Academic Medicine最新文献

{"title":"Two-Phase Individual Assessments: A Second-Chance Assessment Strategy With Individualized Feedback to Promote Assessment for Learning.","authors":"Munder Zagaar, Sandra B Haudek, Peter Boedeker","doi":"10.1097/ACM.0000000000005876","DOIUrl":"10.1097/ACM.0000000000005876","url":null,"abstract":"<p><strong>Problem: </strong>High-stakes multiple-choice question (MCQ) exams in medical education typically focus on assessment of learning at a single point without providing feedback for improvement. Educators can achieve a more balanced approach to MCQ exams by combining efficient assessment of learning with the feedback and improvement opportunities of assessment for learning.</p><p><strong>Approach: </strong>As part of a curriculum renewal at Baylor College of Medicine's MD program, the Two-Phase Individual Assessment (TPIA) model was launched within a 4-week preclinical Foundations of Medicine course in August 2023. The TPIA model featured weekly assessments, each consisting of 2 MCQ exams given on the same day with a 4-hour study period in between. Exams were paired, consisting of an equal number of items that addressed the same learning objectives. After the initial exam, students received an individualized feedback report indicating correctly and incorrectly answered objectives. Students applied individualized feedback reports to self-identify and remediate deficiencies in preparation for the second-chance exam. Only the highest score counted toward the final grade.</p><p><strong>Outcomes: </strong>Among 230 medical student participants, significant performance improvements between morning and afternoon exams were observed across the first 3 weekly TPIAs, with mean score increases of 4.93, 5.06, and 10.86. Mean change in performance in week 4 was not significant. Student end-of-course survey responses indicated a strong preference for the TPIA format. Responses highlighted the value of offering individualized feedback, unstructured time to address knowledge gaps, and a corresponding opportunity for improvement.</p><p><strong>Next steps: </strong>Future research will extend TPIA's implementation in more clinical-oriented courses to validate TPIA's effectiveness and explore its effect on long-term knowledge retention through more cumulative examinations. Integrating TPIA-based approaches may advance educational systems toward developing a culture of feedback literacy and embracing second chances to support learning and professional growth.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"295-299"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In the Eye of the Beholder: A Stakeholder Analysis of the Value of the \"Promotion in Place\" Competency-Based Time-Variable Graduate Medical Education Pilot.","authors":"Dorene F Balmer, Martin V Pusic, Debra F Weinstein, John Patrick T Co, Mary Ellen J Goldhamer","doi":"10.1097/ACM.0000000000005928","DOIUrl":"10.1097/ACM.0000000000005928","url":null,"abstract":"<p><strong>Purpose: </strong>Competency-based time-variable (CBTV) graduate medical education (GME) has been implemented in Canada, Europe, and the United States, yet its perceived value has not been explored. Promotion in Place (PIP) is a CBTV GME program in which residents graduating early advance to attending status with \"sheltered independence\" until the standard graduation date. This study describes perceived value of CBTV GME and PIP at Mass General Brigham by capturing diverse stakeholder perspectives.</p><p><strong>Method: </strong>In this stakeholder analysis using semistructured interviews (June 2022-August 2023), 49 participants were invited (44 representative members and 5 external stakeholders) from 11 GME programs: PIP eligible residents, program directors (PDs), chairs, service chiefs, and external national medical education organization leaders. Authors' understanding of value was informed by Harvey and Green's conceptualization of quality in higher education as \"fit for purpose,\" \"standards monitoring,\" \"transformation,\" and \"value for the money.\" Deductive codes and inductive subcodes captured diverse perspectives of value.</p><p><strong>Results: </strong>Of the 49 invited stakeholders, 34 (69%) were interviewed across 5 stakeholder groups. Nearly all groups cited aspects of PIP that are \"fit for purpose\" as evidence of value; PIP supported \"workforce readiness\" and provided \"sheltered independence\" as intended. External stakeholders, PDs, service chiefs, hospital leadership, and faculty cited value aligning with \"standards monitoring\" (e.g., PIP must maintain or improve patient and resident outcomes). Nearly all groups cited aspects of PIP aligning with \"transformation\" as evidence of value. PIP promoted \"independent decision-making\" and enhanced trainee confidence. Chairs cited aspects of PIP aligning with \"value for the money\" (e.g., \"cost neutral\" as optimal for sustainability and avoidance of \"hidden costs\" such as assessment burden).</p><p><strong>Conclusions: </strong>Understanding perceptions of PIP and CBTV GME value is critical to engaging diverse stakeholders and extending CBTV GME to more programs and specialties. PIP's transformative nature underscores the added value of CBTV GME.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"331-339"},"PeriodicalIF":5.