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从医学生到医生的职业认同转变。

Social Identification with the Medical Profession in the Transition from Student to Practitioner.

机构信息

School of Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.

Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Teach Learn Med. 2020 Jun-Jul;32(3):271-281. doi: 10.1080/10401334.2020.1723593. Epub 2020 Feb 19.

Abstract

This study explores professional identity formation during a final year of medical school designed to ease the transition from student to practitioner. Although still part of the undergraduate curriculum, this "transitional year" gives trainees more clinical responsibilities than in earlier rotations. Trainees are no longer regarded as regular clerks but work in a unique position as "semi-physicians," performing similar tasks as a junior resident during extended rotations. We analyzed transcripts from interviews with 21 transitional-year medical trainees at University Medical Center Utrecht about workplace experiences that affect the development of professional identity. We used Social Identity Approach as a lens for analysis. This is a theoretical approach from social psychology that explores how group memberships constitute an important component of individual self-concepts in a process called 'social identification.' The transcripts were analyzed using thematic analysis, with a focus on how three dimensions of social identification with the professional group emerge in the context of a transitional year: (the prominence of the group for self-definition), (positivity of feelings associated with group membership) and (perception of fit and ties with group members). Students were very aware of being a practitioner versus a student in the position of semi-physician and performing tasks successfully (i.e., ). Students experienced more continuity in patient care in transitional-year rotations than in previous clerkships and felt increased clinical responsibility. As a semi-physician they felt they could make a significant contribution to patient care. Students experienced a sense of pride and purpose when being more central to their patients' care (i.e., ). Finally, in extended rotations, the trainees became integrated into daily social routines with colleagues, and they had close contact with their supervisors who could confirm their fit with the group, giving them a sense of belonging (i.e., ). Using the three-dimension model of social identification revealed how students come to identify with the social group of practitioners in the context of a transitional year with extended rotations, increased clinical responsibilities, and being in the position of a "semi-physician." These findings shed light on the identity transition from student to practitioner within such a curricular structure.

摘要

本研究探讨了在医学院最后一年进行的专业身份形成,旨在缓解从学生到从业者的过渡。尽管仍属于本科课程的一部分,但这个“过渡年”给予学员比早期轮转更多的临床责任。学员不再被视为普通职员,而是以“半医生”的独特身份工作,在延长轮转期间执行与初级住院医师类似的任务。我们分析了 21 名乌得勒支大学医学中心过渡年医学学员的访谈记录,了解影响专业身份发展的工作场所经历。我们使用社会认同方法作为分析的视角。这是社会心理学中的一种理论方法,探讨了群体成员身份如何在一个称为“社会认同”的过程中构成个体自我概念的重要组成部分。使用主题分析方法对转录本进行分析,重点关注在过渡年背景下,与专业群体的社会认同的三个维度是如何出现的:(群体对自我定义的重要性)、(与群体成员身份相关的积极感受)和(对适应和与群体成员联系的感知)。学生非常清楚自己在半医生的位置上是从业者而不是学生,并且能够成功地完成任务(即,)。与之前的实习相比,在过渡年轮转中,学生在患者护理方面的连续性更强,并且感到临床责任更大。作为半医生,他们觉得自己可以为患者护理做出重大贡献。当学生对患者护理更加重要时,他们会感到自豪和有目标(即,)。最后,在延长轮转中,学员与同事的日常社交惯例融为一体,并且与可以确认他们与群体相适应的主管密切接触,让他们感到归属感(即,)。使用社会认同的三维模型揭示了学生如何在延长轮转、增加临床责任和担任“半医生”的情况下,在过渡年的背景下认同从业者的社会群体。这些发现阐明了在这种课程结构中从学生到从业者的身份过渡。

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