医学实践中的谦逊：对同行提名的优秀临床医生的定性研究。
Humility in medical practice: a qualitative study of peer-nominated excellent clinicians.
机构信息
Department of Pediatrics, University of Toronto and The Hospital for Sick Children, Toronto, Canada.
Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada.
出版信息
BMC Med Educ. 2022 Feb 9;22(1):88. doi: 10.1186/s12909-022-03146-8.
BACKGROUND
Humility has recently been conceptualized as a positive, multifaceted attribute in fields outside of medicine, such as psychology and philosophy. In medicine, there has been limited study into the nature of humility and its role in clinical practice. We sought to develop a deeper understanding of humility in medical practice through the lived-experiences of peer-nominated excellent clinicians.
METHODS
We conducted a qualitative study with secondary analysis of transcripts from individual open ended, semi-structured interviews of 13 peer nominated physicians [7 (54%) female] at an academic centre. Using constant comparative analysis, the transcripts were analyzed for instances where humility was discussed as it related to clinical practice.
RESULTS
Participants perceived humility to be an important driver for excellence in clinical practice. This was further explained using two overarching themes: an inward, intellectual perspective and an outward, social perspective. The physician's inward perspective was their view of their abilities and limits, their self-confidence, and their intellectual openness and adaptability to the limitations and evolving nature of knowledge in medicine. Their outward perspective was an understanding and appreciation for the larger system in which they worked, an openness to others, and valuing patients' experience. Through these perspectives, humility positively influenced clinical care, learning and curiosity, motivation in the care of others, and relationships with team members and patients.
CONCLUSIONS
Humility in medicine is a rich, multifaceted construct that was perceived to be a driver for excellence in medical practice by peer-nominated excellent clinicians. Humility was seen as an active force in formulating and calibrating a clinician's perspective of self and of others, and as such, positively influencing clinical practice. These findings will help inform a discourse in medical education and faculty development about the important role of humility in medical practice.
背景
谦逊最近在医学以外的领域，如心理学和哲学，被概念化为一种积极的、多方面的特质。在医学领域，对谦逊的本质及其在临床实践中的作用的研究有限。我们试图通过同行提名的优秀临床医生的生活经验，更深入地了解医学实践中的谦逊。
方法
我们进行了一项定性研究，对 13 名同行提名的医生[7 名（54%）女性]在学术中心进行的个人开放式、半结构化访谈的记录进行了二次分析。使用恒定性比较分析，对与临床实践相关的谦逊讨论的记录进行了分析。
结果
参与者认为谦逊是临床实践卓越的重要驱动因素。这可以进一步用两个总体主题来解释：内在的、智力的视角和外在的、社会的视角。医生的内在视角是他们对自己能力和局限性的看法，他们的自信，以及他们的智力开放性和对医学知识局限性和不断发展的本质的适应性。他们的外在视角是对他们所工作的更大系统的理解和欣赏，对他人的开放，以及对患者经验的重视。通过这些视角，谦逊对临床护理、学习和好奇心、关心他人的动机以及与团队成员和患者的关系产生了积极的影响。
结论
医学中的谦逊是一个丰富的、多方面的结构，被同行提名的优秀临床医生认为是卓越的医学实践的驱动因素。谦逊被视为一种积极的力量，它塑造和调整了医生对自我和他人的看法，从而对临床实践产生了积极的影响。这些发现将有助于在医学教育和教师发展中就谦逊在医学实践中的重要作用展开讨论。
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