摘要：Objectives: To inform evidence-based design and implementation of medical school learning communities (LCs) by investigating which LC components medical students at one school with a multi-component LC were most valued and which were associated with desirable outcomes. Methods: In this cross-sectional study, all Johns Hopkins School of Medicine (JHSOM) students were surveyed in Spring 2016 regarding perceived value of LC components (peers, faculty advisors, Clinical Foundations of Medicine (CFM) clinical skills course, quarterly reflective discussion sessions, social activities, and LC rooms) with learning environment (LE) perceptions, quality of life, burnout, and empathy assessed as outcomes. Multivariate logistic regressions analyzed associations between LC components and outcomes. Results: Overall 368/480 (77%) students responded. CFM was highly valued by 286 (80%) students, advisors by 277 (75%). All LC components were significantly associated with favorable overall LE perceptions, but associations with LE subdomains varied. CFM was the only LC component to have significant associations with greater empathic concern (OR 2.1, 95% CI=1.2-3.7) and perspective-taking (OR 1.8, 95% CI=1.0-3.1), less emotional exhaustion (OR 0.4, 95% CI=0.2-0.6) and depersonalization (OR 0.3, 95% CI=0.1-0.5), and good quality of life (OR 3.7, 95% CI=1.9-7.1). Every other LC component, except LC rooms, was associated with greater empathy or enhanced well-being. Conclusions: Components within an LC are valued differently and vary in their relationships with student outcomes. Future LC research may isolate the effects of and explore interactions among different LC components, leading to more purposeful LC design and allocation of resources.
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