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跨专业学习体验:基于门诊环境的定性研究结果

The interprofessional learning experience: Findings from a qualitative study based in an outpatient setting.

作者信息

Jakobsen Flemming, Mørcke Anne Mette, Hansen Torben Bæk

机构信息

a University Clinic for Hand, Hip and Knee Surgery, Regional Hospital West Jutland, Aarhus University , Aarhus , Denmark.

b Copenhagen Academy for Medical Education and Simulation , Rigshospitalet , Copenhagen , Denmark.

出版信息

J Interprof Care. 2017 Sep;31(5):613-619. doi: 10.1080/13561820.2017.1322560. Epub 2017 Jul 10.

Abstract

Clinical interprofessional education has traditionally taken place in hospital wards, but much diagnosis and treatment have shifted to the outpatient setting. The logical consequence is to shift more students' clinical placements from the "bedside" to outpatient settings. However, it is unclear how we ensure that this shift maximises learning. The purpose of this article is to understand the authentic learning experience in an interprofessional outpatient clinic setting. We performed an exploratory case study with interviews of four nursing students, 13 medical students, and six staff members who worked in an interprofessional outpatient orthopaedic clinic from March 2015 to January 2016. The interviews were transcribed and analysed using systematic text condensation. The students' self-reported learning experience in this outpatient clinic was characterised by direct patient contact and by authentic, interprofessional, task-based learning, and a preference for indirect supervision when conducting uncomplicated patient consultations. The supervisors intended to create this interprofessional outpatient clinic experience by having a clear teaching approach based on adult learning principles in a safe and challenging learning environment. The shift to the outpatient setting was strongly and practically supported by the management. This study indicates that student learning can be shifted to the outpatient clinic setting if there is supportive management and dedicated supervisors who establish a challenging yet safe interprofessional learning environment.

摘要

传统上,临床跨专业教育是在医院病房进行的,但如今许多诊断和治疗工作已转移到门诊环境。合理的结果是将更多学生的临床实习从“床边”转移到门诊环境。然而,目前尚不清楚我们如何确保这种转变能最大限度地促进学习。本文的目的是了解跨专业门诊环境中的真实学习体验。我们进行了一项探索性案例研究,采访了2015年3月至2016年1月期间在一家跨专业骨科门诊工作的4名护理专业学生、13名医学专业学生和6名工作人员。访谈内容经转录后采用系统文本浓缩法进行分析。学生们在这家门诊的自我报告学习体验的特点是直接接触患者、进行真实的跨专业任务式学习,以及在进行简单患者咨询时倾向于间接监督。主管人员打算通过在安全且具有挑战性的学习环境中采用基于成人学习原则的明确教学方法来打造这种跨专业门诊体验。向门诊环境的转变得到了管理层强有力的实际支持。这项研究表明,如果有支持性的管理以及敬业的主管人员来营造一个具有挑战性但安全的跨专业学习环境,学生学习可以转移到门诊环境中。

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