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医学生受虐的另一面:跨越代际鸿沟传授文化能力

The Other Side of Medical Student Mistreatment: Teaching Cultural Competency Across the Generational Divide.

作者信息

Feldman Nathalie L, Lewis Judith L, Patel Charmaine K, Ackerman Sean F, Howe Alison K, Harari David Y, Evans Katherine M, Adams David C

机构信息

Educational Assistant Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Larner College of Medicine.

Director, Learning Environment, University of Vermont Larner College of Medicine.

出版信息

MedEdPORTAL. 2019 Oct 25;15:10847. doi: 10.15766/mep_2374-8265.10847.

Abstract

INTRODUCTION

Medical student mistreatment continues to be a significant problem despite increased awareness and longitudinal efforts to address the issue. Through audience discussions of a previously published film depicting learner mistreatment, we identified challenges created by student behaviors that negatively impact the learning environment. In addition, the need to address cultural competency in a multigenerational clinical environment became apparent.

METHODS

We created a film of three vignettes based on perspectives shared in focus groups by faculty, residents, nurses, and staff who work with medical students. We used this film to develop student and faculty curricula elucidating generational differences in behaviors and expectations while also exploring the learner's role in creating a more positive learning environment.

RESULTS

Our film was presented to medical education professionals at faculty development workshops and meetings, clerkship students at orientation sessions, residents as part of residents-as-teachers curricula, and faculty at departmental grand rounds. Evaluation data from 176 students and 42 faculty showed that a majority of our participants believed the film accurately reflected challenges they faced in the learning environment and felt better equipped to address them.

DISCUSSION

Film is an effective way to stimulate discussion about complex interactions in the clinical learning environment. Divergent perspectives on behaviors depicted in the film served as a stimulus to create targeted curricula for faculty and student education. Stimulating dialogue through film may enhance understanding and empathy among disparate groups, which is likely to be a necessary step for lasting change.

摘要

引言

尽管人们对医学生受虐问题的认识有所提高,且长期致力于解决该问题,但这仍是一个重大问题。通过对一部先前发布的描绘学习者受虐情况的影片进行观众讨论,我们发现了学生行为给学习环境带来负面影响所造成的挑战。此外,在多代临床环境中解决文化能力问题的必要性也变得显而易见。

方法

我们根据与医学生共事的教师、住院医师、护士和工作人员在焦点小组中分享的观点,制作了一部包含三个小插曲的影片。我们利用这部影片开发了学生和教师课程,阐明行为和期望方面的代际差异,同时探讨学习者在营造更积极学习环境中的作用。

结果

我们的影片在教师发展研讨会和会议上向医学教育专业人员播放,在迎新会上向见习学生播放,作为住院医师即教师课程的一部分向住院医师播放,并在科室大查房时向教师播放。来自176名学生和42名教师的评估数据显示,大多数参与者认为这部影片准确反映了他们在学习环境中面临的挑战,并觉得自己更有能力应对这些挑战。

讨论

影片是激发关于临床学习环境中复杂互动讨论的有效方式。对影片中所描绘行为的不同观点,促使我们为教师和学生教育制定有针对性的课程。通过影片激发对话可能会增强不同群体之间的理解和同理心,这可能是实现持久变革的必要步骤。

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