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Korean J Med Educ > Volume 36(4); 2024 > Article
Lee, Park, Yune, and Park: Structural relationships between psychological factors and college adjustment among medical students in South Korea: focusing on helicopter parenting and respectful parenting

Abstract

Purpose

This study aims to determine the impact of helicopter parenting and respectful parenting on medical students’ mindset, grit, self-directedness, and college adjustment.

Methods

This study constructed a hypothetical model based on the relationship between helicopter parenting, respectful parenting, mindset, grit, self-directedness, and college adjustment. It set up a structural model to test the fit of the model based on empirical data. The significance of the mediating effects of the paths was tested using multiple mediation analysis.

Results

The fit of the initial measurement model did not meet the goodness-of-fit acceptance criteria; therefore, revised models were established. The revised models all showed good fit indices, and the overall path coefficients were significant. Helicopter parenting and respectful parenting are inversely correlated and affect the mindset of medical students, which, in turn, affects their adjustment to college through grit and self-directedness. The results of the multimodal effects of each pathway showed that helicopter parenting negatively affects college adjustment, while respectful parenting has a positive mediating effect on college adjustment.

Conclusion

Parenting attitudes have a significant impact on medical students’ mindset, grit, and self-direction, which affects their college adjustment. Parents need to respect their children’s autonomy and independence and avoid excessive interference.

Introduction

Parenting style is critical in a child’s development. Parenting that infringes on a child’s autonomy can negatively impact their psychological health. “Helicopter parenting” is a term used to describe parents who are overly involved in all aspects of their child’s life and schoolwork and have an overly controlling parenting style that often persists into adolescence and early adulthood [1]. This parenting style has been observed in various situations.
In Korea’s competitive educational environment, high academic achievement is required for admission to medical school, which leads many parents to become excessively involved in their children’s learning process and career choices. This can lead to intense pressure and stress and hinder children’s autonomy and independence [2]. Furthermore, it reduces children’s ability to self-regulate and negatively impacts college adjustment [3]. College students are in the transition period to adulthood, and parents’ helicopter parenting style can delay the role of independent adulthood for college students in this transition period [3].
Helicopter parenting and parental over-involvement in learning lower children’s self-esteem and increase depression, stress, and anxiety [4]. Furthermore, it can impair students’ ability to self-regulate, which can negatively impact college adjustment [5]. Parental overinvolvement in learning may improve grades in the short term; nonetheless, in the long term, it hinders students’ ability to learn and their academic success. However, parents who respect and are supportive of their children’s learning styles promote a growth mindset and grit. When students’ efforts are recognized by their parents, they are more willing to take on challenges and strive to overcome difficulties [5].
Hence, how parents raise their children can influence children’s mindset and grit. “Mindset” refers to a person’s beliefs about their intellectual abilities in a given situation [6]. It is categorized into fixed and growth mindsets. A person with a “fixed mindset” believes that their abilities or intelligence are fixed, while a person with a “growth mindset” believes that their abilities or intelligence can be developed through effort and experience [6]. Both mindsets lead to different reactions to failure or difficult situations in the learning process, leading to different responses to situations [7]. A person’s mindset in a learning situation leads to differences in goal setting, reactions to failure, and learning attitudes [7]. Learners with a “growth mindset” are more adaptive in their achievement standards, goal orientation, beliefs about effort, learning strategies, task difficulty preferences, and responses to criticism compared to those with a “fixed mindset [8].”
Furthermore, parenting style can affect grit through mindset. “Grit” refers to sustaining passion and persistence to achieve long-term goals [9]. Children with a growth mindset are reported to have strong grit and resilience [7]. Parenting styles that support children’s autonomy positively impact mindset and grit [10], while helicopter parents’ overprotection and control negatively impact grit, which further negatively impacts college adjustment [11]. Helicopter parenting impedes the growth mindset that enables students to solve problems and face challenges independently, thereby affecting their grit, self-directedness, and ultimately their college adjustment. Parenting styles can significantly affect students’ access to essential psychological resources, such selfdirectedness and grit, which are crucial for achieving long-term goals. Therefore, it is important to examine the relationships between parenting styles, mindset, grit, self-directedness, and college adjustment in detail, as these dynamics may influence students’ ability to develop resilience and autonomy in their learning processes.
The better the mindset and grit, the more engaged a student is in learning. A growth mindset positively impacts grit because it encourages persistence under challenging situations through the belief that one’s abilities can be changed and helps students examine and adjust their learning situation [12]. However, it has both a direct positive effect and a static effect on self-directed learning (SDL) through the mediation of grit [13]. SDL refers to learning in which learners set their learning goals, develop a learning plan, use appropriate learning strategies, and self-assess their learning outcomes [14]. In SDL, selfdirectedness is an important factor in increasing learner success and effectiveness.
In medical school, it is important to organize study plans, manage materials efficiently, and apply suitable learning strategies because the content is vast and complex [15]. In addition, it is important to develop the ability to solve problems independently in various clinical situations, which requires self-direction to analyze problems and find solutions [15]. Helicopter parenting and respectful parenting may influence mindset and grit, which in turn affect self-directedness and college adjustment. Based on these assumptions, the research model was established as shown in Fig. 1, and this study explores how helicopter parenting and respectful parenting impact mindset, grit, self-directedness, and college adjustment. To achieve the objectives of this study, the research questions are outlined as follows. (1) What is the relationship between helicopter parenting, respectful parenting, mindset, grit, self-directedness, and college adjustment? (2) What is the multi-mediating effect of mindset, grit, and self-directedness in the relationship between parenting styles and college adjustment?

