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超越宣泄:扮演教育者角色的患者讲述者的微妙情感。

Beyond catharsis: the nuanced emotion of patient storytellers in an educational role.

机构信息

Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Patient Experience, London Health Sciences Centre, London, Ontario, Canada.

出版信息

Med Educ. 2018 May;52(5):526-535. doi: 10.1111/medu.13510. Epub 2018 Feb 12.

Abstract

CONTEXT

As health care organisations seek to cultivate patient and family-centred care, patient storytelling has emerged as a valued educational resource. However, repeatedly harnessing patient perspectives to educate health care professionals may have consequences. We need robust insight into what it means to be a patient storyteller in order to ensure ethical and appropriate engagement with patients as an educational resource.

METHODS

Constructivist grounded theory was used to explore the experience of patients involved in a storytelling curriculum as part of hospital staff continuing education. All 33 storytellers were invited by e-mail to participate in the study. Twenty-six storytellers responded to the invitation, and 25 could be scheduled to participate. Using theoretical sampling, semi-structured interviews were conducted and analysed in a process that was inductive, iterative and comparative.

RESULTS

Participants described the central role of emotions in their storytelling experience, which varied from 1 to 25 tellings over a period of 1 month to 2 years. These emotions were shaped by the passage of time, repetition of storytelling and audience acknowledgement. However, emotion remained unpredictable and had lingering implications for storytellers' vulnerability.

CONCLUSION

The multiple storytelling experiences of our participants and ongoing educational nature of their role provides unique insight into how emotions ebb and flow across tellings, how emotions can be both a surprise and a rhetorical strategy, and how emotions are influenced by audience acknowledgement. These findings contribute to an emerging conversation regarding the power and politics of selecting and using storytellers for organisational purpose. Implications include how we support patient storytellers in educational roles and how we can sustainably integrate patient storytelling into health professional education.

摘要

背景

随着医疗机构寻求培养以患者和家庭为中心的护理模式,患者叙事已成为一种有价值的教育资源。然而,反复利用患者视角来教育医疗保健专业人员可能会产生后果。为了确保以教育资源的身份与患者进行道德和适当的互动,我们需要深入了解作为患者叙事者意味着什么。

方法

采用建构主义扎根理论,探讨了参与医院员工继续教育叙事课程的患者的体验。通过电子邮件邀请所有 33 名叙事者参与研究。26 名叙事者对邀请做出回应,其中 25 名可以安排参与。使用理论抽样,对 25 名参与者进行了半结构化访谈,并在一个归纳、迭代和比较的过程中进行了分析。

结果

参与者描述了情感在他们的叙事体验中的核心作用,这种情感体验在 1 个月到 2 年的时间内,从 1 次到 25 次叙事中不断变化。这些情感受到时间的推移、叙事的重复和观众的认可的影响。然而,情感仍然是不可预测的,并对叙事者的脆弱性产生持久影响。

结论

我们的参与者的多次叙事体验以及他们角色的持续教育性质,提供了独特的视角,了解情感如何在叙事中起伏,情感如何既是一种惊喜,也是一种修辞策略,以及情感如何受到观众认可的影响。这些发现为关于为组织目的选择和使用叙事者的权力和政治的新兴对话做出了贡献。其影响包括如何在教育角色中支持患者叙事者,以及如何可持续地将患者叙事融入医疗保健专业人员的教育中。

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