探索居民对种族在临床决策中的作用的信念:一项定性研究
Elizabeth Selden1, Julia Perry2, Kahiau Cockett-Nagamine2
1is an Associate Professor of Medicine, Medstar Georgetown University Hospital, Washington, DC, USA.
Journal of graduate medical education
|August 20, 2025
概括
内部医学医生在临床决策中使用种族,从生物学转向社会构造的理解. 这一转变凸显了关于公平的患者护理需要更新指导的必要性.
科学领域:
- 医学教育 医学教育
- 健康 公平 卫生 公平
- 健康的社会决定因素
背景情况:
- 从历史上看,种族一直被错误地视为医学中的生物决定因素,影响临床实践.
- 医学界正在远离基于种族的医学转型,面临着解决种族影响而不使伤害延续的挑战.
- 内科住院医生在将种族纳入临床推理方面收到相互矛盾的指导,需要了解他们当前的观点.
研究的目的:
- 调查内科医生在临床决策中对种族的信仰和概念化.
- 确定居民如何从种族作为生物概念转变为患者护理中的社会构造.
主要方法:
- 这是一项定性研究,涉及对来自美国三个项目的24名内科住院医生进行半结构面试.
- 居民们获得了一张临床图片,讨论管理和种族对他们的决策的影响.
- 采用了诱导性主题分析,并使用让·皮亚杰的认知发展理论来解释研究结果.
主要成果:
- 三个主题出现了:坚持认为种族是生物的信念,由于信息冲突而导致的认知不平衡,以及承认种族是社会构造的新平衡.
- 居民表示,理解种族作为一种社会构造和遇到将其视为生物的临床规范之间存在矛盾.
- 这些发现揭示了居民在临床环境中对种族的使用进行质疑和重新定义的认知过程.
结论:
- 居民们正在积极质疑和重新定义种族在临床护理中的作用,朝着社会构造模型迈进.
- 该研究强调需要更清晰的教育框架,以支持居民提供公平,以患者为中心的护理.
- 解决种族主义对健康结果的影响对居民至关重要,因为他们适应了当代医学理解.
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