Wear Delese, Zarconi Joseph
NEOUCOM, Rootstown, OH, USA.
J Gen Intern Med. 2008 Jul;23(7):948-53. doi: 10.1007/s11606-007-0501-0.
Medical educators act on the belief that students benefit from formal and informal educational experiences that foster virtues such as compassion, altruism, and respect for patients.
The purpose of this study is to examine fourth year medical students' perspectives on how, where, and by whom they believe the virtues associated with good physicianhood have been taught to them.
Fourth year students were assigned a two- to three-page essay that asked them to reflect on how their medical education had "fostered and hindered" their conceptions of compassion, altruism, and respect for patients.
All 112 students completed this assignment, and 52 (46%) gave us permission to use their essays for this study.
An inductive, qualitative approach was used to develop themes derived from students' essays.
Students' thoughts were organized around the idea of influences in three areas to which they consistently referred. Foundational influences included parents and "formative years," religious faith, and other experiences preceding medical school. Preclinical education influences comprised formal classroom experiences (both positive and negative effects). Clinical education influences included role modeling (both positive and negative) and the clinical environment (notable for emphasis on efficiency and conflicting cues). Students' essays drew most heavily on the effects of role modeling.
Medical students arrive at our doors as thoughtful, compassionate people. Positive role models and activities to promote critical self-reflection may help nurture these attitudes.
医学教育工作者秉持这样一种信念,即学生能从正式和非正式的教育经历中受益,这些经历能培养同情心、利他主义和对患者的尊重等美德。
本研究旨在考察四年级医学生对于他们认为与优秀医师素养相关的美德是如何、在何处以及由谁传授给他们的看法。
给四年级学生布置一篇两到三页的短文,要求他们反思医学教育如何“培养和阻碍”了他们对同情心、利他主义和对患者尊重的观念。
所有112名学生都完成了这项作业,其中52名(46%)允许我们将他们的短文用于本研究。
采用归纳性的定性方法来提炼从学生短文中得出的主题。
学生的想法围绕他们一直提及的三个影响领域展开。基础性影响包括父母和“成长岁月”、宗教信仰以及医学院之前的其他经历。临床前教育影响包括正式课堂经历(既有积极影响也有消极影响)。临床教育影响包括榜样作用(既有积极的也有消极的)和临床环境(以强调效率和相互冲突的提示而显著)。学生的短文最着重于榜样作用的影响。
医学生进入我们的校门时都是有思想、有同情心的人。积极的榜样和促进批判性自我反思的活动可能有助于培养这些态度。