Department of Community Mental Health, Focus for Excellence in Patient-Professional Relationships in Health Care, University of Haifa, Haifa, Israel.
Acad Med. 2010 Jan;85(1):124-33. doi: 10.1097/ACM.0b013e3181c42896.
The aim of this study was to use medical students' critical incident narratives to deepen understanding of the informal and hidden curricula.
The authors conducted a thematic analysis of 272 stories of events recorded by 135 third-year medical students that "taught them something about professionalism and professional values." Students wrote these narratives in a "professionalism journal" during their internal medicine clerkships at Indiana University School of Medicine, June through November 2007.
The majority of students' recorded experiences involved witnessing positive embodiment of professional values, rather than breaches. Attending physicians and residents were the central figures in the incidents. Analyses revealed two main thematic categories. The first focused on medical-clinical interactions, especially on persons who were role models interacting with patients, families, coworkers, and colleagues. The second focused on events in the teaching-and-learning environment, particularly on students' experiences as learners in the clinical setting.
The findings strongly suggest that students' reflective narratives are a rich source of information about the elements of both the informal and hidden curricula, in which medical students learn to become physicians. Experiences with both positive and negative behaviors shaped the students' perceptions of the profession and its values. In particular, interactions that manifest respect and other qualities of good communication with patients, families, and colleagues taught powerfully.
本研究旨在利用医学生的关键事件叙述，深入了解非正式和隐性课程。
作者对印第安纳大学医学院 135 名三年级医学生记录的 272 个事件的故事进行了主题分析，这些故事“让他们了解了一些关于专业精神和专业价值观的知识”。2007 年 6 月至 11 月，学生在内科实习期间在“专业精神杂志”上撰写了这些叙述。
大多数学生记录的经验涉及见证专业价值观的积极体现，而不是违反。主治医生和住院医师是事件中的核心人物。分析揭示了两个主要的主题类别。第一个重点是医疗-临床互动，特别是那些作为榜样与患者、家属、同事和同事互动的人。第二个重点是教学和学习环境中的事件，特别是学生在临床环境中作为学习者的经验。
调查结果强烈表明，学生的反思性叙述是了解非正式和隐性课程要素的丰富信息来源，医学生在这些课程中学习成为医生。积极和消极行为的经验塑造了学生对专业及其价值观的看法。特别是，与患者、家属和同事表现出尊重和良好沟通其他品质的互动具有很强的教育意义。
