Integrated Curriculum for Anthroposophic Medicine (ICURAM), Chair for Medical Theory, Integrative and Anthroposophic Medicine, Department for Health, Faculty of Medicine, Witten / Herdecke University, Gerhard Kienle Weg 4, 58313, Herdecke, Nordrhein-Westfalen, Germany.
Department of Psychosomatic Medicine, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany.
BMC Med Educ. 2017 Jul 14;17(1):122. doi: 10.1186/s12909-017-0951-y.
Professional competence is important in delivering high quality patient care, and it can be enhanced by reflection and reflective discourse e.g. in mentoring groups. However, students are often reluctant though to engage in this discourse. A group mentoring program involving all preclinical students as well as faculty members and co-mentoring clinical students was initiated at Witten-Herdecke University. This study explores both the attitudes of those students towards such a program and factors that might hinder or enhance how students engage in reflective discourse.
A qualitative design was applied using semi-structured focus group interviews with preclinical students and semi-structured individual interviews with mentors and co-mentors. The interview data were analyzed using thematic content analysis.
Students' attitudes towards reflective discourse on professional challenges were diverse. Some students valued the new program and named positive outcomes regarding several features of professional development. Enriching experiences were described. Others expressed aversive attitudes. Three reasons for these were given: unclear goals and benefits, interpersonal problems within the groups hindering development and intrapersonal issues such as insecurity and traditional views of medical education. Participants mentioned several program setup factors that could enhance how students engage in such groups: explaining the program thoroughly, setting expectations and integrating the reflective discourse in a meaningful way into the curriculum, obliging participation without coercion, developing a sense of security, trust and interest in each other within the groups, randomizing group composition and facilitating group moderators as positive peer and faculty role models and as learning group members.
A well-designed and empathetic setup of group mentoring programs can help raise openness towards engaging in meaningful reflective discourse. Reflection on and communication of professional challenges can, in turn, improve professional development, which is essential for high quality patient care.
专业能力对于提供高质量的患者护理至关重要,而反思和反思性话语可以增强这种能力,例如在指导小组中。然而,学生通常不愿意参与这种话语。威腾-赫德克大学启动了一个涉及所有临床医学前学生以及教职员工和共同指导临床学生的小组指导计划。本研究探讨了学生对这种计划的态度以及可能阻碍或增强学生参与反思性话语的因素。
采用定性设计,对临床医学前学生进行半结构化焦点小组访谈,对指导者和共同指导者进行半结构化个人访谈。使用主题内容分析对访谈数据进行分析。
学生对专业挑战的反思性话语的态度多种多样。一些学生重视新计划,并列举了关于专业发展几个方面的积极成果。丰富的经验得到了描述。其他人则表达了反感的态度。给出了三个原因:目标和收益不明确、小组内的人际关系问题阻碍了发展以及内在的问题,如不安全感和传统的医学教育观念。参与者提到了一些可以增强学生参与此类小组的计划设置因素:彻底解释计划、设定期望并将反思性话语有意义地融入课程中、在没有强制的情况下要求参与、在小组内建立安全感、信任和相互兴趣、随机组成小组以及促进小组主持人作为积极的同伴和教师榜样以及作为学习小组成员。
精心设计和富有同理心的小组指导计划设置可以帮助提高学生对有意义的反思性话语的开放性。对专业挑战的反思和沟通反过来可以促进专业发展,这对于提供高质量的患者护理至关重要。