The association between medical student research engagement with learning outcomes

Figures & data

Table 1. The framework of learning outcomes.

Learning Outcomes (LO)	Descriptions
Science and scholarship (S&S)	Eight learning outcomes that the medical graduate as a scientist and a scholar has to obtain. (e.g., medical knowledge, academic writing skills)
Clinical practice (CP)	Ten learning outcomes that the medical graduate as a practitioner has to obtain. (e.g., physical examination skill, writing medical records)
Health and society (H&S)	Six learning outcomes that the medical graduate as a health advocate has to obtain. (e.g., awareness of advancing public health)
Professionalism (PF)	Ten learning outcomes the medical graduate as a professional has to obtain. (e.g., teamwork skills, respect for others)

Table 2. Demographics and academic characteristics of 10,062 students from 33 medical schools compared with national medical student demographics.

Characteristics	Sample (N&%, or M± SD)	Nationally(%)^[Citation27,Citation28]
Gender
Male	4518(44.9)	45.0
Female	5544(55.1)	55.0
Home location
Urban	6487(64.5)	63.1
Rural	3575(35.5)	36.9
Family Factors
ISEI of the father	38.19(20.4)
ISEI of the mother	36.2(17.9)
Education attainment of the father	11.46(4.1)
Education attainment of the mother	10.45(4.3)
CEE Score	588.4(57.6)
Length of education program
Five-year program	7532(74.9)	89.0
Seven-year program	1583(15.7)	5.6
Eight-year program	947(9.4)	1.8
Academic performance
Top 25%	3260(34.9)
26–50%	2493(31.5)
51–75%	2160(23.1)
Bottom 25%	984(10.5)
Learning outcomes	15.9 (6.3)
Science and scholarship (S&S)	2.8(1.8)
Clinical practice (CP)	5.9(2.1)
Health and society (H&S)	4.2(2.1)
Professionalism (PF)	2.8(1.9)

Note: Percentages may not add to 100 because of rounding. The national data was from the 2020 CMSS which involved 180,348 undergraduate medical students from 119 medical schools. All seven-year degree programs were changed into ‘5 + 3’ master’s degree programs in 2015 so national data about seven-year degree program in 2019 was corresponding to ‘5 + 3’ master’s degree programs in 2020.

Table 3. The landscape of MSRE in China.

	Student engagement in the research projects
Variables	Never (N&%)	Once (N&%)	Twice or more (N&%)	Chi-square
Research engagement	4477(44.5)	4203(41.8)	1382(13.7)
Gender
Male	1996 (44.2)	1813 (40.1)	709 (15.7)	28.4***
Female	2481 (44.8)	2390 (43.1)	673 (12.1)
Length of education programs
Five-year program	3873 (51.4)	2868 (38.1)	791 (10.5)	899.6***
Seven-year program	492 (31.1)	849 (53.6)	242 (15.3)
Eight-year program	112 (11.9)	486 (51.2)	349 (36.9)
Academic performance
Top 25%	1182 (36.3)	1441 (44.2)	637 (19.5)	228.5***
26–50%	1322 (44.9)	1258 (42.8)	363 (12.3)
51–75%	1060 (49.0)	898 (41.6)	202 (9.4)
Bottom 25%	544 (55.3)	350 (35.5)	90 (9.2)

Note: Chi-square tests, *** P < 0.01; Results for other non-significant variables are not reported.

Table 4. The relationship between MSRE and learning outcomes (β, 95%CI).

	Overall LO	S&S	CP	H&S	PF
Research engagement
once	0.43*	0.20***	0.04	0.08	0.12*
	(0.10, 0.76)	(0.11, 0.29)	(−0.11, 0.18)	(−0.03, 0.18)	(0.02, 0.21)
twice or more	0.77**	0.43***	0.03	0.06	0.25**
	(0.22, 1.31)	(0.27, 0.59)	(−0.18, 0.23)	(−0.11, 0.24)	(0.11, 0.39)
Female	−0.53***	0.02	−0.06	−0.17***	−0.32***
	(−0.81, −0.246)	(−0.08, 0.12)	(−0.18, 0.06)	(−0.25, −0.09)	(−0.39, −0.25)
Rural	0.06	−0.005	−0.002	0.03	0.04
	(−0.27, 0.40)	(−0.11, 0.10)	(−0.13, 0.12)	(−0.0697, 0.12)	(−0.06, 0.15)
Education attainment of the father	0.02	−0.01	0.03	0.004	−0.008
	(−0.03, 0.06)	(−0.02, 0.006)	(0.01, 0.04)	(−0.01, 0.02)	(−0.02, 0.01)
Education attainment of the mother	0.04	0.01	0.01	0.002	0.01
	(−0.01, 0.08)	(−0.002, 0.03)	(−0.003, 0.02)	(−0.01, 0.02)	(−0.004, 0.03)
ISEI of the father	−0.002	0.001	−0.004	−0.0002	0.001
	(−0.01, 0.01)	(−0.001, 0.004)	(−0.007, 0.00)	(−0.003, 0.003)	(−0.002, 0.003)
ISEI of the mother	−0.006	−0.0004	−0.002	−0.003	−0.001
	(−0.02, 0.01)	(−0.003, 0.003)	(−0.01, 0.002)	(−0.01, 0.001)	(−0.005, 0.004)
CEE Score	0.04	−0.002	0.08	0.01	−0.06
	(−0.16, 0.23)	(−0.05, 0.05)	(−0.02, 0.18)	(−0.06, 0.08)	(−0.10, −0.01)
Academic performance
26–50%	−0.04	−0.03	−0.004	−0.04	0.03
	(−0.35, 0.27)	(−0.12, 0.06)	(−0.11, 0.10)	(−0.14, 0.06)	(−0.07, 0.14)
51–75%	−0.23	−0.10	−0.02	−0.02	−0.08
	(−0.61, 0.15)	(−0.22, 0.01)	(−0.16, 0.120)	(−0.16, 0.11)	(−0.16, 0.001)
Bottom 25%	−0.40	−0.28**	−0.01	−0.03	−0.08
	(−0.98, 0.17)	(−0.46, −0.10)	(−0.19, 0.17)	(−0.20, 0.14)	(−0.25, 0.08)
Observations	10,062	10,062	10,062	10,062	10,062

