Department of Medical Education, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, 04763, Seoul, Republic of Korea.
Department of Education, College of Educational Sciences, Yonsei University, 50 Yonsei-ro Seodaemun-gu, 03722, Seoul, Republic of Korea.
BMC Med Educ. 2024 Feb 15;24(1):150. doi: 10.1186/s12909-024-05115-9.
To improve the medical professionalism of medical students, it is essential to understand the dilemmas they face in various situations. This study explored the types and distribution of dilemmas Korean medical students encounter during their clinical clerkships. It then compared these with previous dilemma frameworks and identified the types and distribution of "complexity dilemmas," wherein two dilemma themes emerge in a single clinical situation.
The researchers organized and recorded a group discussion with 106 third-year medical students who had completed their clinical clerkships. These students participated in the discussion as part of an assignment, focusing on the dilemmas they encountered during their clerkships. For data analysis and visualization, the researchers employed the MAXQDA software program and utilized the template analysis method, a qualitative research methodology.
A total of seven dilemma themes and sixteen sub-themes were identified. The identity-related dilemma concerning student-doctors had the highest frequency. The themes "mismatch" and "Nun-chi" emerged as new additions not found in previous dilemma frameworks. The complexity dilemmas appeared in the sequence of "identity-dignity," "identity-abuse," and "identity-consent".
To navigate the unique dilemmas present within South Korea's clinical culture, several key issues need consideration: elevating the role of student-doctors, balancing the primary emphasis of educational hospitals on delivering medical services, and understanding interpersonal strategies, such as "Nun-chi".
为提高医学生的医学职业素养，了解他们在各种情况下所面临的困境至关重要。本研究旨在探讨韩国医学生在临床实习中所面临的困境类型和分布，并将其与以往的困境框架进行比较，同时还识别出了“复杂性困境”的类型和分布，即在单一临床情境中出现两个困境主题。
研究人员组织并记录了与已完成临床实习的 106 名三年级医学生进行的小组讨论。这些学生作为作业的一部分参与了讨论，重点是他们在实习中所遇到的困境。为了进行数据分析和可视化，研究人员使用了 MAXQDA 软件程序，并采用了模板分析方法，这是一种定性研究方法。
共确定了七个困境主题和十六个子主题。与学生医生身份相关的困境出现频率最高。“不匹配”和“Nun-chi”这两个主题是以前的困境框架中没有的新内容。复杂性困境依次出现“身份-尊严”、“身份-滥用”和“身份-同意”。
为了解决韩国临床文化中存在的独特困境，需要考虑几个关键问题：提升学生医生的角色、平衡教育医院对提供医疗服务的首要重视、以及理解人际策略，如“Nun-chi”。
