“患者即教师”——对本科医学生参与姑息治疗体验式学习项目的经验进行的主题分析。
"The patient as teacher" - thematic analysis of undergraduate medical students' experiences with an experiential learning project in palliative care.
机构信息
Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Pauwelstraße 30, Aachen, 52074, Germany.
Department of Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, USA.
出版信息
BMC Palliat Care. 2024 Oct 9;23(1):239. doi: 10.1186/s12904-024-01570-9.
BACKGROUND
Experiential learning holds high potential for medical students' education in palliative care. At RWTH Aachen University in Germany, medical students can participate in the course "The Patient as Teacher" offering a one-to-one exchange with a terminally ill patient over a period of several weeks complemented with four supervision sessions and writing of a reflective essay. The course had run from 2005 to 2020 before it was paused due to the Covid-19 pandemic. This study aimed to assess the course's value as a palliative care teaching tool by investigating students' motivation and experiences over the years 2005-2020.
METHODS
A stratified sample of 24 essays was taken from all submitted essays (n = 78), eight essays from the years 2005-2009, 2010-2014, and 2015-2020. Subsequently, a thematic analysis of the selected essays was conducted.
RESULTS
The students felt motivated by the opportunity to gain more experience in palliative care, to improve their communication skills and to decrease insecurities in interaction with terminally ill patients. They learned about the patient's biography and medical history, and encountered physical, psychological, social, and spiritual dimensions of living with a life-limiting disease. Moreover, they experienced relationship building and communication with a terminally ill patient outside their role as future doctors. Ultimately, they considered their participation as a beneficial experience on both a personal and professional level.
CONCLUSIONS
The course "The Patient as Teacher" presents a valuable tool for experiential learning in palliative care, which has elicited an unceasingly positive response among the students who participated over the years. It has facilitated medical students in overcoming insecurities in dealing with terminally ill patients and supported them in further developing their professional identity.
背景
体验式学习在医学学生的姑息治疗教育中具有很高的潜力。在德国亚琛工业大学，医学生可以参加“患者作为老师”课程，与一名绝症患者进行为期数周的一对一交流，并辅以四次监督会议和一篇反思性文章的撰写。该课程从 2005 年运行到 2020 年，随后因 COVID-19 大流行而暂停。本研究旨在通过调查学生在 2005-2020 年期间的动机和经验，评估该课程作为姑息治疗教学工具的价值。
方法
从提交的所有文章中抽取了 24 篇文章的分层样本（n=78），其中 8 篇来自 2005-2009 年、2010-2014 年和 2015-2020 年。随后，对选定的文章进行了主题分析。
结果
学生们感到有机会在姑息治疗方面获得更多经验、提高沟通技巧以及减少与绝症患者互动时的不安全感，这使他们感到很有动力。他们了解了患者的传记和病史，并遇到了患有绝症的身体、心理、社会和精神方面的问题。此外，他们还与绝症患者建立了关系并进行了沟通，而不仅仅是作为未来医生的角色。最终，他们认为自己的参与在个人和专业层面都是有益的经验。
结论
“患者作为老师”课程是姑息治疗体验式学习的一个有价值的工具，多年来一直受到学生的积极响应。它帮助医学生克服了与绝症患者打交道时的不安全感，并支持他们进一步发展自己的专业身份。
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