The ethical experiences of trainees on short-term international trips: a systematic qualitative synthesis
The ethical experiences of trainees on short-term international trips: a systematic qualitative synthesis
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DOI：
10.1186/s12909-018-1424-7
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发表时间：
2018-12-29
影响因子：
3.6
通讯作者：
DeCamp, Matthew
中科院分区：
文献类型：
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作者：
Aluri, James;Moran, Dane;DeCamp, Matthew
在过去的几十年里，医学院学生和住院医生参加短期国际实习旅行（STINTTs）的人数有所增加。然而，对受训者的实际道德经验还没有进行系统的审查。作者试图确定医学实习生在stintt期间遇到的伦理问题，这些问题是由同行评议的定量和定性研究论文引发并报告的。方法系统检索5个学术数据库，检索到659篇独特的题目和摘要。作者将纳入和排除标准应用于这些标题和摘要，结果产生14篇论文，并使用定性主题综合进行分析。结果通过对论文的定性分析，得出了四个主题：(1)实习生对医疗旅游永续化的担忧；(2)难以识别和平衡性传播感染的利弊；(3)复杂的学员心理；(4)学员遇到的道德状况。第四个主题是最大的，进一步分为(a)引导社会和文化动态，(b)学员与学习者角色有关的经验，以及(c)不符合其他类别的道德情况。实证研究论文中报告的一些问题在关于stintt的更广泛的文献中得到了很好的体现，而其他问题则较少，例如虐待受训者。所有纳入的论文都是在2010年之后发表的，总共不到170名医学实习生。医学实习生报告说，他们在从事临床或研究活动的短期国际旅行中遇到了各种各样的道德挑战。作者呼吁教育工作者关注受训者面临的具体挑战。涉及美国和加拿大stintt的相关文献相对较年轻，而且主要是定性的。作者简要概述了一个计划，以扩大对这一日益普遍的教育经验的研究。
BackgroundMedical student and resident participation in short-term international trips for trainees (STINTTs) has increased in the past few decades. However, there has been no systematic review of trainees' actual ethical experiences. The authors sought to identify what ethical issues medical trainees encounter during STINTTs, as elicited by and reported in peer-reviewed, quantitative and qualitative research papers.MethodsThe authors systematically searched five academic databases finding 659 unique titles and abstracts. The authors applied inclusion and exclusion criteria to these titles and abstracts resulting in fourteen papers, which were analyzed using qualitative thematic synthesis.ResultsThe qualitative analysis of the papers generated four themes: (1) Trainees' Concerns Over Perpetuating Medical Tourism; (2) Struggling to Identify and Balance the Benefits and Harms of STINTTs; (3) The Complicated Trainee Mens (mind); and (4) Ethical Situations Encountered by Trainees. The fourth theme, which was the largest, was further divided into (a) Navigating social and cultural dynamics, (b) Trainees' experiences related to the learner role, and (c) Ethical situations not qualifying for other catagories. Some of these issues reported in the empirical research papers are well represented in the broader literature on STINTTs, while others were less sosuch as mistreatment of trainees. All included papers were published after 2010, and comprised a total of less than 170 medical trainees.ConclusionsMedical trainees report experiencing a wide range of ethical challenges during short-term international trips in which they engage in clinical or research activities. The authors call educators' attention to specific challenges that trainees face. The relevant literature covering US and Canadian STINTTs is relatively young and largely qualitative. The authors briefly sketch a program for expanding the research on this increasingly common educational experience.