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[医学生职业认同形成的社会心理决定因素。发展的可能性]

[Social psychological determinants of the formation of medical students' professional identity. Possibilities of development].

作者信息

Csörsz Ilona

机构信息

Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Népegészségügyi Kar, Magatartástudományi Intézet Debrecen Nagyerdei krt. 98. 4032.

出版信息

Orv Hetil. 2011 Mar 20;152(12):475-80. doi: 10.1556/OH.2011.29078.

DOI:10.1556/OH.2011.29078
PMID:21388945
Abstract

Systematic observations regarding techniques of medical career-socialization has hardly ever appeared in Hungarian technical literature yet. Focusing on the need for practical medical training the author elaborated a career-socialization program consisting of a three-level, three-branch training technique. This consisted of a Junior Bálint-group, an imaginative visualization technique, and an expressive, drama-pedagogical working method completed with a projective technique. This career-socialization program focuses on the physician's personality, capability-expansion in relationship management, and practicing a set of professional behavior-roles. During the empirical observations connected to the work the author examined medical students' patient-representation, their relation to the patients, and the development of the physician's professional character. Within the frames of this three-level, three-branch training technique program it enables us to observe which training technique is able to reveal all those psychological qualities that can contribute to the conformation of the representations, thus to the process of career-socialization in the most effective way. The content-analyses of the cases of Junior Bálint-groups (n = 60) revealed that the most frequent problems are fear of intimacy, of bodily contact, communication with patients in a chronic or terminal state, and the fear of medical practice. The content-analyses of imaginary patient-images (n = 62) with Rorschach-signs confirmed that the psychological burdens mentioned above are the most serious problems for medical students. The process-, and content-analyses of drama-games, the integrative healing contact training groups (n = 74) showed that group work primarily intensifies the relationship responsiveness, the ability to adopt the other's (the patient's) viewpoints, and enables an involuntary and distressless identification with the patient and the physician, both agents in the healing relationship. It is the drama-game that gives significant support to experience the physician- patient relationship in a high quality level. In the next phase the author tested the short story used for the drama-game and its projective contents on a sample of medical and psychology students (n = 313). For the statistical analysis the SPSS and the LEM program-packets were applied. Statistical methods included variance analysis, chi-square test and log-linear analysis. The vast similarity of the projective contents appearing in the survey questionnaire and in the drama-group verified that the chosen short story as a projective surface is suitable for recalling the students' typical stereotypes and representations related to diseases, patients, healing experts and therapeutic situations. The drama-group focused on the realization of these stereotypical representations, and also on experiencing and forming the students' emotional relations to them.

摘要

匈牙利的专业技术文献中几乎从未出现过关于医学职业社会化技巧的系统性观察。基于对实践医学培训的需求,作者精心设计了一个职业社会化项目,该项目采用三级、三分支的培训技巧。它包括一个初级巴林特小组、一种想象可视化技巧、一种富有表现力的戏剧教学工作方法,并辅以投射技术。这个职业社会化项目关注医生的个性、人际关系管理能力的拓展以及一系列职业行为角色的实践。在与该工作相关的实证观察中,作者研究了医学生对患者的描述、他们与患者的关系以及医生职业性格的发展。在这个三级、三分支培训技巧项目的框架内,它使我们能够观察到哪种培训技巧能够揭示所有那些有助于形成表象,从而以最有效的方式促进职业社会化进程的心理品质。对初级巴林特小组案例(n = 60)的内容分析表明,最常见的问题是害怕亲密关系、身体接触、与慢性病或绝症患者沟通以及对医疗实践的恐惧。对带有罗夏墨迹测验特征的想象患者形象(n = 62)的内容分析证实了上述心理负担是医学生面临的最严重问题。对戏剧游戏、综合治疗接触训练小组(n = 74)的过程和内容分析表明,小组工作主要强化了关系反应能力、采纳他人(患者)观点的能力,并使学生能够不自觉且无痛苦地认同患者和医生,他们都是治疗关系中的参与者。正是戏剧游戏为高质量地体验医患关系提供了重要支持。在下一阶段,作者在医学和心理学专业学生样本(n = 313)上测试了用于戏剧游戏的短篇小说及其投射内容。统计分析使用了SPSS和LEM程序包。统计方法包括方差分析、卡方检验和对数线性分析。调查问卷和戏剧小组中出现的投射内容的高度相似性证实,所选的短篇小说作为投射表面适合唤起学生与疾病、患者、治疗专家和治疗情境相关的典型刻板印象和表象。戏剧小组专注于这些刻板印象表象的实现,以及体验和形成学生与它们的情感关系。

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