Longitudinal Integrated Clerkships, empathy and patient centredness: A prospective cohort study.

IF 3.3 2区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Medical Teacher Pub Date : 2024-12-09 DOI:10.1080/0142159X.2024.2430362

Alastair Dodsworth, Hugh Alberti, David A Hirsh, Paul Paes, Jan Illing

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Abstract

Purpose: Ethical erosion literature describes medical students' patient centredness and empathy declines through their clinical years of training. Longitudinal Integrated Clerkships (LICs), an alternate clinical educational design, have been hypothesised to reduce ethical erosion. The authors aimed to measure change in medical students' patient centredness and empathy at an institution with the largest LIC worldwide.

Method: Two whole LIC cohorts (LIC1 and LIC2) were invited to complete a questionnaire, which included patient centredness and empathy scales. Students completed the questionnaire at the start and end of each academic year. Block-rotation students (Non-LIC) were a comparator cohort. Complete cases data were analysed.

Results: 22 Non-LIC, 66 LIC1 and 33 LIC2 students responded. Non-LIC students experienced a significant decline in empathy ([start] 113.14 vs. [end] 102.68, p<.001). Empathy did not significantly decline in the LIC cohorts. Patient centredness in LIC1 and LIC2 grew and reduced in the Non-LIC cohort, however, these changes were not statistically significant.

Conclusions: This study supports the hypothesis LICs may reduce ethical erosion when compared to block-rotation placements. The results provide evidence that ethical erosion occurs in students who have completed block-rotation placements. This is the first study of UK-based medical students measuring empathy and patient centredness following completion of an LIC.

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目的：伦理侵蚀文献描述了医学生在临床训练中以病人为中心和同理心的下降。纵向综合见习（LICs）是另一种临床教育设计，被认为可以减少道德侵蚀。作者旨在测量医学生在世界上最大的医疗机构中以病人为中心和同理心的变化。方法：对LIC1和LIC2两组患者进行问卷调查，问卷内容包括以患者为中心和共情量表。学生们在每学年开始和结束时完成调查问卷。分组轮换学生（Non-LIC）是一个比较队列。对完整病例资料进行分析。结果：非lic学生22人，LIC1学生66人，LIC2学生33人。非廉租房学生的共情能力显著下降（[start] 113.14 vs. [end] 102.68, p）。结论：本研究支持廉租房与廉租房相比可以减少道德侵蚀的假设。结果提供了证据，证明道德侵蚀发生在完成了街区轮换安置的学生身上。这是英国医学生在完成LIC后测量同理心和以病人为中心的第一项研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Teacher 医学-卫生保健

CiteScore

7.80

自引率

8.50%

发文量

396

审稿时长

3-6 weeks

期刊介绍： Medical Teacher provides accounts of new teaching methods, guidance on structuring courses and assessing achievement, and serves as a forum for communication between medical teachers and those involved in general education. In particular, the journal recognizes the problems teachers have in keeping up-to-date with the developments in educational methods that lead to more effective teaching and learning at a time when the content of the curriculum—from medical procedures to policy changes in health care provision—is also changing. The journal features reports of innovation and research in medical education, case studies, survey articles, practical guidelines, reviews of current literature and book reviews. All articles are peer reviewed.