University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Medicine-Pediatrics Residency Program, Vanderbilt University, Nashville, TN, USA.
Matern Child Health J. 2020 Jun;24(6):679-686. doi: 10.1007/s10995-020-02907-5.
Clinical experiences expose learners to the patient perspective, which can have a lasting impact on students' professional identity. However, in busy clinical settings where opportunities for reflection may be limited, listening to patients' stories is often neglected. We used a reflection assignment to augment a new maternal-child health integrated curriculum.
Medical students completed a brief assignment from their session in the neonatal intensive care unit (NICU), which included reflective writing, between fall 2016 and summer 2017. The Depth of Reflection rubric was used to score reflections on a scale: "Knowledge and Comprehension" (Level I), "Analysis" (Level II), and "Synthesis and Evaluation" (Level III). A constant comparison method based on grounded theory elicited prenatal and postnatal themes from medical students' reflective writing.
All students completed narratives (n = 166); 70% (n = 116) achieved a Depth of Reflection of Level II or III. Six overarching themes emerged: (1) Conception, Pregnancy, and Delivery Experiences; (2) Positive Support Structures; (3) Barriers and Stressors to Care; (4) Future Plans; (5) Unexpected Complications; and (6) Student Career and Professional Considerations.
Reflections from a novel and brief integrated maternal-child health experience demonstrated high levels on the Depth of Reflection scale. This experience exposed students to core themes central to a family's pregnancy and perinatal experience. Professional identity formation also emerged as a theme. Reflective writing assignments in a busy NICU can facilitate exploration of medical students' knowledge of maternal-child health patient experiences.
临床经验使学习者接触到患者的视角,这可能对学生的专业身份产生持久影响。然而,在忙碌的临床环境中,可能缺乏反思的机会,倾听患者的故事往往被忽视。我们使用反思作业来补充新的母婴健康综合课程。
2016 年秋季至 2017 年夏季,医学生在新生儿重症监护病房(NICU)完成了一项简短的作业,包括反思写作。使用反思深度评分表对反思进行评分:“知识和理解”(一级)、“分析”(二级)和“综合与评估”(三级)。基于扎根理论的恒比比较方法从医学生的反思写作中提取出产前和产后主题。
所有学生都完成了叙述(n=166);70%(n=116)达到了二级或三级反思深度。出现了六个总体主题:(1)受孕、怀孕和分娩经历;(2)积极的支持结构;(3)护理的障碍和压力;(4)未来计划;(5)意外并发症;(6)学生的职业和专业考虑。
从一个新颖而简短的综合母婴健康体验中得出的反思在反思深度评分表上得分很高。这种体验使学生接触到家庭怀孕和围产期经历的核心主题。专业身份形成也成为一个主题。在繁忙的 NICU 中进行反思写作作业可以促进医学生对母婴健康患者体验的知识探索。