医学和牙科学生在临床轮换期间不专业行为的共享系统级驱动因素:一个解释性描述研究
Hassan Jan1, Malik Zain Ul Abideen2, Maira Sahar Malik3
1Department of Operative Dentistry, Peshawar Dental College, Peshawar, PAK.
Cureus
|February 18, 2026
概括
临床教育中的不专业行为源于体系问题,如层次结构和资源稀缺,而不仅仅是个人的失败. 解决这些问题需要进行制度变革,以改善学习者福祉和患者护理.
科学领域:
- 医学教育 医学教育
- 专业精神 研究 研究 专业精神
- 医疗保健系统研究 医疗保健系统研究
背景情况:
- 在临床环境中不专业的行为会对学习者,患者和专业身份的发展产生负面影响.
- 以前的研究表明,巴基斯坦的临床培训中普遍存在不专业的行为,潜在的隐藏课程将其规范化.
- 对于在资源有限的临床教育中导致虐待的机构和系统层面因素的理解有限.
研究的目的:
- 探索医学和牙科最后一年的学生对在临床轮换期间不专业行为的系统级驱动因素的看法.
- 为改善临床教育环境提供以实践为导向的建议.
主要方法:
- 在巴基斯坦穆尔坦的一所私立医疗和牙科学院进行的一项解释性描述研究.
- 针对医学学士,外科学士 (MBBS) 和牙科手术学士 (BDS) 的最后一年学生进行了有目的的抽样.
- 半结构化,深入的面对面采访,通过代式沉浸和编码手动转录和分析.
主要成果:
- 五个主题模式出现了:等级和权力动态,负面的隐藏课程规范,系统压力 (例如,患者负担,资源稀缺),以患者为中心的护理的挑战,以及对学生的负面影响 (例如,道德困扰).
- 研究结果表明,不专业的行为是系统嵌入和社会学习.
- 学生的经历凸显了耻辱,道德上的痛苦,以及对制度变革的渴望.
结论:
- 临床轮换中的不专业行为是不受管制的权力,负面角色模拟和系统约束的结合.
- 解决这些问题需要以保护教学时间,促进尊重监督和建立安全报告机制为重点的机构战略.
- 这些策略旨在提高学习者的福祉,维护患者的尊严,并加强临床教育的专业性.
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