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医学生与追求单一正确答案:教授复杂性与不确定性

Medical Students and the Drive for a Single Right Answer: Teaching Complexity and Uncertainty.

作者信息

Witt Emily E, Onorato Sarah E, Schwartzstein Richard M

机构信息

Harvard Medical School, Boston, Massachusetts.

Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts; and.

出版信息

ATS Sch. 2021 Dec 7;3(1):27-37. doi: 10.34197/ats-scholar.2021-0083PS. eCollection 2022 Mar.

Abstract

The arrival of Generation Z, the next generation of medical learners, has been accompanied by efforts to adapt teaching practices for this new group of students. Many have identified challenges associated with addressing the needs of modern medical learners. One particular trend we have observed is that medical students are increasingly requesting an "answer key" for all aspects of their medical education. Students often expect to have the correct answers readily available to them to ensure they have reached the correct conclusion and to determine the precise knowledge they need to master. Yet, for much of medicine, and particularly in the care of critically ill patients with multisystem disease in intensive care units, answers are uncertain, and the body of knowledge is ever-growing. Students' regular requests for solutions to be provided to them threaten to undermine their development into critically thinking, self-sufficient physicians. We outline three potential contributors to this multifactorial problem and offer corresponding pedagogical solutions. Specifically, we address how prioritizing outcomes over process, discomfort with uncertainty, and fear of faltering can cause students to seek excessive levels of support that may ultimately do more harm than good. Addressing students' concerns in these three key areas will not only serve students well during their undergraduate medical training but will also equip them with the skills needed to succeed in the clinical realm. To produce physicians capable of navigating an increasingly uncertain world, medical educators will need to help students appreciate that finding the answer is more complex than being provided an answer key.

摘要

Z 世代作为下一代医学学习者的到来,伴随着为适应这群新学生而做出的教学实践努力。许多人已经认识到在满足现代医学学习者需求方面存在的挑战。我们观察到的一个特别趋势是,医学生越来越多地要求获得医学教育各个方面的“答案钥匙”。学生们常常期望能随时得到正确答案,以确保他们得出了正确结论,并确定他们需要掌握的确切知识。然而,对于医学的大部分内容,尤其是在重症监护病房对患有多系统疾病的重症患者的护理中,答案并不确定,知识体系也在不断增长。学生们经常要求为他们提供解决方案,这有可能阻碍他们成长为具有批判性思维、自给自足的医生。我们概述了这个多因素问题的三个潜在促成因素,并提供了相应的教学解决方案。具体而言,我们探讨了如何将结果置于过程之上、对不确定性的不适以及对犯错的恐惧会导致学生寻求过度的支持,而这种支持最终可能弊大于利。在这三个关键领域解决学生的担忧,不仅会在他们本科医学培训期间对学生有益,还会使他们具备在临床领域取得成功所需的技能。为了培养能够在日益不确定的世界中应对自如的医生,医学教育工作者需要帮助学生认识到找到答案比得到答案钥匙要复杂得多。

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