BMC Medical Education最新文献

Objectives: To explore the clinical experiences of graduate-entry medical students; whether ethnicity impacts this and how medical education can better prepare students from a diverse range of backgrounds.

Design: Qualitative study using semi-structured interviews.

Setting: A medical school in Wales.

Participants: Seventeen graduate-entry MBChB students were recruited using volunteer and snowball sampling; 9 students self-identified as being from Black, Asian or Minority Ethnic backgrounds (BAME) and 8 from White Caucasian backgrounds.

Results: When asked whether they felt they had experienced disadvantage during their time on the course, 6 BAME students report feeling disadvantaged during their studies and 2 were unsure. This was compared to 2 white students who felt disadvantaged. Gender was most frequently linked to disadvantage, followed by ethnicity and racial background. Patient interactions were most linked to microaggressions and overt racism, leading to uncomfortable situations for BAME and White students. Clinician interactions were identified as a source of disadvantage, often linked to students' being overlooked in teaching and opportunities. 'Unfamiliar' names were associated with negative experiences, which ranged from being blanked for having a name perceived as difficult to pronounce to being disrespected. Microaggressions by clinicians and patients were identified by BAME and White participants alike, with participants feeling unsure of how to handle them. Institutional factors were divided into language used by lecturers and clinicians and lack of support. Language was felt to be out-dated and furthering the feeling of 'other' felt by BAME students. Students reported feeling unsupported and dismissed when trying to escalate issues, leading to a lack of trying after a while.

Conclusion: In this cohort, although patients were repeatedly linked to discrimination, the disadvantage in medical education was perceived to be impacted most by clinician interactions. Names and being ignored by clinicians most impacted on learning experiences. Institutional factors compounded this and reinforced the feeling of 'other' by BAME students.

Background: Healthcare-related regret adversely affects the well-being and professional growth of undergraduate nursing interns, as well as diminishes patient care quality. However, the heterogeneity of coping mechanisms employed in response to such regret remains unexplored.

Objective: To identify latent profiles of healthcare-related regret coping and to explore the factors associated with these profiles among nursing interns.

Design: A cross-sectional survey.

Methods: Data were collected using validated scales that assess healthcare-related regret coping, personality traits, care-related regret intensity, and patient safety attitudes and professionalism. Latent profile analysis and disordered multinomial logistic regression were applied for data analysis.

Results: Latent profile analysis identified three distinct groups among the 299 undergraduate nursing interns: a positive coping group (32.78%), a negative coping group (41.47%), and a positive coping with negative emotion group (25.75%). Multinomial logistic regression analysis showed that self-responsibility in the most regretted event (Class 1 vs. Class 2, OR = 1.220, P < 0.001; Class 1 vs. Class 3, OR = 1.147, P = 0.038), emotional stability (Class 1 vs. Class 2, OR = 1.311, P = 0.004; Class 1 vs. Class 3, OR = 1.326, P = 0.019), care-related regret intensity (Class 1 vs. Class 3, OR = 0.836, P < 0.001; Class 3 vs. Class 2, OR = 1.161, P < 0.001), patient safety attitudes and professionalism (Class 1 vs. Class 2, OR = 1.025, P = 0.019; Class 3 vs. Class 2, OR = 1.027, P = 0.020) were significant factors influencing the classification of nursing interns' healthcare-related regret coping.

Conclusions: Nursing interns exhibit heterogeneous profiles in healthcare-related regret coping. These distinct patterns were significantly associated with self-responsibility, emotional stability, care-related regret intensity, and patient safety attitudes and professionalism. These findings highlight the necessity for tailored interventions and support strategies targeting these modifiable factors to enhance nursing interns' ability to cope with healthcare-related regret effectively within both nursing education and clinical practice.