J.W. Wilson is associate professor, Division of Internal Medicine, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa General Hospital, Tampa, Florida; ORCID: https://orcid.org/0000-0002-4291-5802. R.D. Baer is professor, Department of Anthropology, University of South Florida, Tampa, Florida. S. Villalona is a first-year medical student, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey.
Acad Med. 2019 Nov;94(11):1722-1727. doi: 10.1097/ACM.0000000000002882.
Questions have been raised about whether undergraduate institutions are effectively preparing premedical students in the sociobehavioral and cognitive reasoning content found on the revised Medical College Admission Test, providing opportunities to understand and apply these sociobehavioral and cognitive reasoning concepts in real-world scenarios, and offering career exploration opportunities.
The Research in Physician-Patient Interactions course is a 15-week course designed for premedical students and taught through the collaboration of an emergency medicine physician and an applied medical anthropologist. As of January 2016, the course is offered each spring at the University of South Florida, Tampa, Florida. The course provides opportunities for patient and physician shadowing within the anthropological methodological framework of participant observation. Other qualitative research methods are also taught, and students complete a group patient experience quality improvement project.
Thematic analysis of students' field notes and reflection essays and follow-up communications with course alumni revealed 3 salient themes regarding the utility of patient shadowing as a research method that provides unique types of qualitative data, as a teaching tool for premedical students to understand the perspectives of patients, and as an approach to developing the professional skills necessary in health care, such as effective communication styles, establishment of rapport, and empathy.
Similar courses should be offered at other universities to premedical students. While it appears that patient shadowing experiences have a great impact during premedical education, there may also be value in integrating a similar experience into medical school and residency training.
问题是，关于本科生是否能有效地为医学生做好准备，使他们在医学院入学考试中掌握社会行为和认知推理方面的内容，提供机会让他们理解并将这些社会行为和认知推理概念应用于实际场景中，并提供职业探索的机会，人们对此存在疑问。
医生-患者互动研究课程是为医学生设计的 15 周课程，由急诊医生和应用医学人类学家合作教授。截至 2016 年 1 月，该课程在佛罗里达州坦帕市的南佛罗里达大学每学年春季开设。该课程为医学生提供在参与观察的人类学方法框架内进行患者和医生观察的机会。还教授了其他定性研究方法，学生们完成了一个小组患者体验质量改进项目。
对学生的实地笔记和反思文章的主题分析，以及与课程校友的后续交流，揭示了 3 个突出主题，即患者观察作为一种研究方法的效用，它提供了独特类型的定性数据；作为医学生理解患者观点的教学工具；以及作为一种发展医疗保健所需的专业技能的方法，例如有效的沟通方式、建立融洽关系和同理心。
应该在其他大学为医学生开设类似的课程。虽然看起来患者观察经验在医学生教育中具有很大的影响，但在医学院和住院医师培训中也可能有价值整合类似的经验。
