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Mustika R, Pinasthika A, Greviana N. The Importance of Learning with Patients: Post-Pandemic Takeaways on Learning Professionalism in Clinical Settings. Malays J Med Sci 2024; 31:140-149. [PMID: 38456115 PMCID: PMC10917595 DOI: 10.21315/mjms2024.31.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/15/2023] [Indexed: 03/09/2024] Open
Abstract
Background Public demands for high-quality healthcare require medical schools to ensure that physicians attain various competencies, including professionalism and humanism. This can be accomplished through various interactions and socialisations within the healthcare community. These meaningful learning experiences become more critical as students face unpredictable learning opportunities in clinical settings. However, professional development focuses on lapses, remediation and knowledge retention rather than its practice. To nurture professional and humanistic physicians, this study explores how medical students perceive learning professionalism in clinical settings. Methods This is a qualitative phenomenology study involving medical students in clinical rotations at the Faculty of Medicine Universitas Indonesia. Respondents were chosen through a purposive sampling method that considered their gender and clinical years. Data were collected through focus group discussions (FGDs) and thematic analysis was used. Results Three FGDs were conducted with 31 clinical students. Learning professionalism in clinical settings presents challenges, including the hidden curriculum (HC), limited exposure to patients and the clinical learning environment because of the social restrictions caused by the COVID-19 pandemic. The tailored strategy to learn professionalism in the clinical learning environment was more teacher-driven, including role modelling, debriefing, providing feedback and teaching context-specific knowledge on professionalism, followed by patient interactions. Conclusion The significance of students' interactions with the clinical learning environment, especially with patients and clinical teachers as role models, is the key to learning professionalism in clinical settings. This finding is an important takeaway in curriculum design for professionalism.
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Affiliation(s)
- Rita Mustika
- Medical Education Collaboration Cluster, Indonesia Medical Education, and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Indonesia
| | - Anyta Pinasthika
- Medical Education Collaboration Cluster, Indonesia Medical Education, and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Indonesia
| | - Nadia Greviana
- Medical Education Collaboration Cluster, Indonesia Medical Education, and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Indonesia
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Howick J, Dudko M, Feng SN, Ahmed AA, Alluri N, Nockels K, Winter R, Holland R. Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies. BMC MEDICAL EDUCATION 2023; 23:270. [PMID: 37088814 PMCID: PMC10124056 DOI: 10.1186/s12909-023-04165-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Several studies suggest that medical student empathy declines throughout medical school. However, no studies have synthesised the evidence regarding why empathy declines. OBJECTIVE To conduct a systematic review and thematic synthesis of qualitative studies investigating why student empathy may change throughout medical school. METHODS We included any qualitative study that investigated why empathy might change during medical school. We searched the Medline, Scopus, CINAHL, ERIC, and APA PsycInfo databases for relevant studies. All databases were searched from their inception to 18 July 2022. We also searched the reference lists of the included studies and contacted experts to identify additional studies. We used the Joanna Briggs Institute tool to evaluate the risk of bias in the included studies. Overall confidence in our results was assessed using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach. We used thematic methods to synthesise our findings. RESULTS Our searches yielded 2523 records, and 16 studies involving a total of 771 students were eligible for analysis. Most studies (n = 11) were from Europe or North America. The descriptive themes and sub-themes were identified for each study. Increased complexity in patients and their diseases, together with the 'hidden curriculum' (including a stressful workload, prioritisation of biomedical knowledge, and (sometimes) poor role models), led to student adaptations, such as cynicism and desensitisation. Students' prior lives and professional experiences appeared to exacerbate the decline in empathy. However, there were bias concerns for most of the included studies. DISCUSSION Many of the included studies included were small, and some did not include demographic participant data. Given the likely benefits of providing empathic care for patients and practitioners, medical education interventions should focus on developing an 'empathic hidden curriculum' that mitigates the decline in medical student empathy. TRIAL REGISTRATION A protocol for this systematic review was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) on 28 July 2022 (registration number CRD42022347856).
