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“成为资源是首要之事”:卫生专业人员支持实习生的职业抵抗行为。

"Being the resource is the number one thing": health professionals supporting trainees' professional acts of resistance.

作者信息

Ma TingLan, Chow Candace J, Nguyen Quang-Tuyen, Scarlett Emily, Wyatt Tasha R

机构信息

Department of Health Professions Education, Uniformed Services, University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD, 20814, USA.

Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA.

出版信息

BMC Med Educ. 2025 May 7;25(1):669. doi: 10.1186/s12909-025-07169-9.

Abstract

PURPOSE

In health professions education (HPE), trainees' resistance against structural harm and social injustice has gained prominence. However, understanding faculty perspectives on supporting such resistance remains limited. This study delves into how HPE faculty conceptualize and support trainees' resistance efforts, exploring boundaries, rationales, and strategies.

METHOD

Using constructivist grounded theory, we interviewed 24 faculty members in HPE, including medicine, nursing, pharmacy, and physician assistant. Data were analyzed using open, focused coding, and constant comparative methods. We also drew from conceptual frameworks including tempered radicals and personal space theory to help understand faculty's conceptualization of boundaries.

RESULTS

We organized the data into four themes. While most HPE faculty acknowledge the importance of supporting trainees, they hold divergent views regarding when to offer such support and how trainees should engage in acts of resistance. We identify four common boundaries-patient safety, professionalism, professional consequences, and personal safety-that influence faculty considerations. within these boundaries, various supporting strategies were employed, including affirming, building mindset against tokenism, and minimizing DEI performative action.

CONCLUSIONS

These findings highlight the dual role of faculty in balancing professional standards while fostering a space for trainees' work, which offer insights for trainees to realign their resistance efforts with these boundaries.

摘要

目的

在卫生专业教育(HPE)中,学员对结构性伤害和社会不公的抵制日益受到关注。然而,对于教师在支持这种抵制方面的观点了解仍然有限。本研究深入探讨了HPE教师如何概念化并支持学员的抵制努力,探索其界限、理由和策略。

方法

采用建构主义扎根理论,我们采访了24位HPE领域的教师,包括医学、护理、药学和医师助理专业的教师。使用开放式编码、聚焦编码和持续比较法对数据进行分析。我们还借鉴了包括温和激进派和个人空间理论在内的概念框架,以帮助理解教师对界限的概念化。

结果

我们将数据整理为四个主题。虽然大多数HPE教师承认支持学员的重要性,但他们在何时提供这种支持以及学员应如何进行抵制行为方面存在不同观点。我们确定了影响教师考量的四个常见界限——患者安全、专业精神、职业后果和个人安全。在这些界限内,采用了各种支持策略,包括肯定、培养反对形式主义的思维方式以及尽量减少多元化、公平与包容的表面行动。

结论

这些发现凸显了教师在平衡专业标准的同时为学员的工作营造空间的双重作用,为学员调整其抵制努力以符合这些界限提供了见解。

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