Faculdade de Medicina de Vassouras, Vassouras, Brazil.
Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
BMC Med Educ. 2024 Mar 8;24(1):259. doi: 10.1186/s12909-024-05186-8.
Teaching professionalism in medical schools is central to medical education and society. We evaluated how medical students view the values of the medical profession on their first day of medical school and the influence of a conference about the competences of this profession on these students' levels of reflection.
We studied two groups of medical students who wrote narratives about the values of the medical profession and the influence of the COVID-19 pandemic on these values. The first group wrote the narratives after a conference about the competences of the medical profession (intervention group), and the second group wrote the same narratives after a biochemistry conference (control group). We also compared the levels of reflection of these two groups of students.
Among the 175 medical students entering in the 2022 academic year, 159 agreed to participate in the study (response rate = 90.8%). There were more references to positive than negative models of doctor‒patient relationships experienced by the students (58.5% and 41.5% of responses, respectively). The intervention group referred to a more significant number of values than the control group did. The most cited values were empathy, humility, and ethics; the main competences were technical competence, communication/active listening, and resilience. The students' perspectives of the values of their future profession were strongly and positively influenced by the pandemic experience. The students realized the need for constant updating, basing medical practice on scientific evidence, and employing skills/attitudes such as resilience, flexibility, and collaboration for teamwork. Analysis of the levels of reflection in the narratives showed a predominance of reflections with a higher level in the intervention group and of those with a lower level in the control group.
Our study showed that medical students, upon entering medical school, already have a view of medical professionalism, although they still need to present a deeper level of self-reflection. A single, planned intervention in medical professionalism can promote self-reflection. The vision of medical professional identity was strongly influenced by the COVID-19 pandemic, positively impacting the formation of a professional identity among the students who decided to enter medical school.
医学院校的医学专业精神教学是医学教育和社会的核心。我们评估了医学生在入学第一天对医学职业价值观的看法，以及关于该职业能力的会议对这些学生反思水平的影响。
我们研究了两组医学生，他们分别就医学职业价值观和 COVID-19 大流行对这些价值观的影响撰写叙述。第一组在关于医学职业能力的会议后撰写叙述（干预组），第二组在生物化学会议后撰写叙述（对照组）。我们还比较了这两组学生的反思水平。
在 2022 学年入学的 175 名医学生中，有 159 名同意参与研究（应答率=90.8%）。学生们提到的医患关系正面模式比负面模式多（分别为 58.5%和 41.5%）。干预组比对照组提到的价值观更多。被引用最多的价值观是同理心、谦逊和道德；主要能力是技术能力、沟通/积极倾听和适应力。学生们对未来职业价值观的看法受到大流行经历的强烈积极影响。学生们意识到需要不断更新，以科学证据为基础开展医疗实践，并运用适应力、灵活性和团队合作等技能/态度。对叙述中反思水平的分析表明，干预组中较高水平的反思占主导地位，对照组中较低水平的反思占主导地位。
我们的研究表明，医学生在入学时已经对医学专业精神有了看法，尽管他们仍需要进行更深入的自我反思。医学专业精神方面的单次、有计划的干预可以促进自我反思。COVID-19 大流行强烈影响了医学专业身份的形成，积极影响了决定学医的学生的专业身份形成。
