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制定关于心理、道德和精神健康的医学院课程:学生和教师的观点

Developing a Medical School Curriculum for Psychological, Moral, and Spiritual Wellness: Student and Faculty Perspectives.

作者信息

Mitchell Christine M, Epstein-Peterson Zachary D, Bandini Julia, Amobi Ada, Cahill Jonathan, Enzinger Andrea, Noveroske Sarah, Peteet John, Balboni Tracy, Balboni Michael J

机构信息

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Department of Medicine, Weill Cornell Medical College, New York, New York, USA.

出版信息

J Pain Symptom Manage. 2016 Nov;52(5):727-736. doi: 10.1016/j.jpainsymman.2016.05.018. Epub 2016 Sep 29.

Abstract

CONTEXT

Although many studies have addressed the integration of a religion and/or spirituality curriculum into medical school training, few describe the process of curriculum development based on qualitative data from students and faculty.

OBJECTIVES

The aim of this study is to explore the perspectives of medical students and chaplaincy trainees regarding the development of a curriculum to facilitate reflection on moral and spiritual dimensions of caring for the critically ill and to train students in self-care practices that promote professionalism.

METHODS

Research staff conducted semiscripted and one-on-one interviews and focus groups. Respondents also completed a short and self-reported demographic questionnaire. Participants included 44 students and faculty members from Harvard Medical School and Harvard Divinity School, specifically senior medical students and divinity school students who have undergone chaplaincy training.

RESULTS

Two major qualitative themes emerged: curriculum format and curriculum content. Inter-rater reliability was high (kappa = 0.75). With regard to curriculum format, most participants supported the curriculum being longitudinal, elective, and experiential. With regard to curriculum content, five subthemes emerged: personal religious and/or spiritual (R/S) growth, professional integration of R/S values, addressing patient needs, structural and/or institutional dynamics within the health care system, and controversial social issues.

CONCLUSION

Qualitative findings of this study suggest that development of a future medical school curriculum on R/S and wellness should be elective, longitudinal, and experiential and should focus on the impact and integration of R/S values and self-care practices within self, care for patients, and the medical team. Future research is necessary to study the efficacy of these curricula once implemented.

摘要

背景

尽管许多研究都探讨了将宗教和/或灵性课程纳入医学院培训的问题,但很少有研究描述基于学生和教师的定性数据进行课程开发的过程。

目的

本研究旨在探讨医学生和牧师实习生对于开发一门课程的看法,该课程旨在促进对重症护理的道德和精神层面的反思,并培训学生进行促进专业精神的自我护理实践。

方法

研究人员进行了半结构化的一对一访谈和焦点小组讨论。受访者还填写了一份简短的自我报告式人口统计问卷。参与者包括来自哈佛医学院和哈佛神学院的44名学生和教师,特别是已接受牧师培训的高年级医学生和神学院学生。

结果

出现了两个主要的定性主题:课程形式和课程内容。评分者间信度很高(kappa = 0.75)。关于课程形式,大多数参与者支持课程采用纵向、选修和体验式的形式。关于课程内容,出现了五个子主题:个人宗教和/或灵性(R/S)成长、R/S价值观的专业整合、满足患者需求、医疗保健系统内的结构和/或机构动态以及有争议的社会问题。

结论

本研究的定性结果表明,未来医学院关于R/S和健康的课程开发应是选修的、纵向的和体验式的,并且应关注R/S价值观和自我护理实践在自我、患者护理和医疗团队中的影响和整合。一旦实施,有必要进行未来研究以探讨这些课程的效果。

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