临床医学生接受问题型教学的积极影响因素探讨。

Asha S Jain, Jacob J Abou-Hanna, Elizabeth M Petty
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引用次数: 0

摘要

导读:学术医学文献报道了临床教学医生在教授医学生时使用问题的犹豫,因为它具有“拉皮条”的负面含义。然而,最新的文献表明,大多数学生更喜欢提问,而只有一小部分人不太欢迎。然而,一些教学医生担心在临床环境中使用问题会使医学生感到羞辱或尴尬。方法:邀请在中西部一所公立医学院完成核心见习轮转的医学生参加4个虚拟焦点小组中的1个。学生被要求反思3个临床教学小插曲。进行归纳专题定性分析,创建一个密码本。脚本由2个独立的编码员针对新兴主题进行编码。结果:26名学生分4组参与。确定了四个主要主题,表明学生对教学医生及其问题的积极接受:教学医生(1)吸引学生,(2)设定明确的期望,(3)对医学生的经历感同身受,(4)提出问题以教学而不是评估。在达到100%的共识之前,对3个小片段进行主题编码的初始互编码可靠性分别为85.4%、87%和79%。学生们描述了理想的教学医生是耐心、敬业和尊重。结论:通过吸引医学生,尽早设定明确的期望,对医学生的经历感同身受,并以教学为目的提出问题,教学医生在利用问题作为教学工具时,可以更少地犹豫是否会让医学生感到不安。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploration of Factors That Positively Influence Medical Student Reception of Question-Based Teaching in Clinical Settings.

Introduction: Academic medicine literature has reported hesitation from clinical teaching physicians to use questions when teaching medical students due to its negative connotation of "pimping." However, newer literature suggests that most students prefer questions, while only a small minority are less welcoming. Some teaching physicians, however, have concerns about using questions due to the risk of humiliating or embarrassing medical students in clinical settings.

Methods: Medical students who completed core clerkship rotations at a public medical school in the Midwest were invited to participate in 1 of 4 virtual focus groups. Students were asked to reflect on 3 clinical teaching vignettes. Inductive thematic qualitative analysis was performed to create a codebook. The transcripts were coded by 2 independent coders for emerging themes.

Results: Twenty-six students participated across 4 groups. Four major themes were identified that demonstrate positive student reception of teaching physicians and their questions: teaching physicians (1) engaging students, (2) setting clear expectations, (3) empathizing with the medical student experience, and (4) asking questions to teach rather than evaluate. Thematic coding of the 3 vignettes resulted in initial intercoder reliabilities of 85.4%, 87%, and 79%, prior to achieving 100% consensus. Students described the ideal teaching physician to be patient, engaged, and respectful.

Conclusions: By engaging medical students, setting clear expectations early on, empathizing with the medical student experience, and asking questions with the purpose of teaching, teaching physicians can be less hesitant about upsetting medical students when utilizing questions as a teaching tool.

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