探讨具有社会科学和人文学科背景的医学生的社会化经验。

Exploring the Socialization Experiences of Medical Students From Social Science and Humanities Backgrounds.

机构信息

J.T.H. Lam is resident physician, Department of Pediatrics, University of Toronto and Hospital for Sick Children, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-7643-1179. M.D. Hanson is professor, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-0820-4521. M.A. Martimianakis is associate professor, Department of Pediatrics, University of Toronto and Hospital for Sick Children, and scientist, The Wilson Centre, University of Toronto and University Health Network, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-2531-3156.

出版信息

Acad Med. 2020 Mar;95(3):401-410. doi: 10.1097/ACM.0000000000002901.

DOI:10.1097/ACM.0000000000002901

PMID:31348068

Abstract

PURPOSE

To explore the structural, cultural, and interpersonal issues that may contribute to the inadvertent marginalization of medical students with social science and humanities (SSH) backgrounds.

METHOD

Using the hidden curriculum as an analytic construct, the lead author interviewed 14 medical students with SSH backgrounds at the University of Toronto Faculty of Medicine from February to October 2015. The authors analyzed the interview transcripts for common themes around positive and negative cultural, structural, and interpersonal dimensions of the socialization process.

RESULTS

Participants reported barriers to applying to medical school: needing to complete prerequisite courses and to do well on an exam geared toward those with a strong science background (the Medical College Admission Test) and lacking an application cohort. Some participants felt they were not ideal candidates for medical school. Participants appreciated how their SSH backgrounds and associated skill sets shaped both their perspectives on patient care and their developing professional identities. However, they perceived that others largely deemed their previous training as irrelevant, and they felt marginalized in medical school by peers, instructors, and the curriculum. These experiences led both to self-censorship, which enabled them to seem to conform to normative behaviors, and to the pursuit of reaffirming elective experiences.

CONCLUSIONS

The existing hidden curriculum inadvertently marginalizes SSH medical students; their experiences likely reflect the socialization experiences of other students from underrepresented backgrounds. Curricular and institutional reforms are imperative to shift the hidden curriculum toward one of epistemological inclusion that better supports students from nontraditional backgrounds.

摘要

目的

探讨可能导致具有社会科学和人文学科背景的医学生无意中被边缘化的结构、文化和人际问题。

方法

使用隐性课程作为分析结构，首席作者于 2015 年 2 月至 10 月在多伦多大学医学院采访了 14 名具有 SSH 背景的医学生。作者分析了访谈记录，以了解社会化过程中积极和消极的文化、结构和人际关系维度的常见主题。

结果

参与者报告了申请医学院的障碍：需要完成预备课程，并在针对具有强大科学背景的人的考试中取得好成绩（医学院入学考试），并且缺乏申请群体。一些参与者认为自己不是医学院的理想人选。参与者赞赏他们的 SSH 背景和相关技能如何塑造他们对患者护理的看法以及他们不断发展的专业身份。然而，他们认为其他人基本上认为他们以前的培训是无关紧要的，他们在医学院中被同龄人、教师和课程边缘化。这些经历导致他们自我审查，这使他们能够看起来符合规范行为，并且追求重新确认选修经验。