Chang Gung Medical Education Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Division of General Internal Medicine and Geriatrics, Department of Internal Medicine, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Taoyuan, 333, Taiwan.
BMC Med Educ. 2021 Jun 5;21(1):321. doi: 10.1186/s12909-021-02741-5.
Reflection and various approaches to foster reflection have been regarded as an indispensable element in enhancing professional practice across different disciplines. With its inherent potential to engage learners in reflection and improvement, narrative medicine has been adopted in various settings. However, the relevance and effectiveness of reflection remains underexplored in the context of narrative medicine, specifically in regard to the concern about variability of learner acceptance and the way learners really make sense of these reflective activities. This study aimed to explore what medical learners experience through narrative medicine and the meanings they ascribe to the phenomenon of this narrative-based learning.
Using a transcendental phenomenology approach, twenty medical learners were interviewed about their lived experiences of taking a narrative medicine course during their internal medicine clerkship rotation. Moustakas' phenomenological analysis procedures were applied to review the interview data.
Six themes were identified: feeling hesitation, seeking guidance, shifting roles in narratives, questioning relationships, experiencing transformation, and requesting a safe learning environment. These themes shaped the essence of the phenomenon and illustrated what and how medical learners set out on a reflective journey in narrative medicine. These findings elucidate fundamental elements for educators to consider how narrative approaches can be effectively used to engage learners in reflective learning and practice.
Adopting Moustakas' transcendental phenomenology approach, a better understanding about the lived experiences of medical learners regarding learning in narrative medicine was identified. Learner hesitancy should be tackled with care by educators so as to support learners with strategies that address guidance, relationship, and learning environment. In so doing, medical learners can be facilitated to develop reflective capabilities for professional and personal growth.
反思以及各种促进反思的方法被视为增强不同学科专业实践的不可或缺的要素。叙事医学具有使学习者参与反思和改进的内在潜力,因此已在各种环境中得到应用。然而,叙事医学背景下的反思的相关性和有效性仍未得到充分探索,特别是在学习者接受程度的可变性以及学习者如何真正理解这些反思性活动方面。本研究旨在探讨医学学习者通过叙事医学体验到了什么,以及他们对这种基于叙事的学习现象赋予了什么意义。
采用先验现象学方法,对 20 名在内科实习轮转期间参加叙事医学课程的医学生进行了访谈,以了解他们的亲身经历。采用 Moustakas 的现象学分析程序对访谈数据进行了回顾。
确定了六个主题:感到犹豫、寻求指导、在叙述中转变角色、质疑关系、体验转变以及要求安全的学习环境。这些主题构成了这一现象的本质,并说明了医学生如何在叙事医学中踏上反思之旅,以及他们的所思所感。这些发现阐明了教育工作者需要考虑的基本要素,即叙事方法如何能够有效地用于促使学习者进行反思性学习和实践。
采用 Moustakas 的先验现象学方法,我们更好地理解了医学生在叙事医学学习中的亲身体验。教育者应谨慎处理学习者的犹豫情绪,通过提供解决指导、关系和学习环境的策略来支持学习者。这样,就可以帮助医学生发展反思能力,以实现专业和个人成长。