Nolan Helen, Owen Katherine
Warwick Medical School, Gibbet Hill, CV4 7AL, Coventry, UK.
BMC Med Educ. 2021 May 19;21(1):285. doi: 10.1186/s12909-021-02726-4.
During the Covid-19 pandemic medical students were offered paid roles as medical student healthcare assistants. Anecdotal reports suggested that students found this experience rich for learning. Previous studies have explored alternative models of student service, however this defined medical student support role is novel.
Individual semi-structured interviews were recorded with 20 medical students at a UK medical school exploring their experiences of placement learning and experiences of working as healthcare assistants. Responses were analysed qualitatively using a framework approach. The framework was developed into a model describing key findings and their relationships.
Interviews yielded data that broadly covered aspects of (1) Medical students' experiences of clinical placement learning (2) Medical students' experiences of working as medical student healthcare assistants (3) Learning resulting from working as a healthcare assistant (4) Hierarchies and professional barriers in the clinical environment (5) Influences on professional identity. Participants described barriers and facilitators of clinical learning and how assuming a healthcare assistant role impacted on learning and socialisation within the multidisciplinary team. Students became increasingly socialised within the healthcare team, contributing directly to patient care; the resulting social capital opened new opportunities for learning, team working and enhanced students' interprofessional identity. Students described the impact of these experiences on their aspirations for their future practice.
Changes to work patterns in healthcare and delivery models of medical education have eroded opportunities for students to contribute to healthcare delivery and be embedded within a team. This is impacting negatively on student learning and socialisation and we suggest that medical curricula have much to learn from nursing and allied health professional training. Longitudinal embedment with a multidisciplinary team, where students have a defined role and work directly with patients may not only add value to clinical service, but also overcome current barriers to effective placement learning and interprofessional identity formation for medical students.
在新冠疫情期间，医科学生被提供了担任医科学生医疗助理的带薪岗位。轶事报告表明，学生们发现这段经历对学习很有帮助。此前的研究探索了学生服务的替代模式，然而这种明确的医科学生支持角色是新颖的。
对英国一所医学院的20名医科学生进行了个人半结构化访谈，探讨他们的实习学习经历和作为医疗助理的工作经历。使用框架方法对回答进行定性分析。该框架被发展成一个描述关键发现及其关系的模型。
访谈得出的数据广泛涵盖了以下方面：（1）医科学生的临床实习学习经历；（2）医科学生作为医科学生医疗助理的工作经历；（3）担任医疗助理工作所带来的学习；（4）临床环境中的层级和专业障碍；（5）对职业身份的影响。参与者描述了临床学习的障碍和促进因素，以及承担医疗助理角色如何影响多学科团队中的学习和社交。学生们在医疗团队中越来越融入，直接为患者护理做出贡献；由此产生的社会资本为学习、团队合作带来了新机会，并增强了学生的跨专业身份认同。学生们描述了这些经历对他们未来职业抱负的影响。
医疗保健工作模式和医学教育交付模式的变化削弱了学生为医疗保健做出贡献并融入团队的机会。这对学生的学习和社交产生了负面影响，我们建议医学课程可以从护理和相关健康专业培训中学到很多东西。与多学科团队进行长期融入，让学生有明确的角色并直接与患者合作，不仅可以为临床服务增加价值，还可以克服当前医科学生有效实习学习和跨专业身份形成的障碍。
