运用快速团队学习理解医学职业精神:一项基于案例的定性研究。

Understanding medical professionalism using express team-based learning; a qualitative case-based study.

机构信息

School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain.

College of Medicine, Clinical Sciences Department, University of Sharjah, Sharjah, UAE.

出版信息

Med Educ Online. 2023 Dec;28(1):2235793. doi: 10.1080/10872981.2023.2235793.

Abstract

Medical Professionalism (MP) defined as values, behaviours and attitudes that promote professional relationships, public trust and patient safety is a vital competency in health profession education. MP has a distinctive uniqueness due to cultural, contextual, conceptual, and generational variations. There is no standard instructional strategy to probe the understanding of MP in a cohesive, structured, interactive manner. This study aimed to investigate undergraduate medical students' understanding of MP using express team-based learning (e-TBL) at both campuses of Royal College of Surgeons Ireland (RCSI). Using the key principles of a sociocultural theoretical lens in adult learning theory, we designed e-TBL as a context-learning-based educational strategy. We conducted three e-TBL sessions on cross-cultural communication and health disparities, a reflective report on clinical encounters, and professionalism in practice. We collected, collated, and analyzed the student experiences qualitatively using data gathered from team-based case discussions during e-TBL sessions. A dedicated working group developed very short-answer questions for the individual readiness assurance test (IRAT) and MP-based case scenarios for team discussions. In this adapted 4-step e-TBL session, pre-class material was administered, IRAT was undertaken, and team-based discussions were facilitated, followed by facilitator feedback. A qualitative inductive thematic analysis was performed, which generated subthemes and themes illustrated in excerpts. Our thematic analysis of data from 172 students (101 from Bahrain and 71 from Dublin) yielded four unique themes: incoming professional attitudes, transformative experiences, sociological understanding of professionalism, and new professional identity formation. This qualitative study provides a deeper understanding of medical students' perceptions of medical professionalism. The generated themes resonated with divergent and evolving elements of MP in an era of socioeconomic and cultural diversity, transformative experiences, and professional identity formation. The core elements of these themes can be integrated into the teaching of MP to prepare fit-to-practice future doctors.

摘要

医学专业精神(MP)是指促进专业关系、公众信任和患者安全的价值观、行为和态度,是卫生专业教育的重要能力。由于文化、背景、概念和代际的差异,MP 具有独特的特点。目前还没有一种标准的教学策略可以以连贯、结构化和互动的方式探究学生对 MP 的理解。本研究旨在通过爱尔兰皇家外科医学院(RCSI)两个校区的表达团队学习(e-TBL)来调查医学生对 MP 的理解。我们使用成人学习理论中的社会文化理论视角的关键原则,将 e-TBL 设计为一种基于情境学习的教育策略。我们进行了三次 e-TBL 课程,分别是跨文化交流和健康差距、临床接触的反思报告以及实践中的专业精神。我们使用从 e-TBL 课程的团队案例讨论中收集的数据,从定性的角度收集、整理和分析学生的经验。一个专门的工作组为个人准备保证测试(IRAT)和基于 MP 的案例情景开发了非常简短的答案,用于团队讨论。在这个改编的 4 步 e-TBL 课程中,先进行课前材料,然后进行 IRAT,再进行团队讨论,并由导师提供反馈。我们对 172 名学生(101 名来自巴林,71 名来自都柏林)的数据进行了定性归纳主题分析,生成了子主题和主题示例。我们对数据的主题分析产生了四个独特的主题:新的职业态度、转型经历、对专业精神的社会学理解和新的职业身份形成。这项定性研究更深入地了解了医学生对医学专业精神的看法。生成的主题与在社会经济和文化多样性、转型经历和职业身份形成的时代中,MP 的不同和不断发展的元素产生共鸣。这些主题的核心要素可以整合到 MP 的教学中,为未来实践做好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3874/10355686/6e4422319a3f/ZMEO_A_2235793_F0001_B.jpg

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