Formative experiences of emerging physicians: gauging the impact of events that occur during medical school.
Formative experiences of emerging physicians: gauging the impact of events that occur during medical school.
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新兴医生的形成经历：衡量医学院期间发生的事件的影响。
DOI：
10.1097/acm.0b013e3181e5d52a
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Wright,ScottM
中科院分区：
文献类型：
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作者：
Murinson,BethB;Klick,Brendan;Haythornthwaite,JenniferA;Shochet,Robert;Levine,RachelB;Wright,ScottM
情感发展是新生专业能力的一个重要组成部分，它很可能是由特定的形成性经历塑造的。这项研究试图确定和衡量在医学院期间发生的高度唤起的经历的影响。方法通过“大学计划”下属的学生指导教师的焦点小组会议，制定了一个34项的候选人形成经验清单。在2007年和2008年的一项队列研究中，研究人员对约翰霍普金斯大学医学院的216名即将毕业的医学生进行了调查。主要结果是经历的曝光率和学生对这些经历的影响的评分。结果181名学生（84%）回答了问题。所有的活动都有大约25%的学生体验过。有两件事被大多数人描述为具有巨大影响：“找到一个杰出的榜样”和“确定一个完美的医学领域”。其他有强烈影响的常见事件包括“特殊的病人护理经历”、“与团队合作良好”、“看到一个病人的生命被挽救了”、“遇到一个负面的榜样”、“看到一个病人死亡”、“看到一个病人经历剧烈的疼痛”和“一个糟糕的临床经历”。因素分析揭示了三个事件集群：“鼓舞人心的经历”、“与死亡有关的经历”和“与学习环境有关的消极经历”。结论特定的形成性经历对医学生的影响尤为显著。虽然这些经验的内在价值应该继续推动教育设计，但对形成性经验的多样性和范围的认识的提高，将使教育者能够更有效地指导积极的情感发展，促进医学院期间的个人和专业成长。
PurposeEmotional development, an important component of nascent professional competence, is likely to be shaped by specific formative experiences. This study sought to identify and gauge the impact of highly evocative experiences occurring during medical school.MethodA 34-item list of candidate formative experiences was developed through focus group meetings of “colleges program”-affiliated student-advising faculty. The resulting survey instrument was administered to 216 graduating medical students at the Johns Hopkins University School of Medicine in 2007 and 2008 in a cohort study. Primary outcomes were exposure rates for the experiences and students' ratings of impact for those that occurred.ResultsOne hundred eighty-one students (84%) responded. All events were experienced by> 25% of students. Two events were described by most as having tremendous impact:“finding an exceptional role model” and “identifying a perfect area of medicine.” Other prevalent events with strong impact included “a special patient-care experience,”“working well with a team,”“seeing a patient whose life was saved,”“encountering a negative role model,”“seeing a patient die,”“seeing a patient experience severe pain,” and “a bad clinical experience.” Factor analysis revealed three event clusters:“inspiring experiences,”“mortality-related experiences,” and “negative experiences relating to the learning environment.”ConclusionsSpecific formative experiences have especially strong impacts on medical students. Whereas the intrinsic value of such experiences should continue to drive educational design, increased awareness of the diversity and range of formative experiences will prepare educators to more effectively guide positive emotional development, enhancing personal and professional growth during medical school.