Barr Jennifer, Bull Rosalind, Rooney Kim
Launceston Clinical School, School of Medicine, University of Tasmania, Locked Bag 1377, Launceston, TAS, 7250, Australia,
Adv Health Sci Educ Theory Pract. 2015 May;20(2):325-38. doi: 10.1007/s10459-014-9530-8. Epub 2014 Jul 10.
Patient encounters are central to the provision of learning opportunities for medical students and their development as medical professionals. The primary aim of the study reported in this paper was to discover how partnering medical students with patients with chronic illness in undergraduate learning influenced the development of a patient centred professional identity and professionalism. An exploratory interpretive research design was used to address the research aim within a patient partner program (P3). Three qualitative data collection methods were used: (1) focus groups (2) extended response questionnaire and (3) semi-structured interviews. Data were coded and analysed thematically. The professional identity of medical students is constructed along traditional lines in the preclinical years. Patient-partnership offers a disruption to this development by way of an intersection with patients with chronic illness which potentially allows meaningful construction of what a patient-centred identity should be. This point of reflection provides an opportunity to engage at a higher level in medical identity development and professionalism. The findings discussed in this paper further stimulate the patient-centred agenda by understanding the conflict associated with the student-patient nexus in medical education and its potential for building professionalism and a patient-centred professional identity. To continue the drive for a patient-centred professional identity there must be ongoing engagement with patients in medical education, preferably commencing early in a student's journey so that it becomes the expected norm. This study has highlighted that a true patient-centred emphasis is being encountered too late in their socialisation process.
患者接触对于为医学生提供学习机会以及他们作为医学专业人员的发展至关重要。本文所报告研究的主要目的是探究在本科学习中让医学生与慢性病患者结对如何影响以患者为中心的职业身份和职业素养的发展。在一个患者伙伴项目(P3)中,采用了探索性解释性研究设计来实现研究目的。使用了三种定性数据收集方法:(1)焦点小组;(2)扩展回答问卷;(3)半结构化访谈。对数据进行编码并进行主题分析。医学生的职业身份在临床前阶段沿着传统路线构建。患者伙伴关系通过与慢性病患者的交集对这种发展产生干扰,这有可能使以患者为中心的身份应是什么样的得到有意义的构建。这个反思点为在医学身份发展和职业素养方面进行更高层次的参与提供了机会。本文所讨论的研究结果通过理解医学教育中与学生 - 患者关系相关的冲突及其在培养职业素养和以患者为中心的职业身份方面的潜力,进一步推动了以患者为中心的议程。为了继续推动以患者为中心的职业身份发展,医学教育中必须持续与患者接触,最好在学生学习过程早期就开始,以便使其成为预期的常态。这项研究强调,在他们的社会化过程中,真正以患者为中心的重点出现得太晚了。