从简化技巧到有意义的学习:床边心脏评估中的信任和谦卑。

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES
Advances in Medical Education and Practice Pub Date : 2025-08-05 eCollection Date: 2025-01-01 DOI:10.2147/AMEP.S520398
James L Meisel, Deborah D Navedo, Isaac O Opole, Gail M Cohen, Sheilah A Bernard, Hugo Carmona, Ahmed H Nahas, Carly M Eiduson, Nick Papps
{"title":"从简化技巧到有意义的学习:床边心脏评估中的信任和谦卑。","authors":"James L Meisel, Deborah D Navedo, Isaac O Opole, Gail M Cohen, Sheilah A Bernard, Hugo Carmona, Ahmed H Nahas, Carly M Eiduson, Nick Papps","doi":"10.2147/AMEP.S520398","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Notions of trust are foundational to competency-based medical education. \"Entrustability\" underlies assessment; assessment is guided by integration into curricula of learners' knowledge, skills, and attitudes. However, attitudinal notions of trust are not commonly conceptualized as integral to such frameworks. Overlap between concepts of entrustability and trust as an attitude creates opportunity to infuse trust into competency frameworks. We explored how an original bedside cardiac assessment (BCA) curriculum that supported professional attitudes, knowledge, and skills scaffolded clinical learning in a cohort of internal medicine clerkship students.</p><p><strong>Methods: </strong>The curriculum urged students to hear patients' perspectives with humility and as key to diagnostic reasoning. Assigned short videos preceded two facilitated classes that included discussing a patient's startling question, \"Why should I trust your clinical skills?\" and recognizing, in simulated clinical encounters, disparate patients' perspectives. To better understand their experiences, we asked sixty-seven students to complete two post-class open-ended questions. We analyzed responses using content and thematic analyses.</p><p><strong>Results: </strong>Emergent codes clustered around themes in two categories: \"Successful Learning\" around effective learning strategies and meaningful peer encounters, skills practice, and educator encounters; and \"Opportunities for Improvement\", around instructional design, learning preferences, and instruction-related improvements.</p><p><strong>Conclusion: </strong>Themes suggested effective learning and meaningful interactions. Comments affirmed the importance of attitudinal aspects of skills development; human interaction while learning; and humility, a linchpin of expertise development and patient-centered communication. All contribute to professional identity formation (PIF). Instructional design improvements were incorporated into the final version of the curriculum. Limitations included inability to examine nuances of emergent themes from the limited data set. We are studying the curriculum's effects on BCA-related knowledge, skills, and attitudes and trust-worthiness as a learning construct. Research opportunities include impacts on humility, patient-centeredness, and PIF. We hope this exploratory work will stimulate conversations around expanded roles of notions of trust in medical education.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"16 ","pages":"1305-1316"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335936/pdf/","citationCount":"0","resultStr":"{\"title\":\"From Reductionist Skills to Meaningful Learning: Trust and Humility in Bedside Cardiac Assessment.\",\"authors\":\"James L Meisel, Deborah D Navedo, Isaac O Opole, Gail M Cohen, Sheilah A Bernard, Hugo Carmona, Ahmed H Nahas, Carly M Eiduson, Nick Papps\",\"doi\":\"10.2147/AMEP.S520398\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Notions of trust are foundational to competency-based medical education. \\\"Entrustability\\\" underlies assessment; assessment is guided by integration into curricula of learners' knowledge, skills, and attitudes. However, attitudinal notions of trust are not commonly conceptualized as integral to such frameworks. Overlap between concepts of entrustability and trust as an attitude creates opportunity to infuse trust into competency frameworks. We explored how an original bedside cardiac assessment (BCA) curriculum that supported professional attitudes, knowledge, and skills scaffolded clinical learning in a cohort of internal medicine clerkship students.</p><p><strong>Methods: </strong>The curriculum urged students to hear patients' perspectives with humility and as key to diagnostic reasoning. Assigned short videos preceded two facilitated classes that included discussing a patient's startling question, \\\"Why should I trust your clinical skills?\\\" and recognizing, in simulated clinical encounters, disparate patients' perspectives. To better understand their experiences, we asked sixty-seven students to complete two post-class open-ended questions. We analyzed responses using content and thematic analyses.</p><p><strong>Results: </strong>Emergent codes clustered around themes in two categories: \\\"Successful Learning\\\" around effective learning strategies and meaningful peer encounters, skills practice, and educator encounters; and \\\"Opportunities for Improvement\\\", around instructional design, learning preferences, and instruction-related improvements.</p><p><strong>Conclusion: </strong>Themes suggested effective learning and meaningful interactions. Comments affirmed the importance of attitudinal aspects of skills development; human interaction while learning; and humility, a linchpin of expertise development and patient-centered communication. All contribute to professional identity formation (PIF). Instructional design improvements were incorporated into the final version of the curriculum. Limitations included inability to examine nuances of emergent themes from the limited data set. We are studying the curriculum's effects on BCA-related knowledge, skills, and attitudes and trust-worthiness as a learning construct. Research opportunities include impacts on humility, patient-centeredness, and PIF. We hope this exploratory work will stimulate conversations around expanded roles of notions of trust in medical education.</p>\",\"PeriodicalId\":47404,\"journal\":{\"name\":\"Advances in Medical Education and Practice\",\"volume\":\"16 \",\"pages\":\"1305-1316\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335936/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Advances in Medical Education and Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/AMEP.S520398\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"EDUCATION, SCIENTIFIC DISCIPLINES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Medical Education and Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/AMEP.S520398","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
引用次数: 0