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing Consensus on the Most Important Teaching Skills for Internal Medicine Residents in Clinician Educator Tracks: A Modified Delphi Study.","authors":"Andrew J Klein, Allie Dakroub, Melissa McNeil, Rongrong Wang, Scott D Rothenberger, Sarah B Merriam","doi":"10.1097/ACM.0000000000006004","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006004","url":null,"abstract":"<p><strong>Purpose: </strong>Internal medicine (IM) residency programs with clinician educator tracks (CETs) have increased during the past decade; however, no standardized list of learning domains and competencies exist. The authors use a modified Delphi approach to determine a consensus set of teaching skills for IM CET residents.</p><p><strong>Method: </strong>A CET teaching skills list was developed from June to August 2023 via a PubMed search through July 31, 2023, by University of Pittsburgh faculty physicians. Seventy-seven potential participants were identified through professional society listservs and publications. Between January and February 2024, participants (current or former CET directors within an IM residency program) iteratively ranked teaching skills based on importance for IM CET residents from 1 (less important) to 4 (most important) for 2 online surveys. Consensus was defined a priori as 80% agreement or higher that a skill is important or most important. Participants identified the most appropriate training level for each skill and the most critical teaching skills for CET residents.</p><p><strong>Results: </strong>Forty-one experts participated, with 31 (76%) completing both surveys. Of the 29 teaching skills in round 1, 12 achieved consensus as important. In round 2 (24 teaching skills), 5 additional teaching skills achieved consensus as important. Panelists ranked the most critical teaching skills for CET residents: teaching in different settings, communicating feedback, fostering a conducive learning climate, teaching across different learner levels, creating learning goals and objectives, and developing and delivering effective chalk talks.</p><p><strong>Conclusions: </strong>This study offers national consensus on a prioritized list of teaching skills for IM CET residents. Consensus skills were foundational and intentional, important for all deliberate educators, and aligned with 2 CE milestone subcompetencies (universal pillars and educational theory and practice). Nonconsensus skills were generally more advanced. Current and aspiring CET leadership can leverage these recommendations to develop and critically appraise CET curricula.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Practical Skills Teaching by Near-Peers and Faculty.","authors":"Roman Hari, Sarah Oppliger, Diana H J M Dolmans, Sören Huwendiek, Renée E Stalmeijer","doi":"10.1097/ACM.0000000000006003","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006003","url":null,"abstract":"<p><strong>Purpose: </strong>Near-peer teaching is a vital teaching resource in most medical schools, but little is known about the comparative benefits of near-peers and faculty teaching or the learning mechanisms that underlie them. This study explored near-peers' and students' perceptions of differences between the way near-peers and faculty teach practical skills.</p><p><strong>Method: </strong>Using qualitative methods, the authors conducted 4 focus groups with near-peers (n = 22) and 4 focus groups with students (n = 26, years 3-6) at the University of Bern, Bern, Switzerland, between September and December 2022. All participants recently participated in near-peer skills training. Vignettes of typical teaching situations guided the focus group discussions. The reflexive thematic analysis was both inductive and deductive; cognitive apprenticeship teaching methods informed the deductive analysis.</p><p><strong>Results: </strong>Three major areas of difference were identified in near-peers and faculty skills teaching methods: (1) learning climate, (2) teaching orientation, and (3) reaction to identified competence gaps and students' questions. Near-peers were perceived to establish a safer learning climate than faculty, lowering the threshold to ask questions. Near-peer teaching was oriented toward the formal curriculum and students' learning needs, resulting in more tailored explanations focused on examination-relevant content. Faculty oriented their teaching toward clinical practice, which helped students transition to clinical practice but could overwhelm novice students. Faculty better stimulated students to think critically about unanswered questions and how to fill their competence gaps.</p><p><strong>Conclusions: </strong>Skills teaching by near-peers and faculty differed in teaching climate and orientation. Near-peers saw students as learners, focused on the learning climate and on students' needs. Faculty saw students as future physicians and facilitated the transition from curricular learning to clinical practice. Curricular design should capitalize on the complementary benefits of near-peer and faculty skills instructors and seek to get the best of both worlds.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Getting Ready for Residency: A Qualitative Analysis of Fourth-Year Medical Student Learning Plans Mapped to Accreditation Council for Graduate Medical Education Residency Competencies.","authors":"Hannah L Mallaro, Celia Laird O'Brien, Sandra M Sanguino, Brigid M Dolan","doi":"10.1097/ACM.0000000000005997","DOIUrl":"https://doi.org/10.1097/ACM.0000000000005997","url":null,"abstract":"<p><strong>Purpose: </strong>Undergraduate medical education (UME) to graduate medical education (GME) transition gaps may limit opportunities for learner improvement along each individual's learning trajectory. Additional information regarding learner perspectives on skill-based learning goals in preparation for the residency transition is needed. The authors hypothesized that fourth-year medical student (MS4) learning plans may provide information to fill the gap in understanding learner perspectives on the knowledge, skills, and opportunities they consider important in supporting their residency readiness.