سنتز پژوهی مطالعات حرفه ای گرایی در آموزش دانشجویان پزشکی
محورهای موضوعی : پژوهش در برنامه ریزی درسی
آرزو وسیلی
1
,
نرگس کشتی آرای
2
,
علیرضا یوسفی
3
1 - دانشجوی دکتری تخصصی برنامه ریزی درسی ، دانشگاه آزاد اسلامی ، واحد اصفهان (خوراسگان)، اصفهان، ایران.
2 - دانشیارگروه علوم تربیتی، دانشگاه آزاد اسلامی ، واحد اصفهان (خوراسگان)، اصفهان، ایران
3 - استاد ، مرکز تحقیقات آموزش علوم پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.
کلید واژه: آموزش پزشکان, دانشجوی پزشکی, حرفه ای گرایی, حرفه ای گرایی پزشکی,
چکیده مقاله :
این مطالعه با سنتز توأمان مطالعات داخلی و خارجی برای دستیابی به مفاهیم بیشتر و تازه‌تر دربارۀ حرفه‌ای‌گرایی در آموزش پزشکی صورت گرفته است. روش این مطالعه کیفی با رویکرد سنتز پژوهی بود. داده های مورد نیاز از طریق جستجو در منابع کتابخانه ای و مقالات موجود در پایگاه های اطلاعاتی ERIC, ProQuest, PubMed, Science Direct, Scopus, springer Magiran, Irandoc جمع‌آوری شد. برای جستجو در پایگاه های اطلاعاتی داخلی و خارجی از واژگان کلیدی پروفیشنالیزم، برنامۀ درسی، برنامۀ درسی حرفه‌ای‌گرایی و آموزش پزشکی استفاده شد. مقالات و منابع بررسی شده مربوط به سال‌های 1998 تا سال 2020 بود. در بررسی نهایی مرتبط‌ترین منابع شامل 53 مقاله بود که مورد بررسی و استخراج مطالب در راستای تحقق هدف مطالعۀ حاضر قرار گرفت. در کدگذاری داده‌ها از روش موضوعی استفاده شد. 270 مفهوم استخراج شد و در قالب 22 مفهوم هم‌دسته گردید . در نهایت مفاهیم هم‌دسته ذیل 6 مفهوم نهایی تعهد حرفه‌ای رفتارمحور، تعهد حرفه‌ای فضیلت‌محور، یادگیرندۀ مادام العمر، اخلاق‌مدار و قانون‌محور، منش حرفه‌ای و نوع برنامۀ درسی قرار گرفتند. نتایج نشان می‌دهد که چنان‌چه در دوران کارورزی باورها و رفتارهای خاص حرفه‌ای در دانشجویان امروز نهادینه نشود، می‌تواند سبب کاهش حساسیت حرفه‌ای‌گرایی دانشجو شود و در نتیجه تصمیم‌گیری‌های حرفه‌ای را برای پزشکان آینده دشوار کند؛ بنابراین نقش آموزش رسمی پروفشنالیزم با در نظر گرفتن نقش برنامۀ درسی پنهان در این باره حائز اهمیت است.
This study has been done with a synthesis of both internal and external studies in order to achieve more and newer concepts regarding professionalism in medical education. The method of this study was synthesis research. The required data were collected by searching library resources and articles in ERIC, ProQuest, PubMed, Science Direct, Scopus, springer Magiran, and Irandoc databases. In order to search domestic and foreign databases, the keywords of professionalism, curriculum, professionalism curriculum, medical education were used. The articles and sources reviewed were from 1998 to 2020. In the final review, the most relevant sources included 53 articles that were reviewed and extracted in order to achieve the purpose of the present study. 270 concepts were extracted and grouped into 22 concepts. Finally, the concepts were categorized into the final 6 concepts of professional commitment, caring behavior, virtue-based professional commitment, lifelong learner, ethics and law-based, professional character and type of curriculum. The results show that if certain professional beliefs and behaviors are not institutionalized in today's students during the internship, it can reduce the sensitivity of students' professionalism and thus make professional decisions difficult for future physicians. Therefore, the role of formal education in professionalism is important in this regard, considering the role of the hidden curriculum.