Methods

1. Research design

This study is a structural model validation study. It seeks to build a hypothesized model based on the relationship between helicopter parenting, respectful parenting, mindset, grit, self-direction, and college adjustment and test the fit of the model based on empirical data.

2. Participants

The study subjects were pre-medical students at medical universities in Busan, Jeolla, and Gyeonggi provinces. In structural equation modeling, considering the criterion that the minimum recommended sample size is 15 times the number of observed variables [16], this study requires at least 210 participants as there are 14 observed variables. After excluding non-respondents and cases of dishonesty, the study had 407 participants. Of these, 259 were firstyear students, 148 were sophomores, 288 were males, and 119 were females.

3. Instruments

The Helicopter Parenting Scale (HPS), developed by LeMoyne and Buchanan [17] and validated for the Korean version by Kang and Lee [18], was used to measure the participants’ perceived helicopter parenting. Out of ten items, eight items were used, as two items had low internal reliability. The reliability coefficient (Cronbach’s α) was 0.787.
The respectful parenting instrument used one of the sub-factors of the Mothers’ Attitudes Toward Learning Instrument developed by Kim [19], with four items and Cronbach’s α of 0.852. Mindset was measured using the Beliefs About Intellectual Ability Scale developed by Ahn et al. [20] based on the Scale by Dweck et al. [21] implicit theory of intelligence. The subfactors of mindset were “incremental” (growth mindset) and “homeostasis” (fixed mindset), with ten items, including five items each. All the homeostasis items were reverse-scored. In this study, Cronbach’s α was 0.852 for incremental and 0.826 for homeostasis.
Grit was measured using an adaptation of the Original Grit Scale developed by Duckworth et al. [9] and later modified by Lee [22]. The subscales of grit consisted of “consistency of interests” and “perseverance of effort,” each with six items. All the items were reverse-scored, and five items were used, excluding one with low internal reliability. The Cronbach’s α was 0.794 for consistency of interests and 0.834 for perseverance of effort. Selfdirectedness was measured using a scale developed by Jeong [23] and modified and supplemented by Kim [24]. The subfactors were autonomy, goal orientation, and responsibility, which are composed of five items each. The Cronbach’s α was 0.835 for autonomy, 0.834 for goal orientation, and 0.899 for responsibility.
College adjustment was measured using a scale developed by Baker and Siryk [25] and modified, adapted, and validated by Lee [26]. The subfactors were academic adjustment, social adjustment, psychological adjustment, physical adjustment, and attachment to college, with a total of 25 items. In this study, 23 items were used, excluding two items with low internal reliability. The reliability of each subfactor ranged from 0.614–0.779, and the overall reliability was 0.886.

