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少数族裔医疗专业人员的职业认同感比较。

A comparison of professional identity experiences among minoritized medical professionals.

机构信息

Uniformed Services University of the Health Sciences, Department of Medicine, Bethesda, Maryland, United States.

Medical College of Georgia at Augusta University, Department of Pharmacology and Toxicology, 1120 15th Street, Augusta, Georgia 30912, United States.

出版信息

J Natl Med Assoc. 2022 Aug;114(4):456-464. doi: 10.1016/j.jnma.2022.05.013. Epub 2022 Jun 18.

Abstract

OBJECTIVE

Professional identity formation (PIF) is considered a fundamental process in the development of healthcare providers. In medical education, the PIF literature has historically centered on medicine's socialization practices involving white male physicians. However, recently researchers have begun to reveal how larger socio-historical contexts influence PIF in minoritized physicians. To better understand what influences Black/African American physicians' PIF, this study compares their PIF experiences to a group of minoritized physician assistants (PAs). In comparing Black physicians' experiences to another provider, this study explored what PIF experiences may be attributed to participants' minoritized status and what might be attributed to the culture of medicine.

METHODS

In this cross-case analysis, 45 minoritized PA students and practicing PAs were recruited from several Southeastern universities. The PA participants included 23 Black/African Americans, 12 Latinx, 4 Indigenous/Native, and 6 of mixed races/ethnicities. Interview data were then compared to previously collected data from 41 Black/African American medical trainees and physicians. Using constant comparative method, similarities and differences in PIF were explored.

RESULTS

Similarities between the two groups included the importance of participants' racial/ethnic identity to patient care, experiences on-going microaggressions from patients and peers, and a desire to engage in racial uplift. However, one marked difference was found, namely that PAs felt they could bring their entire selves to the profession, whereas physicians described feeling splintered early in their training.

CONCLUSIONS

Several possibilities that might explain why Black physicians and minoritized PAs have this one marked difference in their PIF experience, including identity threat, internalization of different discourses, and length of training for physicians. While this study was not designed to answer this question, it is clear that there is something in the culture of medicine and the training of physicians that signals to Black physicians that they cannot bring their whole selves to the profession.

摘要

目的

专业身份认同形成(PIF)被认为是医疗保健提供者发展的一个基本过程。在医学教育中,PIF 文献历史上集中于涉及白人男性医生的医学社会化实践。然而,最近研究人员开始揭示更大的社会历史背景如何影响少数族裔医生的 PIF。为了更好地理解是什么影响了黑人/非裔美国医生的 PIF,本研究将他们的 PIF 经历与一组少数族裔医生助理(PAs)进行了比较。在将黑人医生的经历与另一种提供者进行比较时,本研究探讨了哪些 PIF 经历可能归因于参与者的少数族裔身份,哪些可能归因于医学文化。

方法

在这项跨案例分析中,从几所东南大学招募了 45 名少数族裔 PA 学生和执业 PA。PA 参与者包括 23 名黑人/非裔美国人、12 名拉丁裔、4 名原住民/土著人和 6 名混合种族/族裔。然后将采访数据与之前从 41 名黑人/非裔美国医疗受训者和医生那里收集的数据进行比较。使用恒比方法探讨了 PIF 的相似性和差异。

结果

两组参与者的相似之处包括参与者的种族/族裔身份对患者护理的重要性、持续遭受来自患者和同行的微侵犯的经历以及从事种族提升的愿望。然而,发现了一个显著的差异,即 PA 感到他们可以将自己的全部带到职业中,而医生则在培训早期就感到分裂。

结论

有几种可能性可以解释为什么黑人医生和少数族裔 PA 在他们的 PIF 经历中有这一显著差异,包括身份威胁、不同话语的内化以及医生的培训时间。虽然本研究的设计不是为了回答这个问题,但很明显,医学文化和医生培训中有一些东西向黑人医生发出信号,表明他们不能将自己的全部带到职业中。

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