黎巴嫩公立医学院母乳喂养教育案例研究：探索社交网络在医学教育中的潜在作用。
A case study on breastfeeding education in Lebanon's public medical school: exploring the potential role of social networks in medical education.
机构信息
a Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence , University of California San Diego , La Jolla , CA , USA.
b Department of Education Studies , University of California San Diego , La Jolla , CA , USA.
出版信息
Med Educ Online. 2018 Dec;23(1):1527629. doi: 10.1080/10872981.2018.1527629.
BACKGROUND
Limited knowledge, negative beliefs, and lack of sufficient breastfeeding promotion and support by physicians contribute to global suboptimal breastfeeding rates. Formal medical education is well-known to influence future physicians' knowledge, beliefs, and medical practice. However, less understood is the influence of social networks and processes on the exchange and diffusion of knowledge and practices related to breastfeeding.
OBJECTIVES
We selected the underserved and under-supported public medical school in Lebanon to examine the social side of medical education. Our objectives were to assess knowledge, beliefs, and self-efficacy related to breastfeeding promotion and support among interns and residents. We also examined the social ecosystem surrounding these students concerning the exchange of breastfeeding knowledge.
DESIGN
All data were collected during one study visit per participant. First, an interview-administered structured survey was used to assess beliefs, perceived knowledge, basic breastfeeding knowledge, and self-efficacy related to breastfeeding among n = 70 medical interns and residents. Then, social network data were collected during a semi-structured interview and analyzed using an ego-network approach. All interviews were voice-recorded, transcribed, coded, and thematically analyzed. Descriptive statistics were used to analyze quantitative survey and social network results.
RESULTS
Although interns and residents had positive beliefs about breastfeeding benefits, they had limited knowledge and low self-efficacy related to the psychosocial and clinical aspects of breastfeeding promotion and support. They did not seem to have a well-connected professional network around breastfeeding knowledge and practices. Several tended to rely on their informal/non-professional network, such as their mothers, partners, and sisters, for knowledge and practice.
CONCLUSIONS
Our work using breastfeeding as an exemplary case suggests there is a role for better attending to the beliefs of medical students as well as to the social side of medical education. Future studies can use social network theory to help identify and address influences on medical education outcomes.
背景
有限的知识、负面观念以及医生缺乏足够的母乳喂养促进和支持，是导致全球母乳喂养率不理想的原因。正规医学教育众所周知会影响未来医生的知识、观念和医疗实践。然而，对于社会网络和过程如何影响与母乳喂养相关的知识和实践的交流和传播，人们的了解则较少。
目的
我们选择了黎巴嫩服务不足和支持不足的公立医学院校，以考察医学教育的社会层面。我们的目的是评估实习生和住院医师在促进和支持母乳喂养方面的知识、观念和自我效能。我们还考察了围绕这些学生的社会生态系统，了解母乳喂养知识的交流情况。
设计
所有数据均在每位参与者的一次研究访问中收集。首先，使用访谈式结构化调查评估了 70 名医学实习生和住院医师的信念、感知知识、基本母乳喂养知识以及与母乳喂养相关的自我效能。然后，在半结构化访谈中收集社会网络数据，并使用自我中心网络方法进行分析。所有访谈均进行了录音、转录、编码和主题分析。使用描述性统计来分析定量调查和社会网络结果。
结果
尽管实习生和住院医师对母乳喂养的益处持有积极的观念，但他们在促进和支持母乳喂养的心理社会和临床方面的知识有限，自我效能较低。他们似乎没有一个围绕母乳喂养知识和实践的紧密联系的专业网络。一些人倾向于依靠他们的非专业网络，如他们的母亲、伴侣和姐妹，获取知识和实践。
结论
我们使用母乳喂养作为一个范例的工作表明，更好地关注医学生的观念以及医学教育的社会层面是有作用的。未来的研究可以使用社会网络理论来帮助确定和解决对医学教育成果的影响。
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