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这是一条“双向道”:临床学习环境中有效指导关系的住院医师视角。

It's a 'two-way street': resident perspectives of effective coaching relationships in the clinical learning environment.

作者信息

Trier Jessica, Turnnidge Jennifer, McGuire Cailie S, Côté Jean, Dagnone J Damon

机构信息

Department of Physical Medicine and Rehabilitation, Queen's University, Ontario, Canada.

Providence Care Hospital, Ontario, Canada.

出版信息

Can Med Educ J. 2022 Jul 6;13(3):5-12. doi: 10.36834/cmej.72940. eCollection 2022 Jul.

Abstract

BACKGROUND

Coaching has gained traction in postgraduate medical education to enhance interactions between residents and clinical teachers, but these relationships present unique challenges and tensions. In order to realize the promises of coaching in medical education, we must understand how coaching relationships can be enacted to optimize resident development. The purpose of this study was to explore residents' perceptions of key characteristics for effective clinical teacher-resident (CT-R) coaching relationships.

METHODS

We conducted four focus groups and eight interviews with residents at a Canadian academic center. Using a social constructionist approach, focus groups and interviews were audio recorded, transcribed verbatim, and thematically analyzed.

RESULTS

Residents described three main characteristics that contributed to effective CT-R coaching relationships: safe, meaningful, and collaborative. Residents emphasized that these characteristics needed to be bidirectional in nature to be most effective, in that both the resident and clinical teacher embodied these characteristics.

CONCLUSIONS

Residents identified that effective coaching relationships were shaped not only by clinical teacher behaviours, but importantly, the quality of the interpersonal relationship that was fostered. Thus, it is imperative to consider the bidirectional nature of the CT-R coaching relationship when striving to enhance resident development.

摘要

背景

指导在研究生医学教育中越来越受到关注,以加强住院医师与临床教师之间的互动,但这些关系存在独特的挑战和紧张局面。为了实现指导在医学教育中的前景,我们必须了解如何构建指导关系以优化住院医师的发展。本研究的目的是探讨住院医师对有效临床教师-住院医师(CT-R)指导关系关键特征的看法。

方法

我们在加拿大一个学术中心对住院医师进行了四次焦点小组讨论和八次访谈。采用社会建构主义方法,对焦点小组讨论和访谈进行录音、逐字转录并进行主题分析。

结果

住院医师描述了有助于建立有效CT-R指导关系的三个主要特征:安全、有意义和协作。住院医师强调,这些特征在本质上需要是双向的才能最有效,即住院医师和临床教师都体现这些特征。

结论

住院医师认为,有效的指导关系不仅受临床教师行为的影响,重要的是,还受所培养的人际关系质量的影响。因此,在努力促进住院医师发展时,必须考虑CT-R指导关系的双向性质。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bd4/9297249/ca59762452ac/CMEJ-13-005-g001.jpg

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