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Affiliation(s)
- Jeremy Howick
- Medical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies Centre, Lancaster Rd, Leicester, LE1 7HA, UK.
| | - Maya Dudko
- Medical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies Centre, Lancaster Rd, Leicester, LE1 7HA, UK
| | - Shi Nan Feng
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ahmed Abdirashid Ahmed
- Medical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies Centre, Lancaster Rd, Leicester, LE1 7HA, UK
| | | | - Keith Nockels
- University Library, University of Leicester, Leicester, LE1 7HA, UK
| | - Rachel Winter
- Medical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies Centre, Lancaster Rd, Leicester, LE1 7HA, UK
| | - Richard Holland
- Medical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies Centre, Lancaster Rd, Leicester, LE1 7HA, UK
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Xue M, Sun H, Xue J, Zhou J, Qu J, Ji S, Bu Y, Liu Y. Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: a randomized controlled trial. BMC MEDICAL EDUCATION 2023; 23:38. [PMID: 36653810 PMCID: PMC9850682 DOI: 10.1186/s12909-023-04026-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 01/12/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Narrative medicine has become a solution to cultivate medical students' ability of empathy and humanistic care. However, the role of narrative medicine is lacking in the study of professionalism. The aim of this study was to analyze the effects of narrative medical theory learning and narrative writing on professionalism, empathy and humanistic care ability of nursing students. METHODS This cluster randomized controlled trial was conducted between June 2021 and June 2022 in two universities in Jiangsu, China. The participants of this study were 85 nursing students who were randomly divided into the intervention group (n = 43) or the control group (n = 42). Participants in the intervention group were trained in narrative medical theory learning and narrative writing based on a Web-based platform, while those in the control group were not. Self-report questionnaires of professionalism, empathy and humanistic care ability were used before and after intervention. RESULTS The results showed that the professionalism score of the intervention group was (68.7 ± 6.8 vs. 64.5 ± 7.5; P = 0.005), empathy (99.4 ± 15.7 vs. 92.2 ± 14.6; P = 0.014) and humanistic care ability (127.6 ± 20.0 vs. 113.3 ± 18.8; P = 0.004) were better than the control group. CONCLUSION The results of this quantitative study suggest that narrative medical theory education and narrative writing based on the network platform can promote the development of professionalism, empathy and humanistic care ability of nursing undergraduates.
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Affiliation(s)
- Mengxin Xue
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Huiping Sun
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Jin Xue
- Guangling College, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Jingxin Zhou
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Junchao Qu
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Siqi Ji
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Yuan Bu
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Yongbing Liu
- School of Nursing and Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China.
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Bollos LACL, Zhao Y, Soriano GP, Tanioka T, Otsuka H, Locsin R. Technologies, Physician's Caring Competency, and Patient Centered Care:A Systematic Review. THE JOURNAL OF MEDICAL INVESTIGATION 2023; 70:307-316. [PMID: 37940512 DOI: 10.2152/jmi.70.307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
This study aimed to conduct a systematic review to clarify patient understanding, understanding of caring concepts, understanding of technology, competency to express compassion, appropriate involvement in caring, and ethical and moral attitudes and responses toward patients. This systematic review was conducted through an electronic search across PubMed, Google Scholar, MEDLINE, and Science Direct. Authors independently appraised the methodological quality of the studies using the Mixed Method Appraisal Tool. A narrative synthesis approach was used to present these findings. Nine studies met the inclusion criteria and quality appraisal guidelines. Through thematic analysis, four major themes were identified:Technology and caring competency, Technology and patient-centered care, Empathetic skills, and Caring competency. This review has shown that patients choose physicians considering their emotions and communicate well with them, empowering them to take responsibility of their own or their loved ones' healthcare. In the age of technological advancement and availability of vast sources of information, it is expected of physicians to adapt to these character priorities while maintaining their sense of humanness, not only focusing on healing modalities, but also to guide, educate, and appropriately empower their patients toward achieving their healthcare goals. J. Med. Invest. 70 : 307-316, August, 2023.
