The "difficult" cadaver: weight bias in the gross anatomy lab.
The "difficult" cadaver: weight bias in the gross anatomy lab.
复制标题
“困难”尸体：大体解剖实验室的体重偏差。
DOI：
10.1080/10872981.2020.1742966
复制
发表时间：
2020
影响因子：
4.6
通讯作者：
DeLisser,HoraceM
中科院分区：
文献类型：
--
作者：
Goss,AdelineL;Rethy,Leah;Pearl,RebeccaL;DeLisser,HoraceM
背景：超重和肥胖的流行率持续上升，并与发病率和死亡率的增加有关。体重偏差在医生和医学生中很常见，并限制了提供者和超重和肥胖患者之间的治疗联盟。目的：作者试图探讨大体解剖学课程与医学生对体重和肥胖态度之间的关系。设计：作者采用了一种混合方法，包括半结构化访谈和匿名网络调查的第一，在美国一所医学院学习大体解剖学的一年医学生。他们使用扎根理论方法分析了访谈和自由文本调查的结果，并进行了关联测试，以调查人口统计信息，多项选择调查问题的回答和体重偏差之间的关系。结果：共有319名（52%）一年级医学生（2015-2018）完成了调查，33名参加了访谈。在调查受访者中，71人（22%）回答说，课程改变了他们对超重/肥胖者的看法。这些受访者也更有可能肯定课程影响了他们对自己身体的看法（p < 0.001）。定性数据分析确定了学生对大体解剖实验室对被认为超重的身体的态度的影响的描述中的三个首要主题：这些身体被描述为1）困难，2）不健康，3）引起厌恶。学生推断从他们的经验与尸体想象与未来的病人的互动，在很大程度上依赖于叙事的困难patient.Conclusions：在美国的一所医学院，学生认为他们的经验，在大体解剖学塑造他们对个人的态度超重或肥胖。努力减少医学生的体重偏见应该针对这个以前未探索的潜在的体重偏见的网站。
Background: The prevalence of overweight and obesity continues to rise and is associated with increased morbidity and mortality. Weight bias is common among physicians and medical students and limits the therapeutic alliance between providers and patients with overweight and obesity.Objective: The authors sought to explore the relationship between the gross anatomy course and medical student attitudes towards weight and obesity.Design: The authors employed a mixed-methods approach consisting of semi-structured interviews and anonymous web-based surveys of first-year medical students taking gross anatomy at one USA medical school. They analyzed transcripts of interviews and free-text survey responses using a grounded theory approach and performed tests of association to investigate the relationship between demographic information, responses to multiple-choice survey questions and weight bias.Results: A total of 319 (52%) first-year medical students (2015–2018) completed the survey and 33 participated in interviews. Of survey respondents, 71 (22%) responded that the course had changed how they felt about people with overweight/obesity. These respondents were also more likely to affirm that the course had affected their views toward their own bodies (p < 0.001). Qualitative data analysis identified three overarching themes within students’ descriptions of the effects of the gross anatomy lab on attitudes toward bodies perceived to have excess weight: these bodies were described as 1) difficult, 2) unhealthy, and 3) evoking disgust. Students extrapolated from their experiences with cadavers to imagined interactions with future patients, relying heavily on the narrative of the difficult patient.Conclusions: At one USA medical school, students perceived their experiences in gross anatomy as shaping their attitudes toward individuals with overweight or obesity. Efforts to reduce medical student weight bias ought to target this previously unexplored potential site of weight bias.