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患者对妇产科和新生儿科医院床边教学的看法。

Patient perspectives of bedside teaching in an obstetrics, Gynaecology and neonatology hospital.

机构信息

UCD School of Psychology, University College Dublin, Donnybrook, Dublin 4, Ireland.

Obstetrics and Gynaecology, National Maternity Hospital, Dublin 2, Ireland.

出版信息

BMC Med Educ. 2020 Apr 15;20(1):111. doi: 10.1186/s12909-020-02016-5.

Abstract

BACKGROUND

Osler taught doctors to "have no teaching without a patient for a text, and the best teaching is that taught by the patient himself". Bedside teaching (BST) facilitates clinical practice of skills, teaches empathy, instils confidence and builds on patient-doctor relationships. However, its use has declined dramatically due to concerns regarding privacy and autonomy. Most of the research in this area concentrates on medical student or academic opinion of BST using survey based methods. This qualitative study aimed to explore the patient's experiences and opinions of BST.

METHODS

With ethical approval a qualitative study was conducted using semi-structured interviews which were examined using Thematic Analysis. Patients who had participated in a BST tutorial were invited to participate and gave written consent after discussion with a study researcher.

RESULTS

Twenty-two patients were interviewed (obstetrics ante-natal [n = 10], obstetrics post-natal [n = 5] and gynaecology [n = 7]) ranging from ages 24-80 yrs. Four major themes were identified, with 11 sub-themes. The major themes included (i) Professional Mannerisms (ii) Privacy and Personal Wellbeing (iii) Quality of Patient Experience of BST and (iv) Clinical Experience and Learning Importance. The reaction of patients toward teaching at the bedside was altruistic and positive, with importance placed on learning.

CONCLUSION

This research supports the concept of patient focused learning, and can reassure faculty that patients largely support its continuation as an integral component in education. Future research aims to extend this assessment to other patient groups with the aim of learning from and improving their experience.

摘要

背景

Osler 教导医生“没有患者作为教材就没有教学,而最好的教学是由患者自己教授”。床边教学(BST)有助于临床实践技能,教授同理心,树立信心,并建立医患关系。然而,由于对隐私和自主权的担忧,其使用急剧下降。该领域的大多数研究都集中在使用基于调查的方法对医学生或学术人员对 BST 的看法。这项定性研究旨在探讨患者对 BST 的体验和看法。

方法

在获得伦理批准的情况下,使用半结构化访谈进行了定性研究,然后使用主题分析对访谈进行了检查。邀请参与 BST 辅导的患者参加,并在与研究人员讨论后书面同意参加。

结果

共采访了 22 名患者(产科产前[ n = 10],产科产后[ n = 5]和妇科[ n = 7]),年龄从 24 岁到 80 岁不等。确定了四个主要主题,包括 11 个子主题。主要主题包括(i)专业举止(ii)隐私和个人福祉(iii)BST 患者体验质量和(iv)临床经验和学习重要性。患者对床边教学的反应是利他和积极的,重视学习。

结论

这项研究支持以患者为中心的学习理念,并可以向教师保证,患者在很大程度上支持将其作为教育的一个组成部分继续进行。未来的研究旨在将这种评估扩展到其他患者群体,以从他们的经验中学习并加以改进。

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