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医学生对其关于痛苦的教育的认知

Medical Student Perceptions of Their Education About Suffering.

作者信息

Egnew Thomas R, Lewis Peter R, Myers Kimberly R, Phillips William R

机构信息

University of Washington School of Medicine.

出版信息

Fam Med. 2017 Jun;49(6):423-429.

Abstract

BACKGROUND AND OBJECTIVES

To explore student perceptions of their medical school teaching and learning about human suffering and to elicit student recommendations for better approaches to teaching about suffering.

METHODS

Qualitative study involving focus groups of students from each class at two US medical schools.

RESULTS

Students reported that teaching about human suffering was variable, rarely explicit, and occurred primarily in the pre-clinical curriculum. In the clinical curriculum, addressing patient suffering was neither overtly valued nor evaluated by attending physicians. Students perceived little or no explicit educational attention to the suffering of patients and their families, with the exceptions of specific rotations and attendings. They described little or no teaching of clinical skills to identify and manage suffering and desired such training. Students learned about the clinical management of suffering primarily by ad hoc observation of role models. Some also noted that exposure to patient suffering and the demands of medical education contributed to their own suffering. Students recommended intentional, integrated and longitudinal teaching about suffering, with regular reinforcement and evaluation, across the medical school curriculum.

CONCLUSIONS

Students perceived teaching about human suffering as insufficient at the institutions studied and desired to learn clinical skills to identify and help patients manage suffering. Medical educators should explicitly address patient suffering and create longitudinal curricula with improved clinical teaching, faculty role modeling, and student evaluation.

摘要

背景与目标

探讨学生对医学院关于人类痛苦的教学的看法,并征求学生对改进痛苦教学方法的建议。

方法

对美国两所医学院每个班级的学生进行焦点小组定性研究。

结果

学生报告称,关于人类痛苦的教学参差不齐,很少有明确的教学,且主要出现在临床前课程中。在临床课程中,主治医生既没有公开重视也没有评估处理患者痛苦的情况。学生们认为,除了特定的轮转和带教老师外,对患者及其家属的痛苦几乎没有或根本没有明确的教育关注。他们表示很少或根本没有关于识别和处理痛苦的临床技能教学,并希望得到此类培训。学生主要通过临时观察榜样来学习痛苦的临床处理方法。一些学生还指出,接触患者的痛苦和医学教育的要求也给他们自己带来了痛苦。学生们建议在医学院课程中进行有针对性、综合性和纵向的痛苦教学,并定期进行强化和评估。

结论

在所研究的机构中,学生认为关于人类痛苦的教学不足,并希望学习识别和帮助患者处理痛苦的临床技能。医学教育工作者应明确处理患者的痛苦,并创建纵向课程,改进临床教学、教师示范作用和学生评估。

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