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通过学生施瓦茨轮(Schwartz Rounds)尽早引入多学科团队:一项混合方法研究。

Early introduction of the multi-disciplinary team through student Schwartz Rounds: a mixed methodology study.

机构信息

Medical Education Department, Princess Alexandra Hospital (PAH), Hamstel Road, Harlow, CM20 1QX, UK.

出版信息

BMC Med Educ. 2022 Jul 3;22(1):523. doi: 10.1186/s12909-022-03549-7.

Abstract

BACKGROUND

Medical education has changed continually throughout the covid-19 pandemic, creating additional stress for medical students. Personal reflection can empower an individual to adapt to new challenges, and reflection has gradually become incorporated into medical student training. Schwartz Rounds (SR) offer a compassionate group reflective forum for healthcare staff. SRs have been extensively introduced throughout the NHS, however medical student rounds are yet to be widely adopted. Entirely unresearched is how the multi-disciplinary team impacts a medical student SR. This study aims to compare medical student experience of a single-discipline and a multi-discipline SR using mixed methodology.

METHODS

Two virtual SRs were run at an NHS district general hospital, using the existing structure of the Trust's rounds. The first round included only medical students on placement at the hospital, whereas the second round also involved other student health disciplines. Following each round Likert scale questionnaires were collected, and focus groups were held with a small number of participants. Quantitative analysis used median averages as well direct comparison of scores for each round. Qualitative data from the focus groups underwent thematic analysis.

RESULTS

The quantitative data showed a positive response to both styles of student SRs, with over 87% of participants at both rounds stating they intended to attend further rounds. Direct comparison between the two rounds showed higher feedback scores for the single-discipline round. Qualitative analysis showed strong student interest in further group reflection, noting the value of SRs in improving workplace culture and inter-professional relationships. The analysis also highlighted frustrations with the existing SR structure, namely large group sizes and scripted panellists.

CONCLUSIONS

Both data sets showed a strong positive response to SRs, and a desire to attend again. There is some evidence to suggest the addition of multiple student disciplines at SRs impaired medical student reflection. Changes to the format of the round could result in even greater success in student rounds.

摘要

背景

在新冠疫情期间,医学教育不断变化,给医学生带来了额外的压力。个人反思可以使个人有能力适应新的挑战,并且反思已逐渐纳入医学生培训。Schwartz Rounds(SR)为医护人员提供了一个富有同情心的集体反思论坛。SR 在整个 NHS 中得到了广泛的引入,但是医学生的轮次尚未得到广泛采用。多学科团队如何影响医学生的 SR 完全没有研究。本研究旨在使用混合方法比较单一学科和多学科 SR 中医学生的体验。

方法

在 NHS 地区综合医院进行了两次虚拟 SR,使用了该信托机构轮次的现有结构。第一轮仅包括在医院实习的医学生,而第二轮还包括其他学生健康学科。在每一轮之后,都收集了李克特量表问卷,并与少数参与者进行了焦点小组讨论。定量分析使用中位数平均值以及每一轮的分数直接比较。焦点小组的定性数据进行了主题分析。

结果

定量数据显示,两种类型的学生 SR 都得到了积极的回应,超过 87%的参与者在两轮中都表示打算参加更多轮次。两轮之间的直接比较显示,单一学科轮次的反馈得分更高。定性分析显示,学生对进一步的小组反思表现出浓厚的兴趣,指出了 SR 在改善工作场所文化和跨专业关系方面的价值。分析还突出了对现有 SR 结构的不满,即大组规模和脚本化的小组成员。

结论

两组数据都显示出对 SR 的强烈积极反应,并且有再次参加的愿望。有一些证据表明,在 SR 中增加多个学生学科会损害医学生的反思。改变轮次的格式可能会使学生轮次取得更大的成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9244/9252002/42e105d5086b/12909_2022_3549_Fig1_HTML.jpg

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