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探索高年级医学生对性别与疼痛认知的研究:正式与隐性课程之间相互作用的定性研究。

Exploring the perceptions of senior medical students on gender and pain: a qualitative study of the interplay between formal and hidden curricula.

机构信息

School of Medicine, Newcastle University, Newcastle upon Tyne, UK

School of Medical Sciences, The University of Manchester, Manchester, UK.

出版信息

BMJ Open. 2024 Aug 30;14(8):e080420. doi: 10.1136/bmjopen-2023-080420.

Abstract

OBJECTIVE

Explore the perceptions of senior medical students on the relationship between gender and pain and examine how formal and hidden curricula in medical education shape their experiences.

DESIGN

We conducted a cross-sectional qualitative interview study, using individual semistructured interviews and adhering to interpretative description methodology. We used Braun and Clarke's reflexive approach to thematic analysis to analyse our data.

SETTING

Six medical schools across the UK. Data collection occurred between the autumn of 2022 and the spring of 2023.

PARTICIPANTS

14 senior (penultimate or final year) medical students.

RESULTS

We created three themes, which describe key educational forces shaping students' experiences of the relationship between gender and pain. These are (1) the sociocultural influencer, (2) the pedagogical influencer and (3) the professorial influencer. Our findings highlight the influence of both wider societal norms and students' own identities on their experiences. Further, we explore the nature and detrimental role of formal curricular gaps, and negative role modelling as a key mechanism by which a hidden curriculum relating to gender and pain exerts its influence.

CONCLUSIONS

These findings have several educational implications, including the need for a more holistic, person-centred approach to pain management within medical school curricula. Additionally, we recommend the creation of reflective spaces to engage students in critical thinking around bias and advocacy from the early stages of their training. We present actionable insights for medical educators to address issues of gender bias and pain management.

摘要

目的

探讨高年级医学生对性别与疼痛关系的看法,并研究医学教育中的正式和隐性课程如何影响他们的体验。

设计

我们进行了一项横断面定性访谈研究,采用个体半结构化访谈,并遵循解释性描述方法。我们使用 Braun 和 Clarke 的反思方法进行主题分析来分析我们的数据。

地点

英国六所医学院校。数据收集于 2022 年秋季至 2023 年春季之间进行。

参与者

14 名高年级(倒数第二年或最后一年)医学生。

结果

我们创建了三个主题,描述了影响学生对性别与疼痛关系体验的关键教育力量。这些主题是(1)社会文化影响者,(2)教学影响者和(3)教授影响者。我们的研究结果强调了社会规范和学生自身身份对他们体验的影响。此外,我们探讨了正式课程差距的性质和有害作用,以及负面榜样作为与性别和疼痛相关的隐性课程发挥其影响的关键机制。

结论

这些发现对医学教育具有若干教育意义,包括需要在医学院校课程中采用更全面、以人为本的方法来管理疼痛。此外,我们建议创建反思空间,让学生在培训早期就围绕偏见和倡导进行批判性思考。我们为医学教育工作者提供了可操作的见解,以解决性别偏见和疼痛管理问题。

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