Gishen Faye, Whitman Sophia, Gill Deborah, Barker Rhiannon, Walker Steven
Faculty of Medical Sciences, University College London Medical School, 74 Huntley Street Building, London, WC1E 6AE, UK.
St Gilesmedical, The Vestry House, 60 St Giles High Street, London, WC2H 8LG, UK.
BMC Med Educ. 2016 Sep 22;16(1):246. doi: 10.1186/s12909-016-0762-6.
Training to be a doctor and caring for patients are recognized as being stressful and demanding. The wellbeing of healthcare professionals impacts upon the wellbeing and care of patients. Schwartz Centre Rounds (SCRs), multidisciplinary meetings led by a trained facilitator and designed for hospital staff, were introduced to enhance communication and compassion, and have since been widely adopted as a way of fostering compassion. The continuum of education suggests that medical students need to develop these attributes in conjunction with resilience and maintaining empathy. The benefits of SCRs in fostering this development in medical students is unexplored. The objective of this study was to examine the potential of SCRs within the undergraduate curriculum.
Two student-focused SCRs were piloted at a major medical school. The sessions were based on the current format implemented across the US and UK: a presentation of cases by a multidisciplinary panel followed by an open discussion with the audience. Participants were asked to complete an evaluative questionnaire immediately following the sessions. Seven students took part in a focus group to explore their views on the SCR. Data sets were examined using descriptive statistics and thematic analysis.
Feedback was obtained from 77 % (258/334) Year 5 and 37 % (126/343) Year 6 students. Mean student ratings of the session on a five-point scale, where 1 = poor and 5 = exceptional, were 3.5 (Year 5) and 3.3 (Year 6). Over 80 % of respondents either agreed or strongly agreed that the presentation of cases was helpful and gave them insight into how others feel/think about caring for patients. Eighty percent said they would attend a future SCR and 64 % believed SCRs should be integrated into the curriculum. Focus group participants felt SCRs promoted reflection and processing of emotion. Students identified smaller group sizes and timing in the curriculum as ways of improving SCRs.
Students were positive about SCRs, preferring them to their current reflective practice assignments. Whether this results in sustained benefits to trainee doctors is yet to be explored. Consideration is given to overcoming the challenges that were encountered, such as optimal timing and participation. Staff training and costs are potential obstacles to adoption.
成为一名医生的培训以及照顾患者被认为压力大且要求高。医疗专业人员的福祉会影响患者的福祉和护理。施瓦茨中心圆桌会议(SCRs)是由一名经过培训的主持人主持、面向医院工作人员的多学科会议,旨在加强沟通与同情心,自那以后已被广泛用作培养同情心的一种方式。教育的连续性表明医学生需要结合适应力和保持同理心来培养这些特质。SCRs在促进医学生这方面发展的益处尚未得到探索。本研究的目的是考察SCRs在本科课程中的潜力。
在一所主要医学院试点了两场以学生为中心的SCRs。这些会议基于美国和英国实施的现行形式:由一个多学科小组展示病例,随后与听众进行公开讨论。要求参与者在会议结束后立即填写一份评估问卷。七名学生参加了一个焦点小组,以探讨他们对SCRs的看法。使用描述性统计和主题分析来检查数据集。
从五年级77%(258/334)的学生和六年级37%(126/343)的学生那里获得了反馈。学生对会议的平均评分采用五点量表,其中1 = 差,5 = 优秀,五年级为3.5,六年级为3.3。超过80%的受访者要么同意要么强烈同意病例展示很有帮助,让他们了解到其他人对照顾患者的感受/想法。80%的人表示他们会参加未来的SCRs,64%的人认为SCRs应该纳入课程。焦点小组参与者认为SCRs促进了反思和情绪处理。学生们指出缩小小组规模和调整课程时间安排是改进SCRs的方法。
学生们对SCRs持积极态度,比起他们目前的反思性实践作业更喜欢SCRs。这是否会给实习医生带来持续的益处还有待探索。正在考虑克服所遇到的挑战,比如最佳时间安排和参与度。员工培训和成本是采用SCRs的潜在障碍。