Clinical Teacher最新文献_第6页

Experience informed procedural skills training 经验丰富的程序技能培训。

IF 1.8 Q1 Nursing

Clinical Teacher

Pub Date : 2024-01-04 DOI: 10.1111/tct.13719

Daniel Loeb MD, MEd, Andrew Lautz MD, Jacob Fleck, Matthew Zackoff MD, MEd

Background

Paediatric critical care (PCC) physicians must perform several emergent procedures independently and competently—requiring transition from novice to competent over a 3-year fellowship. However, skill acquisition is not uniform. Individualised training, adapted to the unique experiences and requirements of each trainee, may enhance competency.

Approach

An individualised, longitudinal critical procedure course was initiated at a large academic paediatric medical centre in July 2022 for PCC fellows (n = 5). The course, informed by procedural performance profiles (P3) generated through real-time clinical assessments in the paediatric intensive care unit (PICU), was split into three phases: (1) an Initial Simulation Bootcamp—a 2-day introductory session; (2) Quarterly Structured Booster Sessions (QSBS)—spaced repetition of deliberate practice training individualised to each fellow; and (3) an Annual Refresher Training—a core skills and advanced technique training day.

Evaluation

Fellows began with minimal experience, which formed their initial P3s. Ninety-two percent (166/180) of bedside procedures received real-time feedback, enabling longitudinal P3 modification, which identified focus areas for the QSBS. The sessions were well attended and received. Eighty-nine percent (QSBS #1 5/5, QSBS #2 3/4) of respondents reflected positively on the course's impact on procedural understanding. The course was perceived as more effective than traditional modalities, except bedside training.

Implication

Implementation of a spaced repetition, deliberate practice course informed by longitudinally tracked real-life performance data is feasible for educators and preferred by trainees. This educational construct can be applied to other clinical skills, bringing precision medicine approach to training.

背景：儿科重症监护（PCC）医生必须独立、胜任地完成几项紧急手术，这就要求他们在 3 年的实习期内从新手过渡到胜任者。然而，技能的掌握并不统一。根据每位受训者的独特经历和要求进行个性化培训，可以提高他们的能力：方法：2022 年 7 月，一家大型学术儿科医疗中心为 PCC 学员（n = 5）开设了个性化的纵向关键程序课程。该课程以儿科重症监护室（PICU）实时临床评估生成的手术表现档案（P3）为依据，分为三个阶段：（1）初始模拟训练营--为期两天的入门课程；（2）季度结构化强化课程（QSBS）--针对每位研究员的有间隔重复的刻意练习训练；以及（3）年度进修培训--核心技能和高级技术培训日：学员们从最基本的经验开始，这形成了他们最初的 P3。92%（166/180）的床旁手术得到了实时反馈，从而对 P3 进行了纵向修改，确定了 QSBS 的重点领域。这些会议得到了广泛的参与和好评。89% 的受访者（QSBS #1 5/5，QSBS #2 3/4）对课程对程序理解的影响给予了积极评价。除床边培训外，该课程被认为比传统模式更有效：启示：以纵向追踪的真实表现数据为依据，实施间隔重复、刻意练习课程，对教育者来说是可行的，也是受训者的首选。这种教育结构可应用于其他临床技能，为培训带来精准医学方法。

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引用次数: 0

Exemplar or facilitator: An exploration of the lived experience of nurse mentors supporting the adaptation of internationally educated nurses 榜样还是促进者：探索护士导师支持受过国际教育的护士适应环境的生活经验。

IF 1.8 Q1 Nursing

Clinical Teacher

Pub Date : 2024-01-02 DOI: 10.1111/tct.13702

Carly Smith, Peter Cantillon

Introduction

Deficits in nursing workforces have led to major increases in overseas recruitment in many countries. Internationally educated nurses recruited within Ireland must complete an adaptation programme before they can practice nursing, a process contingent on the support from nurse mentors. However, it is becoming progressively difficult to identify nurses willing to act as mentors, threatening viability of overseas nurse recruitment. This research set out to address this problem by exploring the lived experiences of nurse mentors during the adaptation programme.