Akbary Borng M, Alipour, Maryam Delavar. (2019). The Effect of Students' Perceptions on Relationship between Professors and Patients on Their Professional Ethics in Birjand University of Medical Sciences. Iranian Journal of Medical Education . 19(14):126-135.[Persian]
Al-Eraky M.(2015). Twelve Tips For Teaching Medicalprofessionalism At All Levels Of Medicaleducation. Med Teach. 37(11): 1018-25.
American Board of Internal Medicine. Become certified by ABIM. Available at: www.abim.org/ default.aspx. Accessed February 2, 2015.
Arnold L, Stern DT.(2006). What is Medical Professional-ism? In: Stern DT, ed. Measuring Medical Profession-alism. New York, NY: Oxford University Press.15–37.
Bahazic W, Crosby E.(2011). Physician professional behavior affects outcomes: a framework for teaching professionalism during anesthesia residency. Can J Anesth .58:1039–50.
Barzegar M.(2007). Moghayeseye vizheghehaye yek ulgoye herfei az nazare faragirane pezeshki. [dissertation]. Isfahan: Medical university of Isfahan; 2007: 45-47. [Persian]
Bendapudi NM, Berry LL, Frey KA, Parish JT,Rayburn WL. (2006).Patients' perspectives on idealphysician behaviors. Mayo Clin Proc;81(3): 338-44.
Birden H, Glass N, Wilson I, Harrison M, Usherwood T, Nass D.(2013). Teaching professionalism in medical education: a Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 25. Med Teach.35(7):e1252-e66.
Blue A, Crandall S, Nowacek G, et al.(2009).Assessment of matriculating medical students' knowledge and attitudes towards professionalism. Med Teach. 31(10): 928-32.
Branch WT. (2010).The road to professionalism: reflective practice and reflective learning. Patient Educ Couns .80:327–32.
Brennan MD, Monson V. (2014). Professionalism: good for patients and health care organizations. Mayo Clin Proc .89:444–52.
Brown Jo.(2010). Transferring Clinical Communication Skills From the Classroom to the Clinical Environment: Perceptions of a Group of Medical Students in the United Kingdom. Acad Med. 85(6): 1052-9.
Bryden P, Ginsburg S, Kurabi B, Ahmed N.(2010).Professing Professionalism: Are We Our Own Worst Enemy? Faculty Members’ Experiences Of Teaching And Evaluating Professionalism In Medical Education At One School. Acad Med.85(6): 1025-34.
Buyx AM, Maxwell B, Scho¨ne-Seifert B.(2008). Challenges of educating for medical professionalism:who should step up to the line?. Med Educ. 42(8): 758-64.
Byszewski A, Hendelman W, McGuinty C, Moineau G. (2012).Wanted: role models--medical students' perceptions of professionalism. BMC Med Educ. 12: 115.
Campbell EG, Regan S, Gruen RL, et al. Profession-alism in medicine: results of a national survey of phy-sicians. Ann Intern Med 2007;147:795–802.
Chou CM, Kellom K, Shea JA. (2014). Attitudes and Habits of Highly Humanistic Physicians. Acad Med. 89(9): 1252-8.
Collier R.(2012). Professionalism: assessing physician behavior. CMAJ .184:1349–50.
Cottrell S, Diaz S, Cather A, Shumway J.(2006).Assessing Medical Students Professionalism: An Analysis Of A Peer Assessment. Med Educ Online. 11(1): 4587.
Coulehan J, Williams PC.(2001). Vanquishing Virtue: The Impact Of Medical Education. Acad Med. 76(6): 598-605.
Cruess RL, Cruess SR.(2006). Teaching professionalism: general principles. Med Teach .28:205–8.
Cuesta-Briand B, Auret K, Johnson P, Playford D. (2014). A world of difference’: a qualitative study of medical students’ views on professionalism and the ‘good doctor. BMC medical education. 14(1):77.
Duke LJ, Kennedy WK, McDuffie CH, Miller MS, Sheffield MC, Chisholm MA.(2005). Student attitudes, values, and beliefs regarding professionalism.Am J Pharm Educ.69(5):104.
