Nothnagle Melissa, Reis Shmuel, Goldman Roberta E, Anandarajah Gowri
a Department of Family Medicine , Alpert Medical School of Brown University , Pawtucket , Rhode Island , USA.
Teach Learn Med. 2014;26(3):230-8. doi: 10.1080/10401334.2014.910124.
Residency training is a critical time for physicians' professional formation. However, few structured interventions exist to support residents in this transformative process of integrating personal and professional values, a process that is essential to physician identity formation and preservation of core values such as service and compassion.
The authors created a seminar series, the "Forum," to support resident professional formation and address the hidden curriculum as part of a larger intervention to support self-directed learning skills such as goal setting and reflection.
Ninety-minute sessions with senior residents and faculty held every other month include opportunities for individual reflection, small- and large-group discussion, and brief didactic components focused on skills such as teaching and leadership. The qualitative program evaluation included analyses of individual semistructured interviews with resident and faculty participants from 2008 to 2011 and of notes recorded by an observer during the 1st year's sessions.
Residents appreciated the focus on relevant issues, presence of faculty, opportunities for reflection and interactivity, and inclusion of practical skills. Effects attributed to the Forum included gaining practical skills, feeling a deeper connection to one another and a sense of community, and recognizing progress in their own professional development and growth. Elements described in the literature as essential to professional formation, including encouraging reflection, use of narrative, role modeling, addressing the hidden curriculum, and fostering an authentic community, were recognized by participants as integral to the Forum's success.
A group forum for reflection and discussion with peers and role models, tailored to local needs, offers an effective structure to foster professional formation in residency.
住院医师培训是医生职业形成的关键时期。然而，几乎没有结构化的干预措施来支持住院医师在整合个人和职业价值观这一变革过程中，而这一过程对于医生身份的形成以及诸如服务和同情心等核心价值观的保持至关重要。
作者创建了一个研讨会系列“论坛”，以支持住院医师的职业形成，并解决隐性课程问题，作为支持诸如目标设定和反思等自主学习技能的更大干预措施的一部分。
每两个月与高级住院医师和教员举行一次90分钟的会议，包括个人反思、小组和大组讨论的机会，以及侧重于教学和领导等技能的简短教学内容。定性项目评估包括对2008年至2011年住院医师和教员参与者的个人半结构化访谈分析，以及观察员在第一年会议期间记录的笔记分析。
住院医师赞赏对相关问题的关注、教员的参与、反思和互动的机会以及实用技能的纳入。归因于“论坛”的效果包括获得实用技能、彼此之间有更深的联系和社区感，以及认识到自己职业发展和成长中的进步。文献中描述为职业形成必不可少的要素，包括鼓励反思、使用叙事、树立榜样、解决隐性课程问题以及培养真实的社区，参与者认为这些是“论坛”成功的不可或缺因素。
一个与同行和榜样进行反思和讨论的小组论坛，根据当地需求量身定制，为促进住院医师培训中的职业形成提供了一种有效的架构。
