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通过与患者教师建立纵向指导伙伴关系来促进医学生职业身份的形成。

Stimulating Medical Student Professional Identity Formation Through Mentored Longitudinal Partnerships With Patient Teachers.

作者信息

Busey Lydia, May Natalie, Martindale James R, Bradley Elizabeth B, Plews-Ogan Margaret, Kon Rachel H

出版信息

Acad Med. 2025 Apr 1;100(4):428-432. doi: 10.1097/ACM.0000000000005960. Epub 2024 Dec 23.

Abstract

PROBLEM

Longitudinal patient relationships can positively affect medical students' professional identity formation (PIF), understanding of illness, and socialization within medical practice, but a longitudinal integrated clerkship (LIC) model is not always feasible. The authors describe the novel Patient Student Partnership (PSP) program, which provides authentic roles for students in mentored longitudinal patient relationships while maintaining a traditional block clerkship model.

APPROACH

The PSP program at the University of Virginia School of Medicine pairs all matriculating medical students with a patient living with chronic illness to follow across multiple health care settings until graduation. The 4-year required program is rooted in the conceptual frameworks of PIF, experiential learning, and communities of practice. This program evaluation used survey data collected from the first full cohort of students (Class of 2022) at 5 timepoints during the initial 4 years of implementation (2018-2022).

OUTCOMES

At graduation, 152 students had completed the PSP program. Students' narrative responses on surveys indicated PSP participation helped them connect classroom learning to clinical practice, play meaningful roles in patient care, practice communication skills via electronic health records, and practice self-reflection about their future roles as physicians. On the survey administered as students approached graduation, 54/67 (80.6%) of responding students agreed or strongly agreed that the PSP program allowed them to observe the general trajectory of a patient's chronic illness and its impact on daily life.

NEXT STEPS

This initial evaluation demonstrates the feasibility of integrating a mentored longitudinal experience into an existing block curriculum. Future study of PIF development occurring during PSP activities is needed to explore whether the PSP program stimulates PIF in ways similar to LICs. Additionally, the authors plan to address variability in engagement between medical students and their patient teachers through further student and faculty development regarding role clarification.

摘要

问题

长期的医患关系能够对医学生的职业身份形成(PIF)、疾病理解以及医学实践中的社会化产生积极影响,但纵向整合见习(LIC)模式并非总是可行。作者介绍了新颖的患者-学生伙伴关系(PSP)项目,该项目在维持传统的集中见习模式的同时,为学生在长期指导的医患关系中提供了真实的角色。

方法

弗吉尼亚大学医学院的PSP项目将所有入学的医学生与一名慢性病患者配对,让学生在多个医疗环境中跟踪该患者直至毕业。这个为期四年的必修项目植根于职业身份形成、体验式学习和实践社区的概念框架。该项目评估使用了在实施的最初四年(2018 - 2022年)中从首批完整的学生群体(2022届)在5个时间点收集的调查数据。

结果

毕业时,152名学生完成了PSP项目。学生在调查中的叙述性回答表明,参与PSP项目帮助他们将课堂学习与临床实践联系起来,在患者护理中发挥有意义的作用,通过电子健康记录练习沟通技巧,并对自己未来作为医生的角色进行自我反思。在学生临近毕业时进行的调查中,54/67(80.6%)的回应学生同意或强烈同意PSP项目让他们观察到了患者慢性病的总体发展轨迹及其对日常生活的影响。

下一步

这一初步评估证明了将指导下的长期体验融入现有集中课程的可行性。需要对PSP活动期间发生的职业身份形成发展进行未来研究,以探索PSP项目是否以类似于LIC的方式促进职业身份形成。此外,作者计划通过进一步开展关于角色澄清的学生和教师发展活动,解决医学生与其患者教师之间参与度的差异问题。

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