EdmundC.Short.(2008).Forms of urriculum Inquiry. Translate by: Mahmoud Mehrmohammadi.SAMT.
Egener B, McDonald W, Rosof B, Gullen D. (2012). Organizational professionalism: relevant competen-cies and behaviors. Acad Med .87:668–74.
Eckert, T., Topping, D., Abrams, M., & Daly, K. (2020). Beyond academic learning: how can human cadaver dissection promote medical students’ professional identity development?. The FASEB Journal; 34(S1), 1-10.
Firouzabadi N, Yamani N, Changiz T. (2013). Patients’ Experiences about Their Physician Professional Encounters during Hospitalization. J Isfahan Med Sch . 30(220): 2376-91.
Frost HD , Regehr G.(2013). "I Am A Doctor": Negotiating The Discourses Of Standardization And Diversity In Professional Identity Construction. Acad Med.88(10): 1570-7.
Ginsburg, S., Regehr, G., Stern, D., & Lingard, L. (2002). The anatomy of the professionallapse. bridging the gap between traditional frameworks and students' perceptions.Academic Medicine, 77, 516-522.
Goss BD, Ryan AT, Waring J, Judd T, Chiavaroli NG, O’Brien RC, et al.(2020). The association between Situational Judgement Test (SJT) scores and professionalism concerns in undergraduate medical education. Med Teach.42(8): 937-943.
Goldie J.(2012). The formation of professional identity in medical students: considerations for educators. Med Teach. 34(9): e641-8.
Greysen SR, Chretien KC, Kind T, Young A, Gross CP.(2012). Physician violations of online professionalism and disciplinary actions: a national survey of state medical boards. JAMA 307:1141–2.
Haidet P, Kelly A, Chou C.(2005). Communication, Curriculum, and Culture Study Group. Characterizing the Patient-Centeredness of Hidden Curricula in Medical Schools: Development and Validation of New Measure. Acad Med.80(1): 44-50.
Hojat M, Vergare Mj, Maxwell K, Brainard G, Herrine Sk, Isenberg Ga, et al.(2009). The Devil Is In The Third Year: A Longitudinal Study Of Erosion Of Empathy In Medical School. Acad Med. 84(9):1182–91.
Hur Y.(2009). Are There Gaps between Medical Students and Professors in the Perception of Students’ Professionalism Level? Yonsei Med J .50(6):751-756.
Irby DM, Hamstra SJ. Parting the Clouds: Three Professionalism Frameworks in Medical Education. Acad Med. 2016; 91(12): 1606-1611.
Kebede S, Gebremeskel B, Yekoye A, Menlkalew Z, Asrat M, Medhanyie AA.(2018). Medical professionalism: perspectives of medical students and residents at Ayder Comprehensive and Specialized Hospital, Mekelle, Ethiopia a cross-sectional study. Adv Med Educ Pract. 9: 611-616.
Keshtiaray N, Fathi Vajargah K, Zimitat C, Foroughi A. (2012). Phenomenological explanation of an experiential curriculum in medical education: A feministic approach. Journal of Education & Health promotion. 1(1): 8-15.
Kinghorn WA.(2010). Medical education as moral formation: An Aristotelian account of medical professionalism. Perspect Biol Med. 53(1): 87-105.
Klinkenberg WD, Boslaugh S, Waterman BM, et al.(2011). Inpatients’ willingness to recommend: a multilevel analysis. Health Care Manage Rev .36:349–58.
Lambert V, Glacken M. ) 2004 .(Clinical support roles: areview of the liteAutre.nurse educ pract; 4(3): 177-83.
Leo T , Eagen K.(2008). Professionalism Education: The Medical Student Response. Perspect Biol Med. 51(4): 508-16.
Levinson W, Ginsburg S, Hafferty FW, et al.(2014). Educating for Professionalism. In: Levinson W, Ginsburg S, Hafferty FW, et al., eds. Understanding Medical Professionalism. New York, NY: McGraw-Hill.189–211.
Mazmanian PE, Davis DA. (2002). Continuing medical education and the physician as a learner: guide to the evidence. JAMA .288:1057–60.
