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《从理论学习到临床实践过渡期的体验式学习挑战:普通科、儿科和精神科实习中反思性写作作业的比较分析》

'Challenges in experiential learning during transition to clinical practice: A comparative analysis of reflective writing assignments during general practice, paediatrics and psychiatry clerkships'.

机构信息

Department of General Practice, RCSI, Dublin, Ireland.

Department of Paediatrics, RCSI, Dublin, Ireland.

出版信息

Med Teach. 2020 Nov;42(11):1275-1282. doi: 10.1080/0142159X.2020.1803250. Epub 2020 Aug 10.

Abstract

INTRODUCTION

This study explored the reflective writing (RW) of senior medical students across a co-ordinated reflection education programme in General Practice, Paediatrics and Psychiatry clerkships during their transition to clinical clerkships. The study compared RW themes from within and across three clerkships in order to understand the influence clerkships had on experiential learning and developing professional identity.

METHODS

All medical students in their penultimate year were invited to participate in the study. 135 reflection assignments were analysed. A qualitative thematic analysis of students' RW was performed. An inductive approach was used and data saturation was achieved.

RESULTS

Clerkship specific themes were the intimacy of the experience in General Practice, the powerlessness students felt and the challenge of delivering family centred care in Paediatrics and the sense of perceived risk in Psychiatry. Common themes across the three clerkships were of emotional struggles in developing a professional identity.

CONCLUSION

There is an educational need for developmental space for students during General Practice, greater focus on preparing students for relationship building during Paediatrics and addressing stigma and personal safety issues in students during the Psychiatry clerkships. Across clerkships there is a need for better use of evidence based pedagogies to support emotional development.

摘要

引言

本研究探讨了在普通科、儿科和精神科实习期间协调的反思教育计划中,高年级医学生在向临床实习过渡期间的反思写作(RW)。该研究比较了三个实习科室内部和之间的 RW 主题,以了解实习对体验式学习和发展专业身份的影响。

方法

邀请所有倒数第二年的医学生参加研究。分析了 135 份反思作业。对学生 RW 进行了定性主题分析。采用归纳法,达到了数据饱和。

结果

实习科室特有的主题是普通科实习中体验的亲密性、学生感到的无能为力以及在儿科提供以家庭为中心的护理的挑战以及在精神病学中感知风险的感觉。三个实习科室共有的主题是在发展专业身份方面的情感挣扎。

结论

普通科实习需要为学生提供发展空间,儿科实习更需要注重培养学生建立关系的能力,精神病学实习需要解决学生的耻辱感和个人安全问题。在实习科室中,需要更好地利用循证教学法来支持情感发展。

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