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医生的意义是什么?探索医学生一年级学生的社会想象。

What does it mean to be a physician? Exploring social imaginaries of first-year medical students.

机构信息

Medical College of Georgia, Augusta University, USA.

The Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, USA.

出版信息

Int J Med Educ. 2020 Mar 27;11:76-80. doi: 10.5116/ijme.5e30.8f73.

Abstract

OBJECTIVES

To explore if community embedded discussions with local community members reshape the social imaginary of medicine among students and contribute positively to their professional identity.

METHODS

This explorative, qualitative study involved 35 first-year medical students who volunteered to attend a 2-hour forum at a local church to ask community members about their experiences with doctors and healthcare systems.  Student participants were asked to reflect on five structured questions. The written reflections were submitted for analysis, de-identified, and analyzed using Glaser's classic grounded theory, constant comparative analysis, and Taylor's model of modern social imaginaries as an analytical lens.

RESULTS

The results indicate that student participants identified seven main themes regarding what community members expect from their doctors, including active listening (n=22), physical touch (n=18), and compassion (n=16). Responses also indicated that only 5.6% of the students felt that the preclinical curriculum was adequately preparing them for what local community members identified as important to patient care. However, students recognized that two aspects of the curriculum, Physical Diagnosis (n=12) and volunteering/community engagement (n=9), were congruent with the expectations of future patients.

CONCLUSIONS

The results suggest that students identified educational experiences that were congruent with the social imaginary of patients. However, patient expectations were discordant to some aspects of the medical imaginary of medical students. The experience and subsequent reflections may be salient to contributing to each student's professional identity and provide a model for other medical schools to explore how the curriculum is fulfilling the community's perception of ideal patient care.

摘要

目的

探讨社区成员与当地社区成员进行嵌入式讨论是否能重塑学生对医学的社会想象,并对他们的专业身份产生积极影响。

方法

本探索性定性研究纳入了 35 名自愿参加在当地教堂举行的 2 小时论坛的一年级医学生,让他们向社区成员询问他们对医生和医疗体系的体验。要求学生参与者反思五个结构化问题。提交书面反思进行分析,去识别化,并使用 Glaser 的经典扎根理论、恒比分析和 Taylor 的现代社会想象模型作为分析视角进行分析。

结果

结果表明,学生参与者确定了社区成员对医生的期望的七个主要主题,包括主动倾听(n=22)、身体接触(n=18)和同情(n=16)。学生们的回应还表明,只有 5.6%的学生认为基础临床前课程充分为他们准备了社区成员认为对患者护理重要的内容。然而,学生们认识到课程的两个方面,即物理诊断(n=12)和志愿活动/社区参与(n=9),与未来患者的期望一致。

结论

结果表明,学生们确定了与患者社会想象一致的教育经验。然而,患者的期望与医学生的医学想象的某些方面不一致。这种体验和随后的反思可能对每个学生的专业身份有重要影响,并为其他医学院校探索课程如何满足社区对理想患者护理的看法提供了一个模式。

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Medical professionalism and the social contract.医学职业精神与社会契约。
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Changing face of medical curricula.医学课程不断变化的面貌。
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