Tang Joyce W, Kostas Tia, Verma Anshu, Press Valerie G, Kushner Josef, Gier Nicole, Wiklund Lauren O, Arora Vineet M, Farnan Jeanne, Meltzer David O
Section of Hospital Medicine, University of Chicago, Chicago, IL.
Section of Geriatrics, University of Chicago, Chicago, IL.
J Patient Cent Res Rev. 2022 Oct 18;9(4):290-297. doi: 10.17294/2330-0698.1930. eCollection 2022 Fall.
Longitudinal patient-partnered experiences may promote medical student empathy, but evaluation of such programs is limited. The aim of this study was to compare areas of learning among first-year medical students randomized to a patient-centered track (PCT) or traditional track (TT) longitudinal clinical experience.
PCT students (n=24) were paired with 2 patients and a physician to participate in their patients' care across multiple settings. TT students (n=56) were paired with a physician preceptor and participated in caring for a variety of patients in a single setting. This qualitative study used a phenomenological approach to template analysis, examining and comparing student reflective essays for areas of learning.
Three domains of learning emerged: 1) Focus of learning (biomedical, patient-centered); 2) Roles and relationships (clinical skills, relationship-building, teaching from preceptor and patients); and 3) Context of care (health systems science, interprofessional care). PCT students described patient-centered learning, relationship-building, and patients' role as teachers. In contrast, TT students emphasized biomedical learning, clinical skills development, and teaching from physician preceptors.
Longitudinal patient-partnered clinical experiences provide rich opportunities for preclinical students to cultivate empathy and develop patient-centered values.
患者与学生长期合作的经历可能会促进医学生的同理心，但对此类项目的评估有限。本研究的目的是比较随机分配到以患者为中心的轨道（PCT）或传统轨道（TT）纵向临床经验的一年级医学生的学习领域。
PCT组学生（n = 24）与2名患者和1名医生配对，在多个环境中参与其患者的护理。TT组学生（n = 56）与一名带教医生配对，在单一环境中参与照顾各种患者。这项定性研究采用现象学方法进行模板分析，检查和比较学生的反思性文章以确定学习领域。
出现了三个学习领域：1）学习重点（生物医学、以患者为中心）；2）角色和关系（临床技能、关系建立、带教医生和患者的教导）；3）护理背景（卫生系统科学、跨专业护理）。PCT组学生描述了以患者为中心的学习、关系建立以及患者作为教师的角色。相比之下，TT组学生强调生物医学学习、临床技能发展以及带教医生的教导。
患者与学生长期合作的临床经验为临床前学生培养同理心和形成以患者为中心的价值观提供了丰富的机会。
