从临床实习中发现临床前医科学生的思考:专题分析。

IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Medical Teacher Pub Date : 2025-07-01 Epub Date: 2024-11-02 DOI:10.1080/0142159X.2024.2421993
Chih-Wei Yang, Chun-Ta Huang, Jeng-Yi Shieh, Yen-Lin Chiu, Chiao-Ling Tsai, Chia-Ter Chao, Yi-Ju Tsai, Mong-Wei Lin, Chao-Chi Ho, Shyh-Jye Chen, Chiun Hsu, Huey-Ling Chen
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引用次数: 0

摘要

目的:临床跟班学习(Clinical Shadow,CS)为临床前医科学生提供了观察执业医师实践的机会。通过分析学生的反思性写作(RWs)内容,了解他们在CS过程中感知到的核心能力,以及他们反思的阶段,可以为课程设计和教师指导提供有价值的见解。本研究旨在通过对学生的反思性写作进行主题分析来探讨 CS 的学习成果,从而解决这一问题:主题分析的数据集包括台湾大学医学院2019学年第一学期参加临床影子课程的临床前医学生的去标识化RW。两名研究人员独立从RW文本中提取相关内容并进行分类,将其与ACGME的六项核心能力相一致,并将其映射到Kolb学习周期的各个阶段。此外,还调查了与跟班专业和领域的相关性:结果:共分析了 155 份 RW。病人护理是最常反映的能力(30%),其次是基于系统的实践(23%)和医学知识(21%)。跟岗学习的专业和领域对学生感知的核心能力有影响。从科尔布的学习阶段来看,具体经验(66%)在跟岗学习中占主导地位,而抽象概念(19%)和反思观察(14%)则较少。就每种能力而言,具体体验是最主要的阶段,而积极实验是最不主要的阶段。在每个核心能力的不同阶段,学生表现出不同比例的反思:临床跟岗实习使临床前医学生能够探索所需的临床核心能力,重点取决于跟岗实习的专业和领域。目前,大多数反思都集中在柯尔布的具体经验阶段。这项研究为设计未来的临床跟师项目和改善教师发展提供了宝贵的见解,旨在帮助学生在核心能力甚至专业身份方面实现更深入、更全面的反思性学习。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Uncovering Reflections of Preclinical Medical Students from Clinical Shadowing: A Thematic Analysis.

Purpose: Clinical shadowing(CS) offers preclinical medical students the opportunity to observe certified physicians in practice. Analyzing the content of students' reflective writings(RWs) to understand core competencies they perceived during CS, as well as stages of their reflections, can offer valuable insights for course design and instructor guidance. This study aimed to address this matter by employing a thematic analysis of students' RWs to explore the learning outcomes derived from CS.

Materials and methods: The dataset of the thematic analysis comprised de-identified RWs from preclinical medical students who participated in the clinical shadowing program during the first semester of the 2019 academic year at National Taiwan University College of Medicine. Two researchers independently extracted and categorized pertinent content from the texts of RWs, aligning them with the six core competencies of ACGME and mapping them to the stages of Kolb's learning cycle. Additionally, correlation with shadowing specialties and fields was investigated.

Results: In total, 155 RWs were analyzed. Patient care emerged as the most frequently reflected competency(30%), followed by systems-based practice(23%), and medical knowledge(21%). The shadowing specialties and fields had an impact on the core competencies students perceived. In terms of Kolb's learning stages, concrete experience(66%) predominated in RWs, while abstract conceptualization(19%) and reflective observation(14%) were less prevalent. For each competency, concrete experience was the prevailing stage, with active experimentation being the least dominant one. Students exhibited varying proportions of reflections at different stages for each core competency.

Conclusions: Clinical shadowing experiences enable preclinical medical students to explore required clinical core competencies, with emphases depending on the shadowing specialties and fields. Currently, most reflections are concentrated at Kolb's concrete experience stage. This study offers valuable insights for designing future CS programs and improving faculty development, aimed at helping students achieve deeper and more comprehensive reflective learning in relation to core competencies, and even professional identity.

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来源期刊
Medical Teacher
Medical Teacher 医学-卫生保健
CiteScore
7.80
自引率
8.50%
发文量
396
审稿时长
3-6 weeks
期刊介绍: Medical Teacher provides accounts of new teaching methods, guidance on structuring courses and assessing achievement, and serves as a forum for communication between medical teachers and those involved in general education. In particular, the journal recognizes the problems teachers have in keeping up-to-date with the developments in educational methods that lead to more effective teaching and learning at a time when the content of the curriculum—from medical procedures to policy changes in health care provision—is also changing. The journal features reports of innovation and research in medical education, case studies, survey articles, practical guidelines, reviews of current literature and book reviews. All articles are peer reviewed.
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