Department of Medicine, Faculty of Medicine, Programs in Whole Person Care, McGill University, Montreal, Quebec, Canada.
Department of Pediatrics, Faculty of Medicine, Programs in Whole Person Care, McGill University, Montreal, Quebec, Canada.
Perspect Med Educ. 2020 Aug;9(4):256-259. doi: 10.1007/s40037-020-00591-3.
Medical students show a decline in empathy and ethical reasoning during medical school that is most marked during clerkship. We believe that part of the problem is that students do not have the skills and ways of being and relating necessary to deal effectively with the overwhelming clinical experience of clerkship.
At McGill University in Montreal, starting in January 2015, we have taught a course on mindful medical practice that combines a clinical focus on the combination of mindfulness and congruent relating that is aimed at giving students the skills and ways of being to function effectively in clerkship. The course is taught to all medical students in groups of 20, weekly for 7 weeks, in the 6 months immediately prior to clerkship, a time when students are very open to learning the skills they need to take effective care of patients.
The course has been well accepted by students as evidenced by their engagement, their evaluations, and their comments in the essays that they write at the end of the course. In a follow-up session at the simulation centre one year later students remember clearly and enact what they were taught in the course.
The next steps will be to conduct a formal evaluation of the effect of our teaching that will involve a combination of qualitative methods to clarify the nature of the impact on our students and a quantitative assessment of the difference the course makes to students' experience and performance in clerkship.
医学生在医学院期间表现出同理心和伦理推理能力的下降,在实习期间最为明显。我们认为部分问题在于,学生缺乏有效应对实习期间压倒性临床经验所需的技能和存在方式。
在蒙特利尔的麦吉尔大学,从 2015 年 1 月开始,我们开设了一门关于正念医疗实践的课程,该课程将正念与一致关系的临床焦点相结合,旨在为学生提供技能和存在方式,使其在实习期间有效运作。该课程面向所有医学生,以 20 人为一组,每周一次,共 7 周,在实习前的 6 个月进行,此时学生非常愿意学习照顾患者所需的技能。
该课程受到学生的欢迎,这从他们的参与度、评价和课程结束时撰写的文章中的评论中可以看出。一年后,在模拟中心的后续会议上,学生们清楚地记得并实施了他们在课程中所学的内容。
下一步将对我们的教学效果进行正式评估,评估将结合定性方法,以澄清对学生的影响性质,以及对课程对学生在实习期间的体验和表现的影响进行定量评估。