探索医学学生教育中尊重的含义：对学生叙事的分析。
Exploring the meaning of respect in medical student education: an analysis of student narratives.
机构信息
Department of Community Mental Health, University of Haifa, Haifa, Israel.
出版信息
J Gen Intern Med. 2010 Dec;25(12):1309-14. doi: 10.1007/s11606-010-1471-1. Epub 2010 Aug 17.
BACKGROUND
Respect for others is recognized in the medical literature and society as an essential attribute of the good medical professional. However, the specific meaning of respect varies widely and is underexplored as a lived experience of physicians-in-training.
OBJECTIVE
To describe third-year medical students' narratives of respect and disrespect [(dis)respect] during their internal medicine clerkship.
DESIGN
Qualitative thematic analysis of 152 third-year student narratives that 'taught them something about professionalism,' focusing on (dis)respect.
APPROACH
Immersion/crystallization narrative analysis.
RESULTS
We reviewed 595 professionalism narratives and found that one in four narratives involved (dis)respect. We then found that 2/3 of these narratives were negative (describing instances of disrespect rather than respect). In the other coded categories, the proportion of negative narratives was significantly lower. In order to better understand these results, we analyzed the content of the (dis)respect narratives and identified six primary themes: (1) content and manner of communication (including, appreciating or belittling, being sensitive or blunt and respecting privacy); (2) conduct: behaviors expressing (dis)respect; (3) patient centeredness: honoring others' preferences, decisions and needs; (4) treating others as equals; (5) valuing the other and their experience and/or problem; and (6) nurturing students' learning.
CONCLUSIONS
Focusing on the lived experience of (dis)respect on wards broadens the concept of respect beyond any one type of act, behavior or attitude. Students perceive respect as a way of being that applies in all settings (private and public), with all participants (patients, family members, nurses, colleagues and students) and under all circumstances (valuing others' time, needs, preferences, choices, opinions and privacy). Respect seems to entail responding to a need, while disrespect involves ignoring the need or bluntly violating it.
背景
尊重他人被医学文献和社会公认为是优秀医疗专业人员的重要特质。然而，作为医学生的一种真实体验，尊重的具体含义差异很大，且尚未得到充分探索。
目的
描述实习医师在实习期间对尊重和不尊重（无礼）的体验。
设计
对 152 名三年级医学生的叙事进行定性主题分析，这些叙事“让他们对专业精神有了一些了解”，重点关注尊重和不尊重。
方法
沉浸式/结晶叙事分析。
结果
我们回顾了 595 篇专业叙事，发现其中四分之一的叙事涉及尊重和不尊重。然后我们发现，这些叙事中有三分之二是负面的（描述的是不尊重的情况，而不是尊重的情况）。在其他编码类别中，负面叙事的比例明显较低。为了更好地理解这些结果，我们分析了尊重和不尊重叙事的内容，并确定了六个主要主题：（1）沟通的内容和方式（包括赞赏或贬低、敏感或直率以及尊重隐私）；（2）行为：表现出尊重和不尊重的行为；（3）以患者为中心：尊重他人的偏好、决定和需求；（4）平等对待他人；（5）重视他人及其经验和/或问题；（6）培养学生的学习。
结论
关注病房中尊重和不尊重的真实体验，拓宽了尊重的概念，超越了任何一种行为、行为或态度。学生将尊重视为一种存在方式，适用于所有环境（私人和公共）、所有参与者（患者、家属、护士、同事和学生）和所有情况（尊重他人的时间、需求、偏好、选择、意见和隐私）。尊重似乎涉及满足需求，而不尊重则涉及忽视或直接违反需求。
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