Note: Medical school fixed effects, and robust standard errors are clustered at the medical school level. *** P < 0.001, ** P < 0.01, * P < 0.05.

Abbreviations: CI = Confidence Interval, LO = Learning Outcome, S&S = Science and Scholarship, CP = Clinical Practice, H&S = Health and Society, PF = Professionalism.

Table 5. The relationship between MSRE and learning outcomes: by gender (β, 95%CI).

	Overall LO	S&S	CP	H&S	PF
Male: Research engagement(N = 4518)
once	0.48	0.28***	0.04	0.08	0.08
	(−0.02, 0.98)	(0.16, 0.40)	(−0.18, 0.26)	(−0.10, 0.26)	(−0.08, 0.23)
twice or more	0.94*	0.56***	−0.001	0.10	0.28**
	(0.17, 1.71)	(0.34, 0.78)	(−0.33, 0.32)	(−0.13, 0.33)	(0.10, 0.46)
Female: Research engagement(N = 5544)
once	0.40	0.14	0.04	0.07	0.15*
	(−0.12, 0.92)	(−0.02, 0.30)	(−0.14, 0.21)	(−0.08, 0.23)	(0.01, 0.28)
twice or more	0.56	0.30**	0.05	0.01	0.20*
	(−0.10, 1.22)	(0.12, 0.48)	(−0.18, 0.28)	(−0.21, 0.22)	(0.004, 0.40)

Note: Medical school fixed effects, and robust standard errors are clustered at the medical school level. *** P < 0.001, ** P < 0.01, * P < 0.05.

Abbreviations: CI = Confidence Interval, LO = Learning Outcome, S&S = Science and Scholarship, CP = Clinical Practice, H&S = Health and Society, PF = Professionalism.

Table

Overall learning outcomes	Pre-college	After-college
Science and scholarship (S&S)
1. The fundamental knowledge and methods of natural sciences such as mathematical and chemical disciplines
2. The fundamental knowledge and methods of humanities and social sciences
3. The fundamental knowledge and methods of medicine
4. Understand the etiology, clinical features, diagnosis, treatment and prognosis of common presentations at the stages of life
5. Mastery and application the knowledge of traditional Chinese medicine
6. Academic writing ability
7. Mathematical statistical analysis ability
8. Critical thinking
Clinical practice (CP)
1. Take a medical history
2. Perform a physical examination
3. Write medical records
4. Perform disease diagnosis and differential diagnosis based on medical history, physical examination, auxiliary examination
5. Be able to select appropriate clinical examination methods according to the actual situations of patients
6. Be able to help determine patients’ treatment plans and explain the rationality
7. Ability to integrate knowledge such as disease prevention and health maintenance into clinical practices
8. Assess the extent and changes of patients’ condition
9. First aid ability
10. Ability to retrieve and interpret information in clinical data systems
Health and society (H&S)
1. Responsibility to protect and advance the health and well-being of individuals and populations
2. Understand factors that contribute to health, illness, disease and success of treatment of populations
3. Understand the quality assurance system and safety management system of health care in Chinese hospitals
4. Ability to attach importance to patients’ safety and identify risk factors that are detrimental to patients
5. Understand the structures and functions of the national health care system in China
6. Understand global health/ health conditions and issues
Professionalism (PF)
1. Be familiar with the Ethic Principles of China Physicians and related laws and regulations regarding medical industry
2. Attention to providing humanitarian care for patients
3. Ability to apply medical ethics in clinical services
4. Ability to communicated efficiently with patients and their family members
5. Ability to cooperate and learn from each other
6. Ability to empathize with the feelings of colleagues, patients and the family members
7. Understand the factors affecting physicians’ health and wellbeing
8. Awareness of respect for others
9. Ability of self-awareness and reflection
10. Awareness of lifelong learning

Li L, Wu H, Xie A, et al. Students’ initial perspectives on online learning experience in China during the COVID-19 outbreak: expanding online education for future doctors on a national scale. BMC Med Educ. 2021;21(1):1–10.

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National Centre for Health Professions Education Development. China medical students survey 2020 all schools summary report. 2020. Accessed 9th July, 2021. https://medu.bjmu.edu.cn/cms/show.action?code=publish_4028801e6bb6cf11016be526c0dc0014&siteid=100000&newsid=50947b6c789248b39fca817dfb9ba3ee&channelid=0000000008.

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Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.