4. Data collection procedure

Data collection was conducted between July and September 2022. The questionnaire did not contain any personally identifiable information. To ensure the ethical protection of the participants, the purpose and content of the study, anonymity, and the fact that the data will not be used for any other purpose than this study was explained verbally. Participation was voluntary, and the questionnaire was administered only after written consent was obtained. The questionnaire took approximately 25 minutes to complete. This study was approved by the Gil Medical Center Institutional Review Board of Gachon University (IRB approval no., GCIRB2022-183).

5. Data analysis

For the data analysis, the descriptive statistics of the participants’ general characteristics and measured variables were obtained. Analysis of variance and t-test were conducted to examine the differences in helicopter parenting, respectful parenting, mindset, grit, selfdirectedness, and adaptation to college life according to the general characteristics. Pearson’s correlation coefficient was used to examine the relationship between the variables. To examine the structural relationship between the variables, the measurement model was analyzed based on the structural equation model, and then the structural model was analyzed. The maximum likelihood method was used to estimate the model, and the fit indices of the model were χ2 and root mean square error of approximation (RMSEA) as absolute fit indices, and Turkey-Lewis index (TLI) and comparative fit index (CFI) as incremental fit indices. To analyze the multimodal effects, bootstrapping was performed by re-sampling 1,000 standards and analyzed with a 95% bias-corrected confidence interval. IBM SPSS for Windows ver. 26.0 and AMOS ver. 23.0 programs (IBM Corp., Armonk, USA) were used for this purpose.

Results

1. General characteristics of participants

All the participants were undergraduate medical students, with 259 (63.6%) first-year and 148 (36.4%) secondyear students. Of these, 288 (70.8%) were males and 119 (29.2%) were females.

2. Correlation among variables

Helicopter parenting was inversely correlated with respectful parenting (r=-0.397, p=0.00), grit (r=-0.178, p=0.00), mindset (r=-0.190, p=0.00), self-directedness (r=-0.275, p=0.00), and college adjustment (r=-0.259, p=0.00). Respectful parenting was positively correlated with grit (r=0.102, p=0.039), mindset (r=0.234, p=0.00), self-directedness (r=0.302, p=0.00), and college adjustment (r=0.238, p=0.00). Grit, mindset, self-directedness, and college adjustment were positively correlated with each other, ranging from r=0.364–0.605 (Table 1).

3. Structural relationships among variables

To analyze the structural relationships between parenting attitudes, mindset, grit, self-directedness, and college adjustment among medical students, a structural equation model was established and analyzed (Fig. 2). The model fit of the initial model was χ2 =196.567 (degrees of freedom [df]=67, p< 0.001), CFI=0.941, TLI=0.920, and RMSEA=0.069. In the initial model, non-significant paths were identified (respectful parenting → college adjustment, grit → college adjustment), leading to a revised model excluding these paths. A comparison test revealed no significant difference in χ2 (Δχ2=1.295, Δdf=2, p> 0.05). Consequently, the revised model, being more parsimonious, was selected as the final model. The final model fit indices were CFI=0.942, TLI=0.923, and RMSEA =0.068, indicating a very good fit with CFI and TLI values above 0.9 and RMSEA below 0.08.
The path coefficients in the modified model showed that both helicopter parenting (β=-0.141) and respectful parenting (β=0.272) significantly affected mindset. Helicopter parenting was found to have a direct effect on college adjustment (β=-0.138). Mindset significantly affected grit (β=0.654) and self-directedness (β=0.363). Grit significantly affected self-directedness (β=0.654). Self-directedness significantly affected college adjustment (β=0.632). Hence, it can be concluded that helicopter parenting and respectful parenting are inversely correlated and affect the mindset of medical students, which further affects college adjustment through grit and selfdirectedness (Table 2).