</p><p><strong>Method: </strong>Directed thematic analysis informed by a constructivist analytical approach was used to review readiness for residency reflections as part of a portfolio assessment system at a large, urban, research-intensive medical school during academic years 2021 and 2022. The authors identified student-selected Accreditation Council for Graduate Medical Education (ACGME) competencies and subcompetencies, iteratively identified non-subcompetency-based themes, refined the codes, and achieved consensus. They then analyzed the frequency of competencies and subcompetencies within learner reflections and explored additional themes.</p><p><strong>Results: </strong>In the final set of 291 reflections, the ACGME competencies selected for MS4 learning plans were patient care (227 learning plans), medical knowledge (144 learning plans), interpersonal and communication skills (94 learning plans), practice-based learning and improvement (79 learning plans), system-based practice (67 learning plans), and professionalism (63 learning plans). The top 3 ACGME subcompetencies identified as growth areas by MS4s were practice-based learning and improvement: evidence-based and informed practice, patient care: clinical reasoning, and interpersonal and communication skills: interprofessional and team communication. Teaching was the most common learning goal outside the ACGME subcompetencies.</p><p><strong>Conclusions: </strong>The MS4 readiness for residency reflections offered important insight into student perspectives on UME to GME transition preparation. Learners' reflections yielded a diverse set of learning goals for the fourth year of medical school, highlighting the importance of individualized approaches in addition to standardized curricula at the time of transition.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Ode to Small Towns\".","authors":"Irène P Mathieu, Benjamin J Martin","doi":"10.1097/ACM.0000000000006013","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006013","url":null,"abstract":"","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fostering Global Research Collaborations: An Update on Duke-NUS Medical School, the Duke University and National University of Singapore Partnership.","authors":"May May Yeo, Patrick J Casey, R Sanders Williams, Silke Vogel, Michael L James","doi":"10.1097/ACM.0000000000006006","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006006","url":null,"abstract":"<p><strong>Problem: </strong>Navigating the complexities of international research collaborations is a challenge. This article provides a detailed examination of the international collaboration between Duke University and the National University of Singapore to establish the Duke-NUS Medical School. It explores the evolution and impact of the partnership, focusing on outcomes, knowledge advancement, and the dynamics of international collaborations in academic medicine.</p><p><strong>Approach: </strong>The partnership began in 2005 and applies a collaborative approach, including aligning research foci with Singapore's national health priorities, the formation of an academic medical center, faculty exchanges, joint funding for pilot research, and pooling of expertise, diverse and multiethnic data, and samples.</p><p><strong>Outcomes: </strong>The collaboration has led to educational and research advancements, including significant contributions to global health, such as the development of the first U.S. Food and Drug Administration-approved SARS-CoV-2 antigen test and a nasal COVID-19 vaccine candidate. Additionally, it has enhanced academic medicine capabilities within Singapore by transforming teaching hospitals into fully integrated academic medical centers. This experience suggests the following toward advancing the partnership: (1) agreement on and revisiting of the shared vision of the partnership by institutional leaders, (2) middle- and end-period reviews within multiyear funding cycles from local ministries, (3) faculty engagement through collaborative resources and spaces, and (4) similar first languages and health systems of the partners.</p><p><strong>Next steps: </strong>The Duke-NUS Medical School partnership aims to expand its research areas to address more global health challenges, such as the impact of climate change on health and the advancement of precision medicine. This article offers valuable insights for understanding the dynamics, benefits, and challenges of international collaborations in academic medicine.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Professional and Personal Impacts of the COVID-19 Pandemic on Early Career Researchers.","authors":"Lucy O Alejandro, Monica Kowalczyk, Sandra A Ham, Valerie G Press, Rachel K Wolfson, Vineet M Arora, Anna Volerman","doi":"10.1097/ACM.0000000000006005","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006005","url":null,"abstract":"<p><strong>Purpose: </strong>Early career researchers (ECRs) are crucial to scientific advancement, but ECRs, particularly those from underrepresented groups, face unique challenges as they establish careers. Given the disruptions of the COVID-19 pandemic, this study aimed to identify the pandemic's professional and personal impacts on ECRs.