评估一年级医学和牙科学生在临终关怀和姑息医学指导下的临床见习经验的影响:一项试点研究。

Kirsten G Engel, Lucia R I Millham, Irene M Yeh, Patrick W Malecha, Kate Brizzi, Andrea Wershof Schwartz, Dorothy W Tolchin
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引用次数: 0

摘要

背景:所有的医生都会遇到重病患者。医学生认识到临终关怀和姑息医学(HPM)的价值,并希望在这一领域获得更多的知识和技能。然而,临床前和临床HPM内容在医学院课程中代表性不足。目的:开展一项试点研究,通过对学生反应的混合方法评估,研究一种新的HPM临床经验对临床前医学和牙科学生学习的影响。设计:在为期半天的HPM指导的临床见习体验(HPM- mcse)之后,学生完成了两部分的电子调查,其中包括介绍环节、教师指导的见习体验和汇报环节。背景/对象:2022年美国马萨诸塞州波士顿市哈佛医学院163名一年级学生。测量方法:调查收集了人口统计信息和学生对封闭式(李克特量表)和开放式提示的回答。数据采用描述性统计进行定量分析,采用恒定比较方法进行定性分析。结果:回复127名医、牙专业学生,回复率78%。定性分析产生了三个主要主题:获得关于HPM的操作维度的知识,获得关于HPM的心理社会维度的知识,以及个人影响,包括意识到期望与HPM实践的实际经验之间的不一致。在完成整个调查的109名学生中,67%的人表示这一经历增加了他们对姑息治疗的兴趣,98%的人表示他们对姑息治疗如何提高患者护理的理解有所增加。结论:一年级学生早期临床接触HPM刺激了HPM的多维学习,并唤起了个人对重症护理的反思。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessing the Impact of a Hospice and Palliative Medicine Mentored Clinical Shadowing Experience for First-Year Medical and Dental Students: A Pilot Study.

Background: All physicians encounter patients with serious illness. Medical students recognize the value of hospice and palliative medicine (HPM) and desire more knowledge and skills in this area. However, both pre-clinical and clinical HPM content are underrepresented within medical school curricula. Objectives: To conduct a pilot study examining the impact of a novel required HPM clinical experience on pre-clinical medical and dental students' learning through mixed methods evaluation of student responses. Design: Students completed a two-part electronic survey following a half-day HPM mentored clinical shadowing experience (HPM-MCSE) which included an introductory session, a faculty-mentored shadowing experience and a debriefing session. Setting/subjects: 163 first-year students at Harvard Medical School in Boston, Massachusetts, USA in 2022. Measurements: The survey collected demographic information and student responses to both closed-ended (Likert-scale) and open-ended prompts. Data were analyzed quantitatively using descriptive statistics and qualitatively using constant comparative methodology. Results: 127 medical and dental students responded (78% response rate). Qualitative analysis yielded three overarching themes: acquisition of knowledge about operational dimensions of HPM, acquisition of knowledge about psychosocial dimensions of HPM, and personal impact including an awareness of discordance between expectations and lived experience of HPM practice. Of the 109 students who completed the entire survey, 67% indicated that this experience increased their interest in palliative care and 98% reported an increase in their understanding of how palliative care enhances patient care. Conclusions: Early clinical exposure to HPM for first year students stimulates multi-dimensional learning about HPM and evokes personal reflection about serious illness care.

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