Methods

An interpretative phenomenological analysis research design was utilised to explore the experiences of nurse mentors. Semi-structured interviews were conducted with a maximum variance sample of 11 nurse mentors. The data were subjected to an Interpretive Phenomenological Analysis (IPA) sequential analytical approach yielding integrative themes.

Results

The lived experiences of participants coalesced into three conceptual themes, mentor identity, sustainability, and learner socialisation. Participants who self-identified as ‘mentor exemplars’ expressed more negative perceptions of the role when compared with nurses who positioned themselves as ‘mentor facilitators’. Nurse mentors were challenged by the complexities of intercultural dissonance and insufficient time and training for their mentoring role because of the pressures of clinical service.

Conclusion

Although mentorship is essential for the integration of internationally educated nurses, the sustainability of the mentorship role is contingent on how it is supported through training and protected within busy clinical environments. Critically, nurse mentors need to learn how to conceptualise their role as one of facilitating the development of others rather than presenting themselves as exemplary role models.

导言：护理人员短缺导致许多国家大量增加海外招聘。在爱尔兰招聘的受过国际教育的护士必须完成一项适应计划，然后才能从事护理工作，这一过程取决于护士导师的支持。然而，越来越难找到愿意担任导师的护士，这威胁到海外护士招聘的可行性。本研究旨在通过探索护士导师在适应计划期间的生活经历来解决这一问题：方法：采用解释性现象学分析研究设计来探讨护士导师的经历。研究人员对 11 名护士导师进行了半结构式访谈，并对访谈样本进行了最大方差分析。对数据进行了解释性现象学分析（IPA）顺序分析法，得出了综合主题：结果：参与者的生活经验凝聚成三个概念性主题：导师身份、可持续性和学习者社会化。与将自己定位为 "导师促进者 "的护士相比，自我认同为 "导师典范 "的参与者对导师角色表达了更多负面看法。由于临床服务的压力，护士导师面临着跨文化失调的复杂性以及没有足够的时间和培训来履行其导师职责的挑战：尽管导师制对接受过国际教育的护士的融入至关重要，但导师角色的可持续性取决于如何通过培训来支持导师，以及如何在繁忙的临床环境中保护导师。至关重要的是，护士导师需要学习如何将自己的角色概念化为促进他人发展的角色，而不是将自己树立为模范榜样。

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引用次数: 0

Medical student motivation in specialised contexts 专业背景下医学生的学习动机。

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2023-12-30 DOI: 10.1111/tct.13717

Stacey M. Frumm, Sam Brondfield

Purpose

During their clinical years, medical students rotate in diverse environments, each with unique factors motivating or demotivating learning. Student motivation to learn in specialised clinical settings has not been robustly described. One framework to understand motivation to learn is self-determination theory (SDT), which posits that intrinsic motivation requires fulfilment of three innate psychological needs: competence, relatedness and autonomy. Referencing SDT, the authors aimed to understand factors influencing student motivation to learn in the specialised context of internal medicine (IM) subspecialty consult services, with the goal of optimising teaching and learning during these experiences.

Method

Focus groups were conducted with 12 fourth-year medical students who had completed at least one inpatient IM subspecialty consult elective at the University of California, San Francisco, in 2020–2021. Students discussed factors that promoted and hindered their learning and motivation. The authors performed abductive thematic analysis using SDT as a sensitising framework.

Results

Three themes were identified and provided insight into how student motivation to learn can be supported: teaching at the appropriate level; integration into the team and workflow; and self-directed learning and career exploration. These themes were overlaid onto the needs of SDT, demonstrating that, in specialised clinical contexts, fulfilment of the needs is interconnected.

Conclusion

This study provided insight into how students' innate needs can be satisfied in the learning environment of IM subspecialty consult electives, thereby promoting students' intrinsic motivation. Based on insights from the study, the authors offer recommendations for how educators can optimise student motivation to learn.

