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理解医学生在实习教育中的转变和发展:一项使用扎根理论的定性研究。

Understanding medical students' transition to and development in clerkship education: a qualitative study using grounded theory.

机构信息

Department of Medical Education, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.

Department of Medical Education, College of Medicine, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea.

出版信息

BMC Med Educ. 2024 Sep 3;24(1):910. doi: 10.1186/s12909-024-05778-4.

Abstract

BACKGROUND

Medical students perceive the transition to clerkship education as stressful and challenging and view themselves as novices during their rotation in clerkship education. The developmental perspective is thus important because the transition to clerkship supports rather than hinders growth. Accordingly, this study examines medical students' transition to clerkship and their developmental features.

METHODS

In-depth interviews were conducted with 18 medical students or graduates who had completed clerkships as medical students. Based on Straussian grounded theory, the collected data were analyzed in terms of the differences between pre- and post-clerkship education.

RESULTS

Our data analysis revealed five stages of the transition process: "anticipation and anxiety," "reality check," "seeking solutions," "practical application," and "transition and stability." The core category, that is, "growing up from being students to being student doctors," was driven by patients who perceived the participants as student doctors. Meanwhile, the participants recognized that having a solution that is agreed upon by colleagues was more important than knowing the correct answer. The participants undergoing the transition to clerkship showed developmental features divided into three categories: personal, social, and professional. Specifically, they attempted to balance clerkship and life through personal development, learned to navigate around the hospital and reduced tension through social development, and developed clinical competencies focused on efficiency through professional development.

CONCLUSIONS

This study explores the process of students' transition to clerkship education and the developmental features that emerge during this period. The students were motivated by patients who perceived them as student doctors. Through the transition, they maintained a work-life balance and adapted to hospitals but developed an overly doctor-centered attitude by cultivating clinical competencies with a focus on efficiency. To develop them into medical professionals, it is essential to assist their transition and cultivate a patient-centered attitude.

摘要

背景

医学生认为从基础医学教育过渡到实习教育是有压力和具有挑战性的,并且在实习教育轮转期间将自己视为新手。发展的视角因此很重要,因为向实习的过渡是支持而不是阻碍成长。因此,本研究检查了医学生向实习的过渡及其发展特征。

方法

对 18 名已经完成实习的医学生或毕业生进行了深入访谈。基于施特劳斯扎根理论,根据实习前后教育的差异对收集到的数据进行了分析。

结果

我们的数据分析揭示了过渡过程的五个阶段:“预期和焦虑”、“现实检查”、“寻求解决方案”、“实际应用”和“过渡和稳定”。核心类别,即“从学生成长为学生医生”,是由将参与者视为学生医生的患者推动的。同时,参与者认识到,获得同事认可的解决方案比知道正确答案更重要。经历实习过渡的参与者表现出三个类别的发展特征:个人、社会和专业。具体而言,他们试图通过个人发展来平衡实习和生活,通过社会发展学会在医院中周旋并减少紧张感,以及通过专业发展发展以效率为重点的临床能力。

结论

本研究探讨了学生向实习教育过渡的过程以及在此期间出现的发展特征。促使学生过渡的是将他们视为学生医生的患者。通过过渡,他们保持了工作与生活的平衡并适应了医院,但通过培养以效率为重点的临床能力发展出了一种过于以医生为中心的态度。为了将他们培养成医学专业人员,必须协助他们过渡并培养以患者为中心的态度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/028c/11370017/f4049cd468f1/12909_2024_5778_Fig1_HTML.jpg

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