Foshee Cecile M, Mehdi Ali, Bierer S Beth, Traboulsi Elias I, Isaacson J Harry, Spencer Abby, Calabrese Cassandra, Burkey Brian B
J Grad Med Educ. 2017 Jun;9(3):351-356. doi: 10.4300/JGME-D-16-00421.1.
Using the frameworks of transformational learning and situated learning theory, we developed a technology-enhanced professionalism curricular model to build a learning community aimed at promoting residents' self-reflection and self-awareness. The RAPR model had 4 components: (1) : elicit awareness; (2) : question assumptions and take multiple perspectives; (3) : try new/changed perspectives; and (4) : articulate implications of transformed views on future actions.
The authors explored the acceptability and practicality of the RAPR model in teaching professionalism in a residency setting, including how residents and faculty perceive the model, how well residents carry out the curricular activities, and whether these activities support transformational learning.
A convenience sample of 52 postgraduate years 1 through 3 internal medicine residents participated in the 10-hour curriculum over 4 weeks. A constructivist approach guided the thematic analysis of residents' written reflections, which were a required curricular task.
A total of 94% (49 of 52) of residents participated in 2 implementation periods (January and March 2015). Findings suggested that RAPR has the potential to foster professionalism transformation in 3 domains: (1) attitudinal, with participants reporting they viewed professionalism in a more positive light and felt more empathetic toward patients; (2) behavioral, with residents indicating their ability to listen to patients increased; and (3) cognitive, with residents indicating the discussions improved their ability to reflect, and this helped them create meaning from experiences.
Our findings suggest that RAPR offers an acceptable and practical strategy to teach professionalism to residents.
利用变革性学习和情境学习理论的框架,我们开发了一种技术增强的职业素养课程模型,以建立一个旨在促进住院医师自我反思和自我认知的学习社区。RAPR模型有4个组成部分:(1)引发意识;(2)质疑假设并采取多种视角;(3)尝试新的/改变后的视角;(4)阐明转变后的观点对未来行动的影响。
作者探讨了RAPR模型在住院医师培训环境中教授职业素养的可接受性和实用性,包括住院医师和教员如何看待该模型、住院医师执行课程活动的情况如何,以及这些活动是否支持变革性学习。
一个由52名1至3年级内科住院医师组成的便利样本参加了为期4周、共10小时的课程。采用建构主义方法指导对住院医师书面反思的主题分析,这是课程要求的一项任务。
共有94%(52人中的49人)的住院医师参加了两个实施阶段(2015年1月和3月)。研究结果表明,RAPR有潜力在三个领域促进职业素养的转变:(1)态度方面,参与者报告他们对职业素养的看法更为积极,对患者更有同理心;(2)行为方面,住院医师表示他们倾听患者的能力有所提高;(3)认知方面,住院医师表示讨论提高了他们的反思能力,这有助于他们从经历中创造意义。
我们的研究结果表明,RAPR为向住院医师教授职业素养提供了一种可接受且实用的策略。