目的：在临床学习期间，医科学生在不同的环境中轮转，每种环境都有独特的激励或抑制学习动机的因素。学生在专业临床环境中的学习动机尚未得到有力的描述。了解学习动机的一个框架是自我决定理论（SDT），该理论认为内在学习动机需要满足三种与生俱来的心理需求：能力、相关性和自主性。作者参考 SDT，旨在了解影响学生在内科（IM）亚专业咨询服务这一专业背景下学习动机的因素，目的是优化这些经历中的教学：与 12 名四年级医学生进行了焦点小组讨论，这些学生于 2020-2021 年在加州大学旧金山分校完成了至少一次住院内科亚专科会诊选修课。学生们讨论了促进和阻碍他们学习和动力的因素。作者使用 SDT 作为感性框架，进行了归纳主题分析：结果：作者确定了三个主题，并深入分析了如何支持学生的学习动机：适当水平的教学；融入团队和工作流程；自主学习和职业探索。这些主题与 SDT 的需求相重叠，表明在专门的临床环境中，需求的满足是相互关联的：本研究深入探讨了如何在 IM 亚专业咨询选修课的学习环境中满足学生的内在需求，从而促进学生的内在动力。根据研究结果，作者就教育者如何优化学生的学习动机提出了建议。

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引用次数: 0

How to … grow a team in clinical education research 如何......壮大临床教育研究团队。

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2023-12-20 DOI: 10.1111/tct.13718

Ana Da Silva, Sonia Bussey, Colin Macdougall, Hugh Alberti, Aaron M. Lett, Ray Samuriwo

The Incubator for Clinical Education Research (ClinEdR) is a UK-wide network, established with support from the National Institute for Health and Care Research (NIHR), to lead initiatives to build capacity in the field. Our lived experiences as members of the NIHR ClinEdR Incubator and wider literature are woven into this ‘How to …’ paper, which outlines what to consider as you seek to grow and develop a ClinEdR team. This paper sets out pragmatic steps to grow an effective ClinEdR team that has a wider impact and mutual benefits for its members and their institution(s). Growing a ClinEdR team requires more than a dynamic character to bring people together. In our view, you can grow a ClinEdR team with other people through a structured, well-thought-out approach, in which its members develop through collaborative work to achieve a shared objective.

临床教育研究孵化器（ClinEdR）是在英国国家健康与护理研究所（NIHR）的支持下建立的一个全英网络，旨在领导该领域的能力建设活动。作为 NIHR ClinEdR 孵化器的成员，我们的亲身经历和更广泛的文献被编入这篇 "如何...... "论文中，其中概述了在您寻求发展壮大 ClinEdR 团队时需要考虑的事项。本文提出了一些务实的步骤，以发展一个有效的 ClinEdR 团队，为其成员及其所在机构带来更广泛的影响和互惠互利。要发展一支 ClinEdR 团队，需要的不仅仅是将人们聚集在一起的活力。我们认为，您可以通过结构化、深思熟虑的方法，与其他人共同组建一支 ClinEdR 团队，让团队成员通过合作实现共同目标。

引用次数: 0

Preparedness for the transition to medical registrar from senior house officer—What's the problem? 从高级住院医师过渡到注册医师的准备工作--问题出在哪里？

IF 1.8 Q1 Nursing

Clinical Teacher

Pub Date : 2023-12-18 DOI: 10.1111/tct.13712

Eileen Shannon, Peter Cantillon

Introduction

Transitions in clinical training are a hallmark in medical trainee's careers. The transition from senior house officer (SHO) to the role of medical registrar is often viewed as one of the most challenging, but to date, there is little research exploring why the transition is proving problematic for so many learners. The aim of this study was to explore the experiences of trainees preparing to make this transition.

Methods

Using an interpretative phenomenological analysis (IPA) approach, this qualitative study employed semi-structured interviews to explore the lived experiences of transition in a purposive sample of trainees on the cusp of transition from SHO to registrar or who were in their first year of being a medical registrar. Interviews were recorded, transcribed verbatim and analysed using an IPA approach.