摘要

目的:信任观念是能力医学教育的基础。“可信赖性”是评估的基础;评估的指导是将学习者的知识、技能和态度整合到课程中。然而,信任的态度概念通常不被概念化为这些框架的组成部分。可信赖性和信任作为一种态度的概念之间的重叠创造了将信任注入能力框架的机会。我们在一组内科实习学生中探讨了原始床边心脏评估(BCA)课程如何支持专业态度、知识和技能,从而为临床学习奠定基础。方法:课程鼓励学生以谦卑的态度倾听患者的观点,并将其作为诊断推理的关键。在两节辅助课程之前,安排了短视频,其中包括讨论病人提出的令人吃惊的问题,“我为什么要相信你的临床技能?”以及在模拟的临床接触中识别不同病人的观点。为了更好地了解他们的经历,我们要求67名学生完成两个课后开放式问题。我们使用内容和主题分析来分析回应。结果:紧急代码围绕两类主题聚集:“成功学习”围绕有效的学习策略和有意义的同伴接触、技能练习和教育者接触;以及“改进的机会”,围绕教学设计、学习偏好和与教学相关的改进。结论:主题提示有效的学习和有意义的互动。评论肯定了技能发展的态度方面的重要性;学习时的人际互动;谦逊是专业知识发展和以病人为中心的沟通的关键。所有这些都有助于职业身份形成(PIF)。教学设计的改进被纳入课程的最终版本。限制包括无法从有限的数据集中检查突发主题的细微差别。我们正在研究课程对bca相关知识、技能、态度和可信度的影响。研究机会包括对谦卑、以病人为中心和PIF的影响。我们希望这项探索性工作将激发围绕信任概念在医学教育中扩大作用的对话。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
From Reductionist Skills to Meaningful Learning: Trust and Humility in Bedside Cardiac Assessment.

Purpose: Notions of trust are foundational to competency-based medical education. "Entrustability" underlies assessment; assessment is guided by integration into curricula of learners' knowledge, skills, and attitudes. However, attitudinal notions of trust are not commonly conceptualized as integral to such frameworks. Overlap between concepts of entrustability and trust as an attitude creates opportunity to infuse trust into competency frameworks. We explored how an original bedside cardiac assessment (BCA) curriculum that supported professional attitudes, knowledge, and skills scaffolded clinical learning in a cohort of internal medicine clerkship students.

Methods: The curriculum urged students to hear patients' perspectives with humility and as key to diagnostic reasoning. Assigned short videos preceded two facilitated classes that included discussing a patient's startling question, "Why should I trust your clinical skills?" and recognizing, in simulated clinical encounters, disparate patients' perspectives. To better understand their experiences, we asked sixty-seven students to complete two post-class open-ended questions. We analyzed responses using content and thematic analyses.

Results: Emergent codes clustered around themes in two categories: "Successful Learning" around effective learning strategies and meaningful peer encounters, skills practice, and educator encounters; and "Opportunities for Improvement", around instructional design, learning preferences, and instruction-related improvements.

Conclusion: Themes suggested effective learning and meaningful interactions. Comments affirmed the importance of attitudinal aspects of skills development; human interaction while learning; and humility, a linchpin of expertise development and patient-centered communication. All contribute to professional identity formation (PIF). Instructional design improvements were incorporated into the final version of the curriculum. Limitations included inability to examine nuances of emergent themes from the limited data set. We are studying the curriculum's effects on BCA-related knowledge, skills, and attitudes and trust-worthiness as a learning construct. Research opportunities include impacts on humility, patient-centeredness, and PIF. We hope this exploratory work will stimulate conversations around expanded roles of notions of trust in medical education.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Advances in Medical Education and Practice
Advances in Medical Education and Practice EDUCATION, SCIENTIFIC DISCIPLINES-
CiteScore
3.10
自引率
10.00%
发文量
189
审稿时长
16 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信