Khoo See Meng, Wong Xin Lin Serene
S.M. Khoo is currently senior consultant, Department of Medicine, Chronic Program, Alexandra Hospital, Queenstown, Division of Respiratory Medicine and Critical Care, National University Hospital, Kent Ridge, Singapore, and associate professor, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, Singapore. When this research was conducted, he was program director, Internal Medicine Residency Program, National University Health System, Kent Ridge, Singapore.
X.L.S. Wong is consultant, Department of Medicine, Chronic Program, Alexandra Hospital, Queenstown, and Division of Respiratory Medicine and Critical Care, National University Hospital, Kent Ridge, Singapore.
Acad Med. 2022 Mar 1;97(3):385-388. doi: 10.1097/ACM.0000000000004256.
Most training programs have focused on the explicit teaching of professionalism, an approach that has seen limited success, to transform trainees into physicians. It is possible that faculty members' reflective narratives, if appropriately shared with trainees, can facilitate the processes of reflection and socialization and help shift the training paradigm toward supporting professional identity formation.
In May 2010, an online forum, where faculty could share personal reflective narratives with all residents and faculty via email, was created for the National University Health System's internal medicine residency program. By 2016, 40 letters had been written and nearly 200 residents and 30 faculty members had read these. This repository of faculty members' reflective narratives touches on a broad range of issues related to professionalism, including altruism, humanism, excellence, and accountability. In February 2017, the authors conducted semistructured focus group discussions with 20 residents to explore the impact of faculty members' reflective narratives on their professional identity development.
Residents reported that narratives, if written by authors who were recognized as role models, triggered the processes of reflection and socialization; were more effective in provoking reflection if they resonated with residents' experiences; inspired them to follow how their role models reflected on and coped with challenges; and influenced the culture of the workplace, impacting the residents' daily experiences and leading to socialization and development of their professional identity.
These early observations on the role of faculty members' reflective narratives highlight the importance of credible role models, the daily work experience, and the culture of the workplace and provide information educators could use to more effectively support trainees' professional identity formation as they design curricula. Among other things, future studies should explore the role and effectiveness of faculty members' reflective narratives in different educational contexts.
大多数培训项目都侧重于对职业精神进行明确的教学,然而这种方法在将学员转变为医生方面取得的成功有限。如果教师的反思性叙述能够适当地与学员分享,那么有可能促进反思和社会化进程,并有助于将培训模式转向支持职业身份的形成。
2010年5月,为国立大学卫生系统的内科住院医师培训项目创建了一个在线论坛,教师可以通过电子邮件与所有住院医师和教师分享个人反思性叙述。到2016年,已经撰写了40封信,近200名住院医师和30名教师阅读了这些信件。这个教师反思性叙述库涉及与职业精神相关的广泛问题,包括利他主义、人文主义、卓越和问责制。2017年2月,作者与20名住院医师进行了半结构化焦点小组讨论,以探讨教师反思性叙述对他们职业身份发展的影响。
住院医师报告称,如果叙述是由被视为榜样的作者撰写的,会引发反思和社会化进程;如果与住院医师的经历产生共鸣,则在激发反思方面更有效;激励他们效仿榜样如何反思和应对挑战;并影响工作场所的文化,影响住院医师的日常经历,导致他们的社会化和职业身份的发展。
这些关于教师反思性叙述作用的早期观察突出了可信榜样、日常工作经验和工作场所文化的重要性,并为教育工作者在设计课程时更有效地支持学员职业身份形成提供了可用信息。此外,未来的研究应该探讨教师反思性叙述在不同教育背景下的作用和有效性。