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反思作为医学生在临床实践中识别和解决性别偏见的工具:一项定性研究。

Reflexivity as a tool for medical students to identify and address gender bias in clinical practice: A qualitative study.

机构信息

Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.

Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.

出版信息

Patient Educ Couns. 2022 Dec;105(12):3521-3528. doi: 10.1016/j.pec.2022.08.017. Epub 2022 Aug 30.

Abstract

OBJECTIVES

Gender bias interferes with medical care for both men and women, leading to health inequalities. Reflexivity is used in medical education to improve health provision. This study aims to understand if a reflective approach integrated in medical practice enables raising awareness of gender bias during medical school teaching.

METHODS

We conducted this study in general ambulatory medicine in Lausanne Hospital, Switzerland with 160 Master's students. Through group discussions and reflection questionnaires, students were asked to discuss clinical cases they encountered focusing on potential gender bias. We analyzed the data using a thematic analysis approach.

RESULTS

The reflection on the clinical reasoning steps from a real case identified gender bias at each stage of the clinical case management. The analysis revealed two factors that facilitated gender reflexivity: guidance from a gender expert and peer-to-peer exchange.

CONCLUSIONS

Our study shows that a reflective approach integrated in medical practice enables raising awareness of gender bias during medical teaching. It provides students with a systematic method they can apply in their future clinical work, thus improving care processes and experiences towards more equitable care.

PRACTICE IMPLICATIONS

All gender and medicine curricula should include teaching such as this linking theory and practice through reflexivity.

摘要

目的

性别偏见会干扰男女双方的医疗服务,导致健康不平等。反思被用于医学教育中,以改善医疗服务。本研究旨在了解在医学实践中整合反思方法是否能够提高医学生教学中对性别偏见的认识。

方法

我们在瑞士洛桑医院的普通门诊医学中进行了这项研究,共有 160 名硕士学生参与。通过小组讨论和反思问卷,要求学生讨论他们遇到的临床病例,重点关注潜在的性别偏见。我们使用主题分析方法对数据进行分析。

结果

对真实案例的临床推理步骤进行反思,确定了在临床病例管理的每个阶段都存在性别偏见。分析揭示了促进性别反思的两个因素:性别专家的指导和同伴交流。

结论

我们的研究表明,在医学实践中整合反思方法可以在医学教学中提高对性别偏见的认识。它为学生提供了一种系统的方法,他们可以在未来的临床工作中应用,从而改善护理流程和体验,实现更公平的护理。

实践意义

所有性别与医学课程都应包括这种教学,通过反思将理论与实践联系起来。

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