Thind Kanwarabijit, Bauer Patrick, Titus Hilary, Niess Meredith, Hasan Reem
Oregon Health & Science University.
University of Utah.
MedEdPublish (2016). 2021 May 24;10:142. doi: 10.15694/mep.2021.000142.1. eCollection 2021.
This article was migrated. The article was marked as recommended. The purpose of this study was to investigate the impact of early longitudinal preceptorship experiences on the evolution of general self-efficacy and patient-centeredness self-efficacy through medical school. Validated surveys for general self-efficacy and patient-centeredness self-efficacy were administered in an allopathic medical school at three timepoints. These data were stratified by traditional and longitudinal preceptorship groups and analyzed using Generalized Estimating Equations. Qualitative analysis of narrative medicine essays by the same cohort during their preceptorship experiences was also performed. While general self-efficacy remained largely unchanged over time, patient-centeredness self-efficacy measures increased throughout medical school in the whole cohort (N=157). The longitudinal preceptorship group had higher gains in patient-centeredness self-efficacy, especially in the domain of exploring patient perspectives (p<0.05). The qualitative analysis of narrative medicine essays showed those in longitudinal preceptorships were more likely to discuss health care systems issues, consider psychosocial factors, and perceive themselves as active members of the care team. Our study indicates greater patient-centeredness attitudes over time among students who have early longitudinal experiences, perhaps due to the self-efficacy building nature of these experiences. Our research suggest that medical school programs should consider incorporating opportunities for early longitudinal clinical experiences for their students.
本文已迁移。该文章被标记为推荐文章。本研究的目的是调查早期纵向导师指导经历对医学院校学生一般自我效能感和以患者为中心的自我效能感发展的影响。在一所全科医学院校的三个时间点对一般自我效能感和以患者为中心的自我效能感进行了有效调查。这些数据按传统导师指导组和纵向导师指导组进行分层，并使用广义估计方程进行分析。还对同一队列在导师指导经历期间的叙事医学文章进行了定性分析。虽然一般自我效能感随时间基本保持不变，但整个队列（N = 157）的以患者为中心的自我效能感测量值在医学院校期间有所增加。纵向导师指导组在以患者为中心的自我效能感方面有更高的提升，尤其是在探索患者观点的领域（p<0.05）。叙事医学文章的定性分析表明，参与纵向导师指导的学生更有可能讨论医疗保健系统问题、考虑心理社会因素，并将自己视为护理团队的积极成员。我们的研究表明，随着时间的推移，有早期纵向经历的学生对以患者为中心的态度更强，这可能是由于这些经历具有自我效能感培养的性质。我们的研究表明，医学院校课程应考虑为学生提供早期纵向临床经历的机会。
