Castillo-Angeles Manuel, Calvillo-Ortiz Rodrigo, Barrows Courtney, Chaikof Elliot L, Kent Tara S
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
J Surg Educ. 2020 Jan-Feb;77(1):61-68. doi: 10.1016/j.jsurg.2019.07.003. Epub 2019 Jul 30.
Multiple efforts have sought to improve teaching effectiveness and the learning environment (LE), but prior research has not focused on attending physicians' perceptions of mistreatment or contribution to the LE. The purpose of this study was to assess the perception and role of surgical faculty in the medical student LE.
A semistructured interview guide was developed using a comprehensive approach including extensive literature search and focus groups. Data were audio-recorded and transcribed verbatim. Content analysis was used to identify emergent themes.
Beth Israel Deaconess Medical Center, an academic tertiary care facility located in Boston, Massachusetts.
Fifteen faculty in the Department of Surgery underwent detailed interviews. Participants were selected using purposive-stratified criterion-based sampling.
Multiple themes emerged: (1) The competing demands on medical student's time are a negative factor in the LE; (2) Faculty expectations conflict with the existing curriculum; (3) Faculty are concerned with the possibility of being reported for providing negative feedback; (4) Faculty remain unfamiliar with policies regarding the LE/mistreatment; (5) A motivated medical student makes the educational interaction more productive independent of specialty of choice.
Faculty identified that the most important factors contributing to a negative LE were a mismatch between expectations of medical students and faculty, and the conflict between the current curriculum and the faculty member's perceived ideal educational framework. Importantly, faculties were largely unfamiliar with LE/mistreatment policies and standards. These findings suggest a need for targeted curricula for faculty to raise awareness of components of a positive LE and tools to teach effectively within the contemporary medical school curriculum.
人们已经做出了多项努力来提高教学效果和学习环境（LE），但先前的研究并未关注主治医生对虐待行为的看法或对学习环境的影响。本研究的目的是评估外科教员在医学生学习环境中的认知和作用。
采用综合方法制定了半结构化访谈指南，包括广泛的文献检索和焦点小组讨论。数据进行了录音并逐字转录。采用内容分析法确定新出现的主题。
位于马萨诸塞州波士顿的学术三级医疗设施贝斯以色列女执事医疗中心。
外科系的15名教员接受了详细访谈。参与者采用基于目的分层标准的抽样方法进行选择。
出现了多个主题：（1）对医学生时间的相互竞争的需求是学习环境中的一个负面因素；（2）教员的期望与现有课程相冲突；（3）教员担心因提供负面反馈而被举报；（4）教员对学习环境/虐待行为的政策仍然不熟悉；（5）积极主动的医学生使教育互动更有成效，而与所选专业无关。
教员们认为，导致负面学习环境的最重要因素是医学生和教员期望之间的不匹配，以及当前课程与教员所认为的理想教育框架之间的冲突。重要的是，教员们对学习环境/虐待行为的政策和标准大多不熟悉。这些发现表明，需要为教员制定有针对性的课程，以提高对积极学习环境组成部分的认识，并提供在当代医学院课程中有效教学的工具。
