of college students ' studies . The multi - level model can effectively estimate individual effects and professional effects by decomposing the random error term of the first year to the professional level and individual level . The first year of the university is the transition period of college students from high school to university . They have experienced personal cognition , behavioral habits , learning environment and learning pattern during the transition period . This study shows that college students are significantly lower in the psychological factors such as target expectation and self - efficacy , which suggests that the relevant departments of the school should pay close attention to the changes of medical students in these aspects . Appropriate measures should be taken to adjust the students ' psychological drop or relieve their learning pressure , and help them to adapt to the university ' s learning life better . In addition , the study also finds that the most important factors in the students ' academic achievement include the participation of the students ' personal characteristics ( such as background characteristics and motivation attitude characteristics ) and the establishment of the college environment ( teacher - student relationship and university participation ) . In addition , the study also finds that the most important factors in the students ' academic achievement include the participation of the students ' personal characteristics ( such as background characteristics and motivation attitude characteristics ) and the establishment of interpersonal relationships , such as the relationship between teachers and students .

【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R-4;G642

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 魯威;楊云;張劍戈;丁巍;樂(lè)子良;胡翊群;;基于高考和醫(yī)學(xué)課程成績(jī)的醫(yī)學(xué)生學(xué)業(yè)潛力的研究[J];上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2012年10期

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本文編號(hào)：1403113