培养医学生的反身性:病人参与是一条有前途的途径吗?定性案例研究。

IF 2 Q2 EDUCATION, SCIENTIFIC DISCIPLINES
Julie Massé, Sarah Numainville, Marie-Claude Tremblay
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引用次数: 0

摘要

背景:反身性使个人能够根据过去的经验分析情况,从而发展出其他的思维方式和行动视角。因此,反身性对于专业实践的改进至关重要。在医学教育中,最近的研究已经确定患者参与是培养学生反身性的一种很有前途的策略;然而,很少有评估性研究探索这种联系。本文描述了一项干预措施的反射效应,该干预措施使患者参与关于实践中产生的伦理、道德和社会问题的小组讨论研讨会(作为拉瓦尔大学本科医学课程的一部分),并介绍了产生这些效应的主要过程。方法:本研究采用定性案例研究设计。病例是2021年冬季接受干预的三组。数据收集包括半结构化访谈和非参与性观察。分析包括案例内分析和跨案例分析。本研究运用了Sandars的三阶段反身过程命题,该命题在其他反身模型的基础上得到了加强。结果:主要的反身效应和过程包括:(1)更好地理解无实体的理论内容;(2)意识到临床观点在把握复杂情况时的局限性;(3)质疑自我和职业信念;(4)意识到医患社会距离。在考虑行动的具体含义时,反射效应指的是以病人为中心的方法,意味着作为医生的其他行为、存在和思考方式。结论:本研究是一个机会,以确定患者参与讨论研讨会是一个有希望的途径,以培养医学生的反身性,并更好地理解其原因和方式。它揭示了病人参与在医学教育中的相关性和价值。通过确定影响反射过程的因素,它还为希望致力于涉及患者的变革性教育姿态和方法的医学院提供具体支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fostering Reflexivity in Medical Students: Is Patient Engagement a Promising Avenue? A Qualitative Case Study.

Background: Reflexivity enables individuals to analyze a situation based on past experience to develop other ways of thinking and perspectives for action. Reflexivity is therefore crucial for the improvement of professional practice. In medical education, recent studies have identified patient engagement as a promising strategy for fostering reflexivity in students; however, few evaluative studies have explored such a link. This article describes the reflexive effects of an intervention that engages patients in small-group discussion workshops about ethical, moral, and social issues arising from practice (as part of an undergraduate medical course at Université Laval) and presents the main processes involved in producing these effects.

Methods: The study subscribes to a qualitative case study design. Cases are three groups that received the intervention in winter 2021. Data collection involved semi-structured interviews and non-participatory observation. Analysis entailed within-case and cross-case analysis. The study mobilizes Sandars' proposition of a three-stage reflexive process which is enhanced with other models of reflexivity.

Results: The main reflexive effects and processes involved: (i) better understanding disembodied theoretical content, (ii) awareness of the limits of the clinical view for grasping complex situations, (iii) questioning one's convictions about the self and the profession, and (iv) awareness of the patient-doctor social distance. When considering concrete implications for action, reflexive effects refer to a patient-centered approach, implying other ways of doing, being, and thinking as a physician.

Conclusions: This study was an opportunity to identify patient engagement in discussion workshops as a promising avenue to foster medical students' reflexivity and to better understand its whys and hows. It sheds new light on patient engagement's relevance and value in medical education. By identifying factors influencing the reflexive process, it also provides concrete support to medical schools wishing to commit to transformative educational postures and approaches involving patients.

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来源期刊
Journal of Medical Education and Curricular Development
Journal of Medical Education and Curricular Development EDUCATION, SCIENTIFIC DISCIPLINES-
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