4. Multiple mediation effects

To test for mediation effects in each pathway, we performed a bootstrap and estimated the 95% biascorrected confidence intervals. The results of the multiple mediation effect analysis are presented in Table 3. For path 1 (helicopter parenting → mindset → grit → selfdirectedness → college adjustment), the mediation effect was significant (p<0.05) as the lower (-0.074) and upper (-0.005) bounds of the 95% confidence interval did not contain zero. In the relationship between helicopter parenting and college adjustment, mindset, grit, and self-directedness have a multiple mediation effect.
For path 2 (helicopter parenting → mindset → selfdirectedness → college adjustment), the mediation effect was not significant (p>0.05) because the lower (-0.061) and upper (0.001) limits of the 95% confidence interval included zero. Therefore, helicopter parenting does not affect college adjustment through the pathway of mindset and self-directedness.
For path 3 (respectful parenting → mindset → grit → self-directedness → college adjustment), the mediation effect was significant (p<0.01) because the lower (0.017) and upper (0.083) limits of the 95% confidence interval did not contain zero. Hence, respectful parenting has a positive mediating effect on college adjustment through mindset, grit, and self-direction.
For path 4 (respectful parenting → mindset → selfdirectedness → college adjustment), the mediation effect was significant (p<0.05) as the lower (0.008) and upper (0.075) limits of the 95% confidence interval did not contain zero. Hence, respectful parenting has a positive mediating effect on college adjustment through selfdirectedness via self-efficacy.

Discussion

This study structurally analyzed the impact of helicopter parenting and respectful parenting attitudes on medical students’ mindset, grit, self-directedness, and college adjustment.
The findings suggest that helicopter parenting negatively impacts medical students’ mindsets and college adjustment. This is consistent with research findings indicating that helicopter parenting hinders medical students’ autonomy and independence, negatively impacting their mindset and college adjustment [27,28]. It reduces college students’ engagement in school and makes them dependent without developing the ability to solve problems independently. This can lead to maladaptive perfectionism, as children feel loved only if they succeed academically. Hence, helicopter parenting can have negative consequences for medical students’ adjustment to college [28].
Respectful parenting, where parents respect their children’s learning styles, positively impacts medical students’ mindsets [2,7]. This suggests that when parents respect and support their children’s learning process, they are more likely to believe that they can improve their abilities.
The multiple mediation effects in the final model showed that children of helicopter parents had difficulty adjusting to medical school, while those with respectful parents could overcome the challenges. This suggests that contributes to a positive mindset, which enables students to demonstrate grit and self-direction to successfully adjust to college life. Recent research is consistent with these findings [28]. It has been reported that children who receive excessive help from their parents may feel less competent or have reduced initiative [29].
The mediating effects of mindset, grit, and selfdirectedness between parenting attitudes and college adjustment were analyzed. The results showed that helicopter parenting negatively mediated college adjustment through mindset, grit, and self-directedness in medical students. However, respectful parenting statically mediated college adjustment through mindset, grit, and self-directedness. Students with a growth mindset believe that they can develop their abilities, which leads to the development of grit and sustains passion and persistence to achieve long-term goals [9,30]. The quality of parenting behavior can moderate this process. Mindset and grit reinforce self-directedness. When learners have the passion and persistence to achieve their goals, an SDL attitude is reinforced, which can be a key factor in a medical student’s college adjustment. Students with high self-direction show better academic adaptation and can lead successful college life [15].
Students attending medical school are generally known to have higher rates of stress depression than other college students. Medical students are overly dependent on their parents during their growing years and are not properly prepared for independence even as they reach adulthood, which can lead to difficulties maintaining their emotional health [31]. Accordingly, for medical students to have a successful college life, it is necessary to establish a support plan to increase their autonomy. Medical students use less self-monitoring strategies during the learning process, and it can be seen that students who monitor their own learning well led to more successful learning than students who do not [15]. Therefore, helping medical students lead SDL can help medical students adapt to college life and further succeed in their studies.