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Affiliation(s)
| | - Yueren Zhao
- Associate Professor, Department of Psychiatry, Fujita Health University, Aichi, Japan
| | - Gil P Soriano
- PhD Student, Graduate School of Health Sciences, Tokushima University, Tokushima, Japan
- Faculty Member, Department of Nursing, College of Allied Health, National University, Manila, Philippines
| | - Tetsuya Tanioka
- Institute of Biomedical Sciences, Tokushima University, Graduate School, Tokushima, Japan
| | - Hideki Otsuka
- Institute of Biomedical Sciences, Tokushima University, Graduate School, Tokushima, Japan
| | - Rozzano Locsin
- Professor Emeritus, Florida Atlantic University, FL, United States
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Wang Z, Xie L, Liang Z, Fan J, Fan L, Deng J, Xu X. Perceived stress and humanistic care ability among Chinese healthcare workers: The chain mediating role of social support and life satisfaction. Front Psychol 2022; 13:1029265. [PMID: 36438328 PMCID: PMC9683107 DOI: 10.3389/fpsyg.2022.1029265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
Previous studies have indicated high perceived stress and its relationship with life satisfaction among healthcare workers. However, most of the existing studies have focused on the investigation and evaluation of the humanistic care abilities among nurses, but few studies revealed the levels of humanistic care ability among other healthcare workers including doctors and technicians. The study aimed to investigate the perceived stress and humanistic care abilities among Chinese healthcare workers. In addition, we further examined the mediating and moderating effects of social support and life satisfaction. A convenience sample of 955 health professionals from 29 hospitals in China was recruited to fill out the questionnaires about perceived stress, humanistic care ability, social support, and life satisfaction. The correlation and multivariate logistic regression analysis were carried out by SPSS 24.0. The Hayes SPSS macro program process (version 2.16.3) was used to analyze the significance of mediating and moderating model. The findings indicated that humanistic care ability was negatively associated with perceived stress and positively correlated with social support and life satisfaction. The effect of the path “perceived stress → social support → humanistic care ability” was −0.017, and the path “perceived stress → life satisfaction → social support → humanistic care ability” was −0.129. The current study contributed to a better understanding of humanistic care abilities and influential factors in Chinese healthcare workers. Thus, it may suggest studies on interventions to interventions to alleviate or eliminate the negative impact of perceived stress and improve humanistic care abilities.
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Affiliation(s)
- Zonghua Wang
- Department of Clinical Nursing, School of Nursing, Army Medical University, Chongqing, China
| | - Langlang Xie
- Department of Clinical Nursing, School of Nursing, Army Medical University, Chongqing, China
- Department of Health Management and Geriatric Nursing, Daping Hospital, Chongqing, China
| | - Zeping Liang
- Department of Nursing, Daping Hospital, Chongqing, China
| | - Jiangshan Fan
- Department of Clinical Nursing, School of Nursing, Army Medical University, Chongqing, China
| | - Liqi Fan
- Department of Health Management and Geriatric Nursing, Daping Hospital, Chongqing, China
| | - Jing Deng
- Department of Respiratory and Critical Care Medicine, Southwest Hospital, Chongqing, China
- *Correspondence: Jing Deng
| | - Xia Xu
- Department of Health Management and Geriatric Nursing, Daping Hospital, Chongqing, China
- Xia Xu
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Zhang Y, Sun J, Qiao S, Wang Y. WITHDRAWN: Assessing the risks of teenagers' socialization and exploring the healthy personality development under the backgrounds of internet society and time-space transformation. Work 2021:WOR205353. [PMID: 34308922 DOI: 10.3233/wor-205353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ahead of Print article withdrawn by publisher.
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Affiliation(s)
- Yushi Zhang
- School of Marxism, Liaoning Normal University, Dalian, China
| | - Jun Sun
- School of Management, Dalian Polytechnic University, Dalian, China
| | - Shuang Qiao
- School of Management, Dalian Polytechnic University, Dalian, China
| | - Yijiang Wang
- College of Social Science, University of Southampton, Southampton, United Kingdom
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