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医学生的情绪挑战产生了不确定感。

Emotional challenges of medical students generate feelings of uncertainty.

机构信息

Department of Learning in Engineering Sciences, School of Industrial Engineering and Management (ITM), KTH Royal Institute of Technology, Stockholm, Sweden.

Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Renal Medicine, Karolinska Institutet, Stockholm, Sweden.

出版信息

Med Educ. 2019 Oct;53(10):1037-1048. doi: 10.1111/medu.13934.

Abstract

OBJECTIVES

Health care students face many situations during their education that might be emotionally challenging. Students are confronted with illness, suffering, death, patient treatment dilemmas, and witnessing unprofessional behaviour on the part of health care professionals. Few studies have focused on what these experiences lead to in relation to the process of becoming a professional. The purpose of the study was to explore medical students' main concerns relating to emotionally challenging situations during their medical education.

METHODS

A constructivist grounded theory approach was used to explore and analyse medical students' experiences. Data were gathered by means of focus group interviews, including two interviews in the middle and two interviews at the end of the students' undergraduate programme. A total of 14 medical students participated.

RESULTS

Students' main concerns relating to emotionally challenging situations were feelings of uncertainty. These feelings of uncertainty concerned: (i) insufficient knowledge and skills; (ii) the struggle to manage emotions in patient encounters; (iii) perceived negative culture and values amongst health care professionals and in the health care system, and (iv) lacking a self-evident position on the health care team. The first two aspects relate to uncertainties concerning their own capabilities and the other two aspects relate to uncertainties regarding the detached medical culture and the unclear expectations of them as students in the health care team.

CONCLUSIONS

In the process of becoming a physician, students develop their professional identity in constant negotiation with their own perceptions, values and norms and what they experience in the local clinical context in which they participate during workplace education. The two dimensions that students have to resolve during this process concern the questions: Do I have what it takes? Do I want to belong to this medical culture? Until these struggles are resolved, students are likely to experience worry about their future professional role.

摘要

目的

医疗保健专业的学生在接受教育的过程中会遇到许多可能带来情感挑战的情况。学生们会面对疾病、痛苦、死亡、患者治疗困境,以及目睹医疗保健专业人员的不专业行为。很少有研究关注这些经历对他们成为专业人员的过程有何影响。本研究的目的是探讨医学生在医学教育过程中对情感挑战情境的主要关注点。

方法

采用建构主义扎根理论方法来探索和分析医学生的经历。通过焦点小组访谈收集数据,包括学生本科课程结束时的两次中间访谈和两次最终访谈。共有 14 名医学生参与。

结果

学生们对情感挑战情境的主要关注点是不确定感。这些不确定感涉及:(i)知识和技能不足;(ii)在与患者互动中管理情绪的困难;(iii)感知医疗保健专业人员和医疗保健系统中存在负面文化和价值观;以及(iv)在医疗团队中缺乏明确的立场。前两个方面涉及对自己能力的不确定,后两个方面涉及对冷漠的医疗文化以及他们作为医疗团队学生的不明确期望的不确定。

结论

在成为医生的过程中,学生通过不断协商自己的认知、价值观和规范以及他们在工作场所教育中参与的当地临床环境中所经历的事情来发展自己的专业身份。学生在这个过程中必须解决的两个维度涉及以下问题:我有能力吗?我想属于这种医学文化吗?在这些斗争得到解决之前,学生可能会对未来的职业角色感到担忧。

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