从挑战到成长:探索住院医师对患者投诉的叙述。

IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Allan McDougall, Fernanda Claudio, Catherine Pound, Karen Pacheco, Jacqueline Fortier, Gary Garber
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引用次数: 0

摘要

导读:患者投诉是医疗保健质量提高和医学教育的重要反馈机制,其对研究生医学实习生(住院医师)的影响尚不明确。本研究调查了住院医师期间收到正式患者投诉的叙述,重点关注这些事件如何影响他们的专业发展和职业轨迹。方法:采用叙述性调查,我们对35名住院医师进行了半结构化访谈,这些医生在住院期间经历了正式的患者投诉。我们运用Ricoeur的叙事理论来探讨这些抱怨对医生的影响。结果:分析揭示了参与者叙事的两个主要因素:就业和重构。在就业期间,参与者最初以痛苦和耻辱为中心构建叙事,往往将自己定位为困惑和孤立。这个过程经常涉及到他们的专业能力和身份的重新评估作为一个有效的医生。重塑展示了参与者如何将这些经历整合到他们的长期职业身份中,揭示了对临床实践、专业选择和职业道路的影响。尽管最初面临挑战,但许多参与者将他们早期的投诉经历重新定义为职业成长的催化剂,特别是在沟通和同事支持等领域。结论:住院医师的病人抱怨会对职业认同的形成产生不稳定的影响。然而,支持性的教育环境和适当的指导可以减轻这些影响,促进学习。本研究强调了医学教育项目的必要性,以支持住院医生有效地解决和学习患者投诉,同时保持对患者安全和质量改进的关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
From challenge to growth: Exploring physician narratives of patient complaints during residency.

Introduction: Patient complaints are an important feedback mechanism for healthcare quality improvement and medical education, and their impact on postgraduate medical trainees (residents) remains under-explored. This study investigates the narratives of physicians who received formal patient complaints during residency, focusing on how these incidents influenced their professional development and career trajectories.

Methods: Using narrative inquiry, we conducted semi-structured interviews with 35 physicians who experienced formal patient complaints during their residency. We applied Ricoeur's narrative theory to explore the impact of these complaints on physicians.

Results: The analysis revealed two main elements of participants' narratives: emplotment and refiguration. During emplotment, participants initially constructed narratives centered on distress and stigma, often positioning themselves as confused and isolated. This process frequently involved a reevaluation of their professional capabilities and identity as an effective physician. Refiguration demonstrated how participants integrated these experiences into their long-term professional identities, revealing impacts on clinical practices, specialty choices and career paths. Despite initial challenges, many participants reframed their early complaint experiences as catalysts for professional growth, particularly in areas such as communication and collegial support.

Conclusions: Patient complaints during residency can have a destabilizing effect on professional identity formation. However, supportive educational environments and adequate mentorship can mitigate these effects and enhance learning. This study underscores the need for medical education programmes to incorporate systems that support residents in effectively addressing and learning from patient complaints while maintaining a focus on patient safety and quality improvement.

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来源期刊
Medical Education
Medical Education 医学-卫生保健
CiteScore
8.40
自引率
10.00%
发文量
279
审稿时长
4-8 weeks
期刊介绍: Medical Education seeks to be the pre-eminent journal in the field of education for health care professionals, and publishes material of the highest quality, reflecting world wide or provocative issues and perspectives. The journal welcomes high quality papers on all aspects of health professional education including; -undergraduate education -postgraduate training -continuing professional development -interprofessional education
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