Mirmoghtadaie Z. S, Ahmadi S, Hosseini MA.(2013). Exploring the Process of Professionalism in Clinical Eductin. Research in Medical Education. 5(2): 46-54. [Persian]
Mohamadimehr and Fathi Vajargah(1387). Jaygahe Barnameh Darseye penhan dar amozeshe pezeshki. The scientific journal of Education Strategies in Medical Sciences. 1(1): 53-48.
Mueller PS, Snyder L. Dealing with the “disruptive” physician colleague. Copyright 2009. Available at: http://www.medscape.org/viewarticle/590319. Accessed February 2, 2015.
Pacie E, Hards MF, Moss F . (2002). How important are role models in making good doctor?. BMJ. 325(7366): 707-10.
Park J, Woodrow SI, Reznick RK,Beales J,Macrae HM.(2010). Observation, Reflection, And Reinforcement: Surgery Faculty Members' And Residents' Perceptions Of How They Learned Professionalism. Acad Med. 85(1): 134-9.
Patenaude J, Niyonsenga T, Fafard D.(2003). Changes in students’ moral development during medical school: a cohort study. JAMC. 168(7): 840-44.
Rahban H, Allami A, Mohammadi N.(2017). Attitudes toward Medical Professionalism and Professional Medical Practices in Medical Students of Qazvin. Journal of Medical Education Development. 10(26): 183-193.
Rajabi Alni J, Borhani F, Ebadi A, Bazmi SH.(2018). Professional Ethical Competence For Medical Students: A Qualitative Study. Electron J Gen Med. 2018; 15(3): Em18.
Ramani S, Leinster S.) 2008.( AMEE Guide no. 34: Teaching in the clinical environment. Med Teach; 30(4):347-64.
Reynolds PP. Reaffirming professionalism through the education community.(1994). Ann Intern Med. 120(7): 609-14.
Sehiralti M, Akpinar A, Ersoy N.(2010). Attributes of a good physician: what are the opinions of first-year medical students?. J Med Ethics. 36(2): 121-5.
Shooshtarizade Sh, Yousefy A, Keshtiarai N. (2018). Is Professionalism Teachable in Medical Education? A Literature Review. Iranian Journal of Medical Education . 18: 269-281.[Persian]
Shoghi Shafagh Aria F, Samadi P ,Yazdani SH.(2019). Qualitative Explanation of the Effect of Changes in the Educational System on the Development of Professionalism in Medical Residents. Strides Dev Med Educ. 2019 ; 16(1): e84144.
Stegers-Jager KM, Cohen-Schotanus J, Themmen AP. (2012).Motivation, learning strategies, participation and medical school performance. Med Educ. 46(7):678-688.
Sullivan ME, Trial J, Baker C, Inaba K, Etcheverry J, Nally M.(2014). A framework for professionalism in surgery: what isimportant to medical students? . Am J Surg. 207(2): 255-9.
Topazian RJ, Hook CC, Mueller PS.(2013). Duty to speak up in the health care setting: a professionalism and ethics analysis. Minn Med .96:40–3.
van de Camp K, Vernooij-Dassen M, RGrol R,Bottema B.(2006). Professionalism in general practice: development of an instrument to assess professional behaviour in general practitioner trainees. Med Educ. 40(1): 43-50.
Wagner P, Hendrich J, Moseley G, Hudson V.(2007). Defining medical professionalism: a qualitative study. Med Educ. 41: 288-284.
Wynia MK, Papadakis MA, Sullivan WM, Hafferty FW.(2014). More than a list of values and desired behaviors: a foundational understanding of medical professionalism. Acad Med. 89(5): 712–714.
Wilson I, Cowin LS, Johnson M, Young H. (2013). Professional identity in medical students: pedagogical challenges to medical education. Teach Learn Med. 25(4): 369-73.
Yamani N, Liaghatdar MJ, Changiz T, Adibi P. (2010). How Do Medical Students Learn Professionalism During Clinical Education? A Qualitative Study of Faculty Members' and Interns' Experiences. Iranian Journal of Medical Education . 9(4): 382-394.
_||_