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对医学院校中指导关系中的伦理问题进行的系统综述。

A systematic scoping review of ethical issues in mentoring in medical schools.

作者信息

Kow Cheryl Shumin, Teo Yao Hao, Teo Yao Neng, Chua Keith Zi Yuan, Quah Elaine Li Ying, Kamal Nur Haidah Binte Ahmad, Tan Lorraine Hui En, Cheong Clarissa Wei Shuen, Ong Yun Ting, Tay Kuang Teck, Chiam Min, Mason Stephen, Krishna Lalit Kumar Radha

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228, Singapore.

Division of Supportive and Palliative Care, National Cancer Centre Singapore, 11 Hospital Dr, Singapore, 169610, Singapore.

出版信息

BMC Med Educ. 2020 Jul 31;20(1):246. doi: 10.1186/s12909-020-02169-3.

Abstract

BACKGROUND

Mentoring provides mentees and mentors with holistic support and research opportunities. Yet, the quality of this support has been called into question amidst suggestions that mentoring is prone to bullying and professional lapses. These concerns jeopardise mentoring's role in medical schools and demand closer scrutiny.

METHODS

To better understand prevailing concerns, a novel approach to systematic scoping reviews (SSR) s is proposed to map prevailing ethical issues in mentoring in an accountable and reproducible manner. Ten members of the research team carried out systematic and independent searches of PubMed, Embase, ERIC, ScienceDirect, Scopus, OpenGrey and Mednar databases. The individual researchers employed 'negotiated consensual validation' to determine the final list of articles to be analysed. The reviewers worked in three independent teams. One team summarised the included articles. The other teams employed independent thematic and content analysis respectively. The findings of the three approaches were compared. The themes from non-evidence based and grey literature were also compared with themes from research driven data.

RESULTS

Four thousand six titles were reviewed and 51 full text articles were included. Findings from thematic and content analyses were similar and reflected the tabulated summaries. The themes/categories identified were ethical concerns, predisposing factors and possible solutions at the mentor and mentee, mentoring relationship and/or host organisation level. Ethical concerns were found to stem from issues such as power differentials and lack of motivation whilst predisposing factors comprised of the mentor's lack of experience and personality conflicts. Possible solutions include better program oversight and the fostering of an effective mentoring environment.

CONCLUSIONS

This structured SSR found that ethical issues in mentoring occur as a result of inconducive mentoring environments. As such, further studies and systematic reviews of mentoring structures, cultures and remediation must follow so as to guide host organisations in their endeavour to improve mentoring in medical schools.

摘要

背景

导师指导为学员和导师提供全面支持和研究机会。然而,这种支持的质量受到了质疑,有人认为导师指导容易出现欺凌和职业失误。这些担忧危及导师指导在医学院校中的作用,需要更密切的审视。

方法

为了更好地理解普遍存在的担忧,提出了一种新的系统综述方法(SSR),以一种可问责且可重复的方式梳理导师指导中普遍存在的伦理问题。研究团队的十名成员对PubMed、Embase、ERIC、ScienceDirect、Scopus、OpenGrey和Mednar数据库进行了系统且独立的检索。每位研究人员采用“协商一致验证”来确定要分析的文章最终列表。评审人员分为三个独立小组。一个小组总结纳入的文章。其他小组分别进行独立的主题分析和内容分析。比较了三种方法的结果。还将非循证文献和灰色文献中的主题与研究驱动数据中的主题进行了比较。

结果

共审查了4600个标题,纳入了51篇全文文章。主题分析和内容分析的结果相似,并反映在列表总结中。确定的主题/类别包括导师和学员、导师关系和/或主办机构层面的伦理问题、诱发因素和可能的解决方案。发现伦理问题源于权力差异和缺乏动力等问题,而诱发因素包括导师缺乏经验和性格冲突。可能的解决方案包括加强项目监督和营造有效的导师指导环境。

结论

这种结构化的系统综述发现,导师指导中的伦理问题是由不利的导师指导环境导致的。因此,必须对导师指导结构、文化和补救措施进行进一步研究和系统综述,以指导主办机构努力改善医学院校中的导师指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6ef/7395401/9b236447b953/12909_2020_2169_Fig1_HTML.jpg

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