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住院医师、医学生和护理学生对跨专业教育的认知:对定量和定性文献的系统综述

Perceptions of residents, medical and nursing students about Interprofessional education: a systematic review of the quantitative and qualitative literature.

作者信息

Visser Cora L F, Ket Johannes C F, Croiset Gerda, Kusurkar Rashmi A

机构信息

Research in Education Department, VUmc School of Medical Sciences (In affiliation with LEARN! Research Institute for Learning and Education, VU University, Amsterdam, The Netherlands), P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.

VUmc Amstel Academie, P.O. Box 7057, 1007 MB, Amsterdam, NL, The Netherlands.

出版信息

BMC Med Educ. 2017 May 3;17(1):77. doi: 10.1186/s12909-017-0909-0.

Abstract

BACKGROUND

To identify facilitators and barriers that residents, medical and nursing students perceive in their Interprofessional Education (IPE) in a clinical setting with other healthcare students.

METHODS

A systematic review was carried out to identify the perceptions of medical students, residents and nursing students regarding IPE in a clinical setting. PubMed, CINAHL, ERIC and PsycInfo were searched, using keywords and MeSH terms from each database's inception published prior to June 2014. Interprofessional education involving nursing and medical students and/or residents in IPE were selected by the first author. Two authors independently assessed studies for inclusion or exclusion and extracted the data.

RESULTS

Sixty-five eligible papers (27 quantitative, 16 qualitative and 22 mixed methods) were identified and synthesized using narrative synthesis. Perceptions and attitudes of residents and students could be categorized into 'Readiness for IPE', 'Barriers to IPE' and 'Facilitators of IPE'. Within each category they work at three levels: individual, process/curricular and cultural/organizational. Readiness for IPE at individual level is higher in females, irrespective of prior healthcare experience. At process level readiness for IPE fluctuates during medical school, at cultural level collaboration is jeopardized when groups interact poorly. Examples of IPE-barriers are at individual level feeling intimidated by doctors, at process level lack of formal assessment and at cultural level exclusion of medical students from interaction by nurses. Examples of IPE-facilitators are at individual level affective crises and patient care crises situations that create feelings of urgency, at process level small group learning activities in an authentic context and at cultural level getting acquainted informally. These results are related to a model for learning and teaching, to illustrate the implications for the design of IPE.

CONCLUSIONS

Most of the uncovered barriers are at the cultural level and most of the facilitators are at the process level. Factors at the individual level need more research.

摘要

背景

识别住院医师、医学和护理专业学生在临床环境中与其他医护专业学生进行跨专业教育(IPE)时所感知到的促进因素和障碍。

方法

进行了一项系统综述,以确定医学生、住院医师和护理专业学生对临床环境中IPE的看法。检索了PubMed、CINAHL、ERIC和PsycInfo数据库,使用每个数据库自创建至2014年6月之前发表的关键词和医学主题词。由第一作者选择涉及护理和医学生及/或住院医师参与IPE的跨专业教育研究。两位作者独立评估研究是否纳入或排除,并提取数据。

结果

确定了65篇符合条件的论文(27篇定量研究、16篇定性研究和22篇混合方法研究),并使用叙述性综合分析进行了综合。住院医师和学生的看法及态度可分为“IPE准备情况”、“IPE障碍”和“IPE促进因素”。在每个类别中,它们在三个层面起作用:个人层面、过程/课程层面和文化/组织层面。无论之前有无医疗保健经验,女性在个人层面上对IPE的准备情况更高。在过程层面,医学生阶段对IPE的准备情况有所波动,在文化层面,当各群体互动不佳时合作会受到损害。IPE障碍的例子在个人层面是害怕医生,在过程层面是缺乏正式评估,在文化层面是护士将医学生排除在互动之外。IPE促进因素的例子在个人层面是情感危机和患者护理危机情况产生紧迫感,在过程层面是在真实情境中的小组学习活动,在文化层面是进行非正式交流。这些结果与一个学习和教学模型相关,以说明对IPE设计的启示。

结论

大多数发现的障碍存在于文化层面,大多数促进因素存在于过程层面。个人层面的因素需要更多研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d781/5415777/c30d629c57a6/12909_2017_909_Fig1_HTML.jpg

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