现代临床学习环境中的学员自主性和监督:对教师和学员观点的混合方法研究
Stephanie M Conner1, Nancy Choi2, Jessica Fuller3
1Washington University School of Medicine.
Research square
|June 19, 2023
概括
住院医生和主治医生希望在临床环境中获得更大的自主权,并发现当前的平衡不够理想. 影响这种平衡的因素包括参与者,实习生,患者,人际关系和机构动态,以及监督的文化转变.
科学领域:
- 医学教育 医学教育
- 医疗保健管理的管理
- 患者安全 患者安全
背景情况:
- 居民自主权和临床监督之间的平衡对于学员发展和患者安全至关重要.
- 在现代临床学习环境中,当这种平衡受到损害时,就会产生紧张关系.
- 这项研究调查了当前和理想的自治和监督状态,确定了导致不平衡的因素.
研究的目的:
- 评估当前和理想状态的自治和监督在医疗住院.
- 从实习生和参加者的角度来看,确定导致自主性和监督不平衡的因素.
主要方法:
- 一种混合方法的方法利用调查和焦点小组与居民和三家医院的护理人员.
- 使用千平方或费舍尔精确测试对调查数据进行定量分析.
- 对开放式调查和重点小组回复进行主题分析.
主要成果:
- 实习生报告说,当前的自主性比参加者更高;这两组都希望获得更大的自主性.
- 确定了影响自主和监督平衡的五个关键因素:主持人,实习生,患者,人际关系和机构.
- 增加医院监督和强调患者安全的文化转变影响了学员的自主性.
结论:
- 实习生和护理人员都同意,临床学习环境应该优先考虑居民的自主权.
- 目前的环境并没有实现自治与监督之间的理想平衡.
- 复杂的,多方面的因素和不断变化的文化动态影响医疗实习生在医疗实习生中的自主性.
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