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医学教育中职业认同形成干预措施的批判性评价

A Critical Review of Professional Identity Formation Interventions in Medical Education.

机构信息

G.R. Mount is associate professor, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: http://orcid.org/0000-0002-5265-2823 .

R. Kahlke is a scientist, McMaster Education Research, Innovation & Theory Program, and assistant professor, Division of Education & Innovation, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; ORCID: http://orcid.org/0000-0002-4473-5039 .

出版信息

Acad Med. 2022 Nov 1;97(11S):S96-S106. doi: 10.1097/ACM.0000000000004904. Epub 2022 Aug 9.

Abstract

PURPOSE

Professional identity formation (PIF) can be defined as the integration of the knowledge, skills, values, and behaviors of a profession with one's preexisting identity and values. Several different, and sometimes conflicting, conceptualizations and theories about PIF populate the literature; applying these different theories in PIF curricula and pedagogic strategies can profoundly impact the PIF of future physicians. The authors conducted a critical review of the recent literature on PIF interventions in medical education to explore the conceptualizations of and theoretical approaches to PIF that underlie them.

METHOD

The authors searched articles on PIF educational interventions published in 5 major medical education journals between 2010 and March 2021. The articles' context and findings were extracted, analyzed, and summarized to identify conceptualizations and theoretical approaches to PIF.

RESULTS

The authors identified 43 studies examining medical education interventions aimed at influencing PIF. The majority of the studies (n = 31) focused on undergraduate medical education. Reflective writing and the use of narrative reflections were the dominant modes of student activity in PIF interventions, supporting the dominant individualist approach to PIF. Less commonly PIF was understood as a socialization process or as an active process with both individually and socially focused influences.

CONCLUSIONS

Relying on reflective writing as the intervention of choice to impact PIF feeds the dominant individualist perspective on PIF. An unintended consequence of this individualist orientation is that cultural problems embedded in the profession can become burdens for individual physicians to personally bear. Future education and research into PIF should account for theoretical preferences and the impact of these preferences.

摘要

目的

专业身份形成(PIF)可以定义为将一个专业的知识、技能、价值观和行为与一个人预先存在的身份和价值观整合在一起。文献中存在几种不同的、有时甚至相互冲突的 PIF 概念化和理论;在 PIF 课程和教学策略中应用这些不同的理论可以深刻影响未来医生的 PIF。作者对医学教育中 PIF 干预的最新文献进行了批判性回顾,以探讨它们所依据的 PIF 的概念化和理论方法。

方法

作者搜索了 2010 年至 2021 年 3 月期间在 5 种主要医学教育期刊上发表的关于 PIF 教育干预的文章。提取、分析和总结文章的背景和发现,以确定 PIF 的概念化和理论方法。

结果

作者确定了 43 项研究,这些研究考察了旨在影响 PIF 的医学教育干预措施。大多数研究(n=31)侧重于本科医学教育。反思性写作和使用叙事反思是 PIF 干预中学生活动的主要模式,支持 PIF 的主导个人主义方法。不太常见的是,PIF 被理解为一个社会化过程,或者是一个具有个人和社会关注影响的积极过程。

结论

依赖反思性写作作为影响 PIF 的干预选择,强化了 PIF 的主导个人主义观点。这种个人主义倾向的一个意外后果是,嵌入专业中的文化问题可能成为个体医生个人承担的负担。未来关于 PIF 的教育和研究应该考虑理论偏好及其影响。

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