Results

Six trainees participated in this study, four of whom were currently in SHO positions, with the remaining two in their first year of medical registrar. Two main themes emerged from data—perception of the medical registrar and barriers in transition. The role of the medical registrar was perceived to represent a strong leadership role, with barriers created due to increasing expectations, lack of support and uncertainties regarding the job.

Conclusion

The role of the medical registrar is a challenging one, representing periods of uncertainty, increased expectations and reduced supports. Within this, there is potential to further support SHOs in transitioning to the role of medical registrar.

简介临床培训的过渡是医学培训生职业生涯的标志。从高级住院医师（SHO）到注册医师的角色转变通常被视为最具挑战性的转变之一，但迄今为止，很少有研究探讨为什么这一转变对如此多的学员来说是个问题。本研究旨在探讨准备过渡的学员的经历：本定性研究采用解释性现象学分析（IPA）方法，通过半结构式访谈，有目的性地抽样调查了处于从 SHO 过渡到注册医师边缘的受训人员或第一年成为注册医师的受训人员的过渡生活经历。我们对访谈进行了录音、逐字记录，并采用 IPA 方法对访谈结果进行了分析：六名受训人员参与了此次研究，其中四人目前担任 SHO 职务，其余两人则处于医学注册师的第一年。数据中出现了两大主题--对注册医师的看法和过渡中的障碍。医学注册官的角色被认为是一个强有力的领导角色，但由于对工作的期望越来越高、缺乏支持和不确定性而产生了障碍：医学注册医师的角色是一个具有挑战性的角色，代表着不确定性、期望增加和支持减少的时期。在这种情况下，有可能进一步支持 SHO 向注册医师的角色过渡。

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引用次数: 0

The Rubik's cube of doing and being: Factors influencing professional identity transition to the medical registrar 做事与做人的魔方：影响医学注册医师职业身份转变的因素

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2023-12-09 DOI: 10.1111/tct.13713

Joanne Kerins, Emma C. Phillips, Samantha E. Smith, Victoria R. Tallentire

Background

Professional identity transitions, such as the transition to medical registrar, are challenging. How minoritised identities influence transitions during medical training requires further study. This study aimed to explore the factors influencing the transition to the medical registrar in Scotland to guide support during training.

Methods

Interviews exploring this transition with internal medicine trainees were audio recorded, transcribed verbatim and double-coded using template analysis. We applied an initial coding template informed by multiple and multidimensional transition theory of individual, interpersonal, systemic and macro-level factors. Using a critical theory lens, a further template analysis specifically sought to understand how trainees' social identities interacted with the various levels.

Findings

Nineteen IM trainees were interviewed between January 2021 and February 2022. Influential factors reflected a parallel process of competence (doing) and identity (being) development. The interaction of social identities, such as gender (being a woman) and country of origin (being an international medical graduate), occurred across levels. This can be conceptualised as a Rubik's cube with the interplay between doing and being from an individual to a macro level with trainees' social identities interacting at all levels.

Conclusion

The transition to the medical registrar is multifaceted; with a challenging balance between support and independence in providing opportunities to perform (doing) whilst identity develops (being). Identity transitions involve multiple Rubik's-cube-like rotations between the facets of ‘doing’ and ‘being,’ until these align. Taking heed of influential factors and the interaction of minoritised social identities could guide a trainee-centred and smoother transition.

职业身份的转变，例如向医疗注册师的转变，是具有挑战性的。少数民族身份如何影响医学培训期间的转变需要进一步研究。本研究旨在探讨影响苏格兰医疗注册师转型的因素，以指导培训期间的支持。与内科实习生探讨这种转变的访谈被录音，逐字转录，并使用模板分析进行双重编码。我们采用了一个初始编码模板，该模板由个体、人际、系统和宏观层面因素的多重和多维过渡理论提供信息。利用批判理论的视角，进一步的模板分析专门试图理解受训者的社会身份是如何与不同层次相互作用的。在2021年1月至2022年2月期间，对19名IM学员进行了采访。影响因素反映了能力(行为)和身份(存在)发展的平行过程。社会身份的相互作用，例如性别(是女性)和原籍国(是国际医学毕业生)，发生在各个阶层。这可以被概念化为一个魔方，从个人到宏观层面的行为和存在之间的相互作用，受训者的社会身份在各个层面上相互作用。向医疗注册机构的过渡是多方面的;在支持和独立之间找到一个具有挑战性的平衡，在提供表演(做)的机会的同时，自我发展(存在)。身份转换包括在“做”和“存在”两个方面之间进行多次像魔方一样的旋转，直到它们对齐。注意影响因素和少数群体社会身份的相互作用，可以指导以学员为中心的更顺利的过渡。

