Harnessing the hidden curriculum: a four-step approach to developing and reinforcing reflective competencies in medical clinical clerkship
Harnessing the hidden curriculum: a four-step approach to developing and reinforcing reflective competencies in medical clinical clerkship
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DOI：
10.1007/s10459-014-9558-9
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发表时间：
2015-12-01
影响因子：
4
通讯作者：
Regehr, Glenn
中科院分区：
文献类型：
--
作者：
Holmes, Cheryl L.;Harris, Ilene B.;Regehr, Glenn
通过医学生的教育来改变医学文化已被提出作为解决我们专业棘手问题的一种方法。然而，很少有人探讨在这种变化中让学生成为合作伙伴的相关问题。有一个强大的隐藏课程，不仅延续了理想的态度和行为，也延续了那些不太理想的态度和行为。那么，我们如何教育医学生抵制他们在临床环境中看到的导师和导师的不专业做法呢？本文探讨了这些问题，并根据文献资料，我们提出了一套具体的反思能力，以供医学生从课堂课程过渡到临床实践的四步方法：(1)启动学生在临床环境中隐藏的课程以及他们遵守或服从外部压力的动机；(2)注意——教育学生意识到他们的动机和行为，当他们遇到压力时，要遵守他们可能认为不专业的做法；(3)加工——引导学生分析他们在合作反思性练习中的经验，最后；(4)选择——支持学生选择能够验证和加强他们发展最佳职业身份的愿望的行为。
Changing the culture of medicine through the education of medical students has been proposed as a solution to the intractable problems of our profession. Yet few have explored the issues associated with making students partners in this change. There is a powerful hidden curriculum that perpetuates not only desired attitudes and behaviors but also those that are less than desirable. So, how do we educate medical students to resist adopting unprofessional practices they see modeled by supervisors and mentors in the clinical environment? This paper explores these issues and, informed by the literature, we propose a specific set of reflective competencies for medical students as they transition from classroom curricula to clinical practice in a four-step approach: (1) Priming-students about hidden curriculum in their clinical environment and their motivations to conform or comply with external pressures; (2) Noticing-educating students to be aware of their motivations and actions in situations where they experience pressures to conform to practices that they may view as unprofessional; (3) Processing-guiding students to analyze their experiences in collaborative reflective exercises and finally; (4) Choosing-supporting students in selecting behaviors that validate and reinforce their aspirations to develop their best professional identity.