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大体解剖实验室中的专业培养与叙事医学:一项探索

Professional Formation in the Gross Anatomy Lab and Narrative Medicine: An Exploration.

作者信息

Kissler Mark J, Saxton Ben, Nuila Ricardo, Balmer Dorene F

机构信息

M.J. Kissler is a resident in combined internal medicine-pediatrics, University of Colorado School of Medicine, Aurora, Colorado. B. Saxton is adjunct professor of medical humanities, McGovern Center for Humanities and Ethics, McGovern Medical School at Houston, Houston, Texas. R. Nuila is assistant professor of internal medicine, medicine, medical ethics, and healthy policy, Baylor College of Medicine, and assistant professor in medical humanities, Honors College, University of Houston, Houston, Texas. D.F. Balmer is director of research on pediatric education, The Children's Hospital of Philadelphia, and associate professor of pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

出版信息

Acad Med. 2016 Jun;91(6):772-7. doi: 10.1097/ACM.0000000000001093.

Abstract

As an early and important experience in medical education, dissection in the gross anatomy lab is a locus of professional formation. Because students often think of their professional development in evolving, narrative terms, the authors propose that close attention to these narratives might add to understanding of professional formation in progress. They solicited written reflections from students, to explore ways that both the content and form of written reflections might illuminate themes relevant to professional formation, and to describe some elements of professional formation in the context of one institution (Baylor College of Medicine, Houston, Texas). Seventeen students participated in writing sessions and wrote in response to an oral interview transcript and to a poem. Using a reading approach that grew out of the narrative medicine movement, the authors collaboratively engaged the content and form of these written reflections.Students' collection of written reflections was a rich source of information about their experiences in the anatomy lab. Through both content (e.g., expressions of gratitude, transitions, self-awareness) and form (e.g., from less detailed writing to literary playfulness), their writings gave a glimpse into the tensions, disappointments, and satisfactions of the practice of gross anatomy.This project models one way that educators can read and respond to the reflective writing that students generate. The authors go on to propose ways that interactions around reflective writing can be part of a broader goal of forming narrative-minded physicians, who become increasingly self- and other-aware as they progress in their education and practice.

摘要

作为医学教育早期的一项重要经历,大体解剖实验室中的解剖操作是专业形成的一个关键场所。由于学生们常常从不断发展的叙事角度来思考自己的职业发展,作者们提出,密切关注这些叙事可能有助于增进对正在进行的专业形成的理解。他们征集了学生的书面反思,以探索书面反思的内容和形式可能阐明与专业形成相关主题的方式,并描述一所机构(德克萨斯州休斯顿贝勒医学院)背景下专业形成的一些要素。17名学生参加了写作环节,并根据一份口述访谈记录和一首诗进行写作。作者们采用一种源自叙事医学运动的阅读方法,共同研究这些书面反思的内容和形式。学生们的书面反思集是有关他们在解剖实验室经历的丰富信息来源。通过内容(例如感恩之情的表达、转变、自我认知)和形式(例如从不太详细的写作到富有文学趣味性的写作),他们的作品让人得以窥见大体解剖实践中的紧张、失望和满足。该项目为教育工作者阅读和回应学生所撰写的反思性写作提供了一种模式。作者们进而提出,围绕反思性写作的互动如何能够成为培养具有叙事思维的医生这一更广泛目标的一部分,这些医生在教育和实践过程中会越来越具有自我意识和对他人的意识。

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