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引用次数: 0

From healthcare professional to degree apprentice 从保健专业人员到学位学徒

IF 1.8 Q1 Nursing

Clinical Teacher

Pub Date : 2023-12-06 DOI: 10.1111/tct.13714

Alexandra Picts, Anne-Marie Russell

Background

In the UK, new degree apprenticeship opportunities are enabling non-medical practitioners to develop advanced roles. Frameworks to structure and standardise this development are also becoming more common. Knowing that historically healthcare professionals moving into advanced roles have experienced a transition period, we undertook a qualitative study to explore how this role transition – from healthcare professional to Advanced Clinical Practitioner (ACP) – was experienced in a degree apprentice programme.

Methods

First year ACP degree apprentices were purposively selected from a cohort of 28 enrolled on a 3-year Masters programme at a UK University in 2021/22. Consenting participants took part in in-depth qualitative online semi-structured interviews, which were recorded, transcribed and analysed thematically.

Findings

The five participants were in their first year of ACP training and represented core professional groups and primary, secondary and tertiary healthcare sectors. Five themes were identified: 1. what ACP apprentices bring; 2. reflections on how they see themselves; 3. how others see them; 4. effects of employing organisation's support; and 5. experience of Masters level learning.

Conclusion

ACP apprentices experienced a strong and often difficult transition period at the beginning of their training. The themes identified as influencing this could be used by higher education providers and clinical workplaces to better understand this period in training. Specifically, having a clear transition point to a defined role; a reduced workload during the transition period; and improved information sharing to better prepare workplaces for trainees, could all improve the experience.

背景：在英国，新的学位学徒机会使非医疗从业人员能够发展高级职位。结构化和标准化发展框架也变得越来越普遍。我们了解到，从历史上看，医疗保健专业人员进入高级角色都会经历一个过渡期，因此我们开展了一项定性研究，以探索学位学徒课程中如何经历这种角色转变--从医疗保健专业人员到高级临床执业医师（ACP）：方法：我们从 2021/22 年在英国一所大学就读三年硕士课程的 28 名学徒中，有目的性地挑选了一年级高级临床执业医师（ACP）学位学徒。经过同意的参与者参加了深入的定性在线半结构式访谈，访谈进行了录音、转录和专题分析：五位参与者都是 ACP 培训的第一年学员，代表了核心专业群体以及初级、二级和三级医疗保健部门。确定了五个主题：1.ACP学徒带来了什么；2.他们如何看待自己的反思；3.他人如何看待他们；4.雇主组织支持的效果；5.硕士水平学习的经验：ACP学徒在培训初期经历了一段艰难的过渡期。高等教育机构和临床工作单位可利用已确定的影响过渡时期的主题来更好地理解这段培训期。具体来说，明确过渡点，确定角色；减少过渡时期的工作量；加强信息共享，让工作场所为学员做好准备，这些都可以改善学员的经历。

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引用次数: 0

‘It's a gamble’: A phenomenological exploration of medical students' learning experiences as newcomers to clinical communities of practice “这是一场赌博”:一个现象学的探索医学生的学习经验，作为新人的临床实践社区。

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2023-12-06 DOI: 10.1111/tct.13708

Alistair W. R. Taylor, Elizabeth S. Anderson, Simon Gay

Background

Medical students become members of the clinical team through participation in their activities, as described by Lave and Wenger's situated learning theory. While there is research into how medical students cognitively engage in clinical learning, there is limited work on clinical experiences using a social theoretical lens such as situated learning theory.