1. Limitations

The study has certain limitations. This is a crosssectional study, and while it can identify the impact of helicopter parenting and respectful parenting on children’s mindset, grit, self-directedness, and adjustment to college, it is limited in providing information about how these factors change and interact over time. The use of selfreported surveys means that the subjective judgment of the respondents may skew the results. In addition to quantitative research, in-depth interviews and qualitative research are needed to gain a deeper understanding of how students experience and perceive their parents’ parenting styles. This study was conducted in the context of Korean educational and cultural characteristics. Hence, it is necessary to conduct the same study in other cultures to compare the results. This would provide an understanding of the impact of parenting styles on medical students’ adjustment to university life worldwide. Furthermore, it will be necessary to develop educational programs to improve the autonomy of medical students and verify whether these educational programs are effective in helping medical students adapt to college life and learn.

2. Conclusion

This study demonstrates that helicopter parenting and respectful parenting have opposing effects on medical students’ mindsets, which affects their adjustment to college. Respectful parenting has a more consistently positive effect than helicopter parenting. Therefore, parents need to respect their children’s autonomy and independence and avoid excessive interference. A supportive parenting style that allows medical students to believe in and develop their abilities will help them develop a growth mindset and grit, strengthen their SDL attitude, and help them successfully adjust to medical school. These findings provide important insights for parents and educators to support students’ academic and emotional development. Furthermore, we must provide support so that medical students can continue their successful college life through educational programs that can improve their self-direction. Furthermore, we must provide support so that medical students can continue their successful college life through educational programs that can improve their self-direction.

Acknowledgments

None.

Notes

Funding
No funding was obtained for this study.
Conflicts of interest
So Jung Yune and Kwi Hwa Park serve as an Editorial Board members of the Korean Journal of Medical Education but have no role in the decision to publish this article. Except for that, no potential conflict of interest relevant to this article was reported.
Author contributions
SJY and KHP conceived and designed the study. JYL, KHP, and HYY drafted the initial version of the manuscript and analyzed the data. All authors discussed and approved the final manuscript.

Fig. 1.
Research Model
kjme-2024-309f1.jpg
Fig. 2.
Final Model Verification Result
kjme-2024-309f2.jpg
Table 1.
Correlation among Variables
Helicopter parenting Respectful parenting Grit Mindset Self-directedness
Respectful parenting -0.397*** -
Grit -0.178*** 0.102* -
Mindset -0.190*** 0.234*** 0.364*** -
Self-directedness -0.275*** 0.302*** 0.605*** 0.560*** -
College adjustment -0.259*** 0.238*** 0.504*** 0.421*** 0.495***

* p<0.05.

*** p<0.001.

Table 2.
The Results of the Path Analysis in the Multiple Mediation Model
Path Estimate
p-value SE CR
B β
Helicopter parenting → mindset -0.121 -0.141 0.016 0.050 -2.410*
Helicopter parenting → college adjustment -0.099 -0.138 0.004 0.034 -2.895**
Respectful parenting → mindset 0.186 0.272 0.000 0.040 4.611***
Mindset → grit 0.238 0.654 0.000 0.058 4.092***
Mindset → self-directedness 0.318 0.363 0.004 0.111 2.865**
Grit → self-directedness 1.570 0.654 0.000 0.398 3.943***
Self-directedness → college adjustment 0.603 0.632 0.000 0.060 10.093***

SE: Standard error, CR: Critical ratio.

* p<0.05.

** p<0.01.

*** p<0.001.

Table 3.
Results of Multiple Mediation Effect Verification
Path B SE β 95% confidence interval
Helicopter parenting → mindset → grit → self-directedness → college adjustment -0.027* 0.017 -0.038 -0.074 to -0.005
Helicopter parenting → mindset → self-directedness → college adjustment -0.023 0.015 -0.032 -0.061 to 0.001
Respectful parenting → mindset → grit → self-directedness → college adjustment 0.042** 0.019 0.074 0.017 to 0.083
Respectful parenting → mindset → self-directedness → college adjustment 0.036* 0.020 0.062 0.008 to 0.075

SE: Standard error.

* p<0.05.

** p<0.01.

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