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培养医护性别不一致患者的医学职业精神:医学生在经历了与性别不一致者及其盟友的课程后反思。

Developing medical professionalism in care of gender nonconforming patients: Reflections of second-year medical students after a curricular experience with gender nonconforming people and allies.

机构信息

Veterinary Administration Department, Purdue University, West Lafayette, IN, USA.

Center for Intercultural Learning, Mentorship, Assessment and Research Purdue University, West Lafayette, IN, USA.

出版信息

Med Teach. 2023 Sep;45(9):984-990. doi: 10.1080/0142159X.2023.2197136. Epub 2023 Apr 17.

Abstract

INTRODUCTION

Negative healthcare experiences persist for gender nonconforming individuals. Clinician-related factors, including lack of comfort with gender nonconforming persons and unexamined personal biases, present barriers to equitable and affirming healthcare. We explored the effects of contact with gender nonconforming individuals in preclinical medical education through a structured curricular intervention designed to build medical and humanistic knowledge and stimulate the development of medical professionalism surrounding the care of gender nonconforming individuals.

METHODS

A curricular module (didactic prework, time-synchronous online panel discussion, and post-event written reflection) was implemented in a second-year preclinical course in a large multi-campus Midwestern medical school. The module was based on pedagogical foundations of contact theory and reflective writing. Post-event written reflections were investigated using thematic analysis.

RESULTS

Analysis of 355 written reflections revealed three major themes (moments of insight, topics of confusion, connections to professional identity formation) and eight sub-themes. The findings demonstrated emerging gender professionalism and the importance of contact in professional development.

DISCUSSION

Contact with gender nonconforming people and the use of written reflections can encourage self-examination and foster professional identity formation among preclinical medical students. Modeling gender-affirming approaches may help counteract negative cultural messages about gender nonconforming people, aiding development of inclusive future physicians.

摘要

引言

性别不一致的个体仍存在负面的医疗体验。与临床医生相关的因素,包括对性别不一致的人缺乏舒适感和未经审视的个人偏见,是实现公平和支持性医疗的障碍。我们通过一项旨在构建医学和人文知识、激发围绕性别不一致个体护理的医学职业精神发展的结构化课程干预,探讨了在临床前医学教育中与性别不一致个体接触的影响。

方法

在一所中西部大型多校区医学院的二年级临床前课程中实施了一个课程模块(理论预修、同步在线小组讨论和事件后书面反思)。该模块基于接触理论和反思性写作的教学基础。使用主题分析方法对事件后书面反思进行了调查。

结果

对 355 份书面反思的分析揭示了三个主要主题(顿悟时刻、困惑主题、与专业身份形成的联系)和八个子主题。研究结果表明,性别专业精神的出现以及接触在专业发展中的重要性。

讨论

与性别不一致的人接触并使用书面反思可以鼓励临床前医学生进行自我检查,并促进其专业身份的形成。对性别肯定方法的示范可能有助于抵消关于性别不一致的人的负面文化信息,帮助培养包容的未来医生。

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