Method

This study explored third year medical students' lived experience as newcomers to clinical teams using a qualitative phenomenological approach. Medical students completed in-depth, semi-structured interviews in 2021. Interpretive phenomenological analysis (IPA) using Lave and Wenger's theory of situated learning was applied to understand students' experiences.

Results

Seven students discussed their variable placement experiences. Learning related to three elements: conditions for participation, modes of participation and products of participation. When certain conditions were met relating to student, clinician and activity, students learned. This drove identity and relationship formation. The findings related and led to a self-perpetuating cycle with potential to advance student learning. When the conditions for participation were not met, the cycle stopped, leading to student disengagement.

Conclusion

Passivity in students is a result of modifiable factors in the workplace. To encourage proactivity, clinicians must enable students to move from observation to participation as their competence increases. Participation should be supervised, challenging and should contribute to patient care. Time pressures can make this difficult; one solution is to nominate a clinician to direct students and account for this in their workload or to employ a clinical fellow to assist with student training.

背景:正如Lave和Wenger的情境学习理论所描述的那样，医学生通过参与他们的活动成为临床团队的成员。虽然有关于医学生如何在认知上参与临床学习的研究，但使用社会理论视角(如情境学习理论)研究临床经验的工作有限。方法:本研究以质性现象学方法探讨医学生初来乍到临床团队的生活经验。医学院学生在2021年完成了深入的半结构化面试。运用Lave和Wenger情境学习理论的解释现象学分析(IPA)来理解学生的体验。结果:7名学生讨论了他们的实习经历。学习涉及三个要素:参与条件、参与方式和参与产品。当满足与学生、临床医生和活动相关的特定条件时，学生就会学习。这推动了身份和关系的形成。这些发现关联并导致了一个自我延续的循环，有可能促进学生的学习。当参与的条件不满足时，循环就会停止，导致学生脱离课堂。结论:学生的被动是工作环境中可改变因素的结果。为了鼓励主动性，临床医生必须使学生能够随着能力的提高而从观察转向参与。参与应受到监督，具有挑战性，并应有助于患者护理。时间压力会让这变得困难;一种解决方案是提名一名临床医生指导学生，并在他们的工作量中考虑到这一点，或者雇用一名临床研究员协助学生培训。

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引用次数: 0

The new mentee: Exploring Gen Z women medical students' mentorship needs and experiences 新导师:探索Z世代女医学生的导师需求和经验。

IF 1.8 Q1 Nursing

Clinical Teacher

Pub Date : 2023-12-05 DOI: 10.1111/tct.13697

Calandra Li, Paula Veinot, Maria Mylopoulos, Fok-Han Leung, Marcus Law

Purpose

The incoming Canadian cohort of medical students is comprised mainly of individuals from Generation Z (Gen Z; born between 1997 and 2012), with greater than 50% of applicants identifying as female. A gap remains in our understanding of Gen Z women learners in their challenges in navigating medical education, their expectations for their medical careers and the influences that have impacted their worldview. This study explored the needs, values, and experiences of Gen Z women medical students and the impact of these factors on mentorship expectations among this population that will soon be entering the workforce.

Methods

Upon receiving ethics approval from the University of Toronto Research Ethics Board, semi-structured interviews were conducted (February–May 2021) with 15 Gen Z women students from 14 English-speaking Canadian medical schools who had given written consent to participate. An iterative constant comparative team approach was utilised in which the interview guide and sampling were adjusted as the data evolved. Transcripts were line by line coded into categories, then grouped into themes using descriptive analysis.

Results

These socially aware learners described how society had afforded them greater opportunities for expression, which gave them a sense of feeling advantaged over older generations. However, participants paradoxically expressed feelings of powerlessness and commented on tensions they experienced when interacting with older generation physician mentors, especially during conversations on social justice issues. They also highlighted instances of biased mentorship specific to their gender. Participants emphasised a desire for inclusive mentorship that considered the mentee's identity and intersectionality.

Conclusions

The growing number of women learners in Canadian medical schools necessitates a re-evaluation of mentorship delivery. Mentors must adapt by integrating Gen Z ideals to overcome mentorship challenges.