</p><p><strong>Method: </strong>This national cross-sectional survey study assessed the effects of the COVID-19 pandemic among ECRs by gender, sexual orientation, race, and ethnicity. Between September and December 2021, the authors invited the 4,440 ECRs with National Institutes of Health training awards in 2020 to complete an online survey with measures assessing career, personal life, and demographics.</p><p><strong>Results: </strong>Of 4,440 eligible ECRs, 1,524 (34.3%) completed the survey and 1,458 (32.8%) met inclusion criteria. Most respondents reported negative impacts to in-person conference cancellations (1,355 [93.1%]), research productivity (K award, 1,148 [87.4%]; overall, 1,192 [81.8%]), career trajectory (891 [61.2%]), and mental health (1,189 [88.1%]). Respondents with childcare responsibilities commonly reported negative impacts (801 [80.1%]). On average, respondents reporting negative impacts identified with more underrepresented groups than those reporting nonnegative impacts for certain measures, such as research productivity (K award, 0.92 vs 0.73, P < .001; overall, 0.92 vs 0.79, P = .01) and mental health (0.92 vs 0.81, P = .03). In free responses, respondents expressed stress as they balanced overwhelming demands of emerging careers and personal lives. Despite setbacks, many respondents cited new opportunities, including new projects (1,156 [79.3%]), new collaborators (926 [63.5%]), and increased flexibility (894 [61.3%]).</p><p><strong>Conclusions: </strong>The pandemic had significant, largely negative, and unequal impacts on ECRs. Underrepresented ECRs were particularly susceptible to pandemic disruptions, potentially exacerbating existing challenges. Individual- and organizational-level interventions are critical to rejuvenate and sustain the early career research pathway. These interventions will foster the success of the next generation of biomedical scientists and the future of scientific advancement.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keepers of the Academic Mission: Calling All Faculty.","authors":"Vincent D Pellegrini, Stewart Babbott","doi":"10.1097/ACM.0000000000006010","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006010","url":null,"abstract":"<p><strong>Abstract: </strong>Academic medical centers expand their patient care mission through mergers often with nonacademic health care organizations to create more clinical revenue and a larger financial margin with the intent of cross-subsidizing the academic mission. Ironically, an unintended consequence of governance changes implicit in such mergers is the marginalization of the academic mission. Historically, the education and research missions have been effectively cross-subsidized by the medical school dean from the margin derived from the faculty clinical practice plan. Yet, in many merged entities the faculty practice is subsumed under the health system, where its margin no longer directly accrues to the school. Concurrent shifts in health system governance have removed clinical enterprise oversight from the dean and chairs, effectively assigning financial support of education and research to the health system where it competes with a strong appetite to grow the clinical enterprise. Likewise, faculty are conscripted to more clinical service rather than encouraged to engage in academic endeavors. Consequently, the vigor of the education and research missions has been compromised in academic health system mergers. This circumstance invites critical review of the fundamental concept of academic medical center mergers and their resulting unintended consequences for the academic mission and faculty well-being to inform the wisdom of continuing this trend. A unified cadre of university leaders, deans, and faculty are needed to advocate for greater reinvestment of the margin in teaching and research efforts. Concurrently, academic medicine must develop more academic physicians committed to the academic mission as leaders of health systems. Taken together, these actions can reinforce that funding the academic mission must be an obligation rather than an option for academic health systems. Nothing less than the future of academic medicine, the well-being of faculty and learners, and the health of the nation depend on it.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Good Questions for Faculty and Their Mentors in Support of Academic Career Development.","authors":"Deborah G Freeland, Jennifer Verbsky, Stewart Babbott","doi":"10.1097/ACM.0000000000006009","DOIUrl":"https://doi.org/10.1097/ACM.0000000000006009","url":null,"abstract":"<p><strong>Abstract: </strong>Faculty mentorship is essential for a successful career in academic medicine, and effective support includes a commitment between a faculty member and mentor to navigate through competing interests and priorities. Many faculty mentorship programs have been described. However, the program content, including guidance tools and guiding questions, are less often defined.To address this gap, the authors draw on their faculty mentor-mentee experience in academic medicine to propose a set of guiding questions in this Commentary called \"3 good questions.\" This supplemental tool encourages mentors to ask of their mentees: (1) Are you doing what you love? (2) Are you making it count twice? (3) Are you staying focused? These questions can be incorporated during mentorship discussion sessions and can be answered in a stepwise approach to reflect, confirm, and explore a mentee's needs in the short- and long-term for a successful career in academic medicine.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}