Wald Hedy S, Anthony David, Hutchinson Tom A, Liben Stephen, Smilovitch Mark, Donato Anthony A
H.S. Wald is clinical associate professor of family medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. D. Anthony is associate professor of family medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. T.A. Hutchinson is professor of medicine and director, McGill Programs in Whole Person Care, McGill University Faculty of Medicine, Montreal, Quebec, Canada. S. Liben is associate professor of pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada. M. Smilovitch is associate professor of medicine, McGill University Faculty of Medicine, Montreal, Quebec, Canada. A.A. Donato is clinical associate professor of medicine, Jefferson Medical College, Philadelphia, Pennsylvania.
Acad Med. 2015 Jun;90(6):753-60. doi: 10.1097/ACM.0000000000000725.
Recent calls for an expanded perspective on medical education and training include focusing on complexities of professional identity formation (PIF). Medical educators are challenged to facilitate the active constructive, integrative developmental process of PIF within standardized and personalized and/or formal and informal curricular approaches. How can we best support the complex iterative PIF process for a humanistic, resilient health care professional? How can we effectively scaffold the necessary critical reflective learning and practice skill set for our learners to support the shaping of a professional identity?The authors present three pedagogic innovations contributing to the PIF process within undergraduate and graduate medical education (GME) at their institutions. These are (1) interactive reflective writing fostering reflective capacity, emotional awareness, and resiliency (as complexities within physician-patient interactions are explored) for personal and professional development; (2) synergistic teaching modules about mindful clinical practice and resilient responses to difficult interactions, to foster clinician resilience and enhanced well-being for effective professional functioning; and (3) strategies for effective use of a professional development e-portfolio and faculty development of reflective coaching skills in GME.These strategies as "bridges from theory to practice" embody and integrate key elements of promoting and enriching PIF, including guided reflection, the significant role of relationships (faculty and peers), mindfulness, adequate feedback, and creating collaborative learning environments. Ideally, such pedagogic innovations can make a significant contribution toward enhancing quality of care and caring with resilience for the being, relating, and doing of a humanistic health care professional.
最近，关于扩大医学教育和培训视角的呼声包括关注职业身份形成（PIF）的复杂性。医学教育工作者面临的挑战是，在标准化和个性化及/或正式和非正式的课程方法中，促进PIF积极的建设性、整合性发展过程。我们如何才能最好地支持人文、有韧性的医疗保健专业人员的复杂迭代PIF过程？我们如何才能有效地为学习者搭建必要的批判性反思学习和实践技能框架，以支持其职业身份的塑造？作者介绍了在他们所在机构的本科和研究生医学教育（GME）中，对PIF过程有贡献的三项教学创新。这些创新包括：（1）互动反思写作，培养反思能力、情感意识和韧性（在探索医患互动中的复杂性时），以促进个人和职业发展；（2）关于正念临床实践和对困难互动的弹性反应的协同教学模块，培养临床医生的韧性和增强幸福感，以实现有效的专业功能；（3）在GME中有效使用专业发展电子档案袋和培养反思性指导技能的教师发展策略。这些作为“从理论到实践的桥梁”的策略体现并整合了促进和丰富PIF的关键要素，包括引导反思、关系（教师和同伴）的重要作用、正念、充分的反馈以及创造协作学习环境。理想情况下，这样的教学创新可以为提高护理质量以及培养有韧性的人文医疗保健专业人员在生存、人际关系和工作方面的关怀能力做出重大贡献。