目的:即将到来的加拿大医科学生群体主要由Z世代(Gen Z;出生于1997年至2012年之间)，超过50%的申请人认为自己是女性。我们对Z世代女性学习者在接受医学教育时面临的挑战、她们对医学职业的期望以及影响她们世界观的因素的理解仍然存在差距。本研究探讨了Z世代女医学生的需求、价值观和经历，以及这些因素对即将进入劳动力市场的这一人群的导师期望的影响。方法:在获得多伦多大学研究伦理委员会的伦理批准后，于2021年2月至5月对来自加拿大14所英语医学院校的15名Z一代女学生进行了半结构化访谈，这些学生已书面同意参加。采用了一种迭代不断的比较团队方法，其中采访指南和抽样随着数据的发展而调整。记录被逐行编码为类别，然后使用描述性分析将其分组为主题。结果:这些具有社会意识的学习者描述了社会如何为他们提供了更多的表达机会，这让他们觉得自己比老一辈人更有优势。然而，参与者矛盾地表达了无能为力的感觉，并评论了他们在与老一辈医生导师互动时经历的紧张情绪，特别是在讨论社会正义问题时。他们还强调了针对其性别的有偏见的导师的例子。参与者强调了包容性指导的愿望，考虑到学员的身份和交叉性。结论:加拿大医学院校中女性学习者的数量不断增加，需要对指导交付进行重新评估。导师必须融入Z世代的理念，以克服导师的挑战。

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引用次数: 0

An internal medicine residency preparatory curriculum for fourth-year medical students 为四年级医学生准备的内科住院医师预备课程。

IF 1.8 Q1 Nursing

Clinical Teacher

Pub Date : 2023-12-04 DOI: 10.1111/tct.13703

Katelyn Donohue, Natalie Davis, Dara Farber, Norman Retener, Philip Dittmar

Background

Intern preparation courses are often broad in scope; there are few published specialty-specific programs outside of General Surgery and Obstetrics. We designed an internal medicine (IM) residency preparatory course at the University of Maryland School of Medicine, which aimed to prepare graduating medical students for the rigours of IM residency training, mapped to Entrustable Professional Activities (EPAs).

Methods

Fourteen fourth-year medical students who were matriculating into IM residency programs enrolled in a 4-week long residency preparation course. The course was designed to teach skills using case-based learning modules, specialty topic seminars, simulation laboratories, procedure laboratories and clinical practice. Participants were surveyed before and after the course on their perceived knowledge and ability with the skills tested.

Results

With the exception of ‘giving signout to a colleague’, there was a significant difference in the participant's perceived ability for each skill taught within the course (P < 0.03 for each), with mean pre-course scores of 1.4–3.7 (SD = 0.5–1.2) and mean post-course scores of 3.2–4.2 (SD = 0.5–1.3). A second survey on course evaluation and perceived impact, completed 3 months after starting intern year, resulted in all respondents reporting that the information learned during the course had directly affected their care of patients on a daily or weekly basis. The modified Ottawa scale was the primary assessment means for the EPAs, with participants approaching entrustment at the conclusion of the course.

Conclusions

Implementation of an IM-specific residency preparation course is a useful adjunct in the fourth year of medical school.

背景:实习准备课程的范围通常很广;在普通外科和产科之外，很少有出版的专科课程。我们在马里兰大学医学院设计了一门内科(IM)住院医师预备课程，旨在为即将毕业的医学生准备严格的内科住院医师培训，并将其映射到可信赖的专业活动(EPAs)中。方法:14名即将进入IM住院医师项目的四年级医学生参加了为期4周的住院医师准备课程。本课程旨在通过案例学习模块、专题研讨会、模拟实验室、程序实验室和临床实践来教授技能。在课程前后，研究人员对参与者的认知知识和能力进行了调查。结果:除了“给同事签到”外，参与者对课程中教授的每种技能的感知能力存在显着差异(P结论:实施针对医学专业的住院医师准备课程是医学院第四年有用的辅助课程。

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