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在基础临床接触中应对社交距离:了解医学生与不同患者的早期接触经历。

Navigating social distance in foundational clinical encounters: Understanding medical students' early experiences with diverse patients.

机构信息

a Faculty of Medicine , McGill University , Montreal , QC , Canada.

b Department of Pediatrics , McGill University , Montreal , QC , Canada.

出版信息

Med Teach. 2018 Sep;40(9):934-943. doi: 10.1080/0142159X.2017.1417578. Epub 2018 Jan 15.

Abstract

BACKGROUND

Social distance between patients and physicians has been shown to affect the quality of care that patients receive. Little is known about how social distance between students and patients is experienced by learners during early clinical exposures in medical school.

OBJECTIVE

This study aims to explore students' stories of experiencing social distance with patients with concordant and discordant social characteristics as themselves, respectively, as well as students' needs from medical curricula regarding developing social competence.

METHODS

Semi-structured interviews of medical students [n = 16] were performed, and a post-interview survey and a visual analog scale were completed. The interviews were audio-recorded and transcribed. The written transcripts were coded using the constant comparison method and analyzed for emerging themes.

RESULTS

Students experience social distance with patients; yet, they are not taught explicitly by their preceptors how to manage these experiences. Students identified their needs for the curriculum in regard to developing social competence and proposed various strategies and curriculum recommendations.

CONCLUSIONS

Our results support that students believe that social competence training is important for their professional development to improve relationship-building with diverse patients. As such, it would be valuable to incorporate student recommendations in the formation of a social competence curriculum.

摘要

背景

医患之间的社会距离已被证明会影响患者所接受的护理质量。然而,对于医学生在早期临床实习中经历的学生与患者之间的社会距离,人们知之甚少。

目的

本研究旨在探讨学生在与具有与自身一致和不一致社会特征的患者相处时的体验,以及学生对发展社交能力的医学课程的需求。

方法

对[ n = 16]名医学生进行半结构化访谈,并在访谈后进行问卷调查和视觉模拟评分。对访谈进行录音和转录。使用恒定比较法对书面记录进行编码,并分析出现的主题。

结果

学生在与患者交往时会体验到社会距离;然而,他们的导师并没有明确教授他们如何处理这些经历。学生确定了他们在发展社交能力方面对课程的需求,并提出了各种策略和课程建议。

结论

我们的研究结果表明,学生认为社交能力培训对他们的专业发展很重要,可以帮助他们与不同背景的患者建立关系。因此,在制定社交能力课程时,考虑学生的建议是很有价值的。

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