Simulation as a Tool to Promote Professional Identity Formation and Patient Ownership in Medical Students

2019 ◽  
Vol 50 (6) ◽  
pp. 711-724
Author(s):  
Lillie Tien ◽  
Tasha R. Wyatt ◽  
Matthew Tews ◽  
A. J. Kleinheksel

Background. Simulation has become a valuable tool in medical education, providing standardized clinical experiences without jeopardizing patient safety. Simulation may also help promote students’ professional identity formation (PIF) and patient ownership. Methods. A mixed-methods study was performed to explore the relationship between simulation, PIF, and patient ownership among third-year medical students in between their clerkship rotation blocks. Data were collected from 76 students after a simulated emergent case. A priori codes were developed and categorized into individual and contextual elements, and latent content analysis was conducted on the responses. Quantitative analysis identified how clerkship rotations and prior clinical experience affected students’ PIF and feelings of patient ownership. Results. Students exhibited both PIF and feelings of patient ownership as a result of the simulation. Students who completed an in-patient clerkship block described individual elements more frequently than students who completed the out-patient clerkship block (p = 0.017). Students who had no clinical experience prior to medical school remarked on individual elements more frequently than students who did have prior clinical experience (p = 0.017). Conclusions. When medical students felt like a physician, they took ownership of their patients. When they took ownership of their patients, they felt like a physician. Simulation has long been recognized as a valuable tool for developing clinical skills and teamwork behaviors, but it also fosters PIF and a sense of patient ownership. By introducing simulation activities earlier in medical education, students will have opportunities to develop patient ownership and professional identity earlier, allowing for a fuller, more mature development process.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Michael Hawking ◽  
Jenny Kim ◽  
Melody Jih ◽  
Chelsea Hu ◽  
John D. Yoon

Abstract Background Efforts have begun to characterize the ethical and professional issues encountered by medical students in their clinical years. By applying previously identified taxonomies to a national sample of medical students, this study seeks to develop generalizable insights that can inform professional identity formation across various clerkships and medical institutions. Methods In a national survey of medical students, participants answered an open-ended survey item that asked them to describe a clinical experience involving an ethical or professional issue. We conducted a content analysis with these responses using the Kaldjian taxonomy of ethical and professionalism themes in medical education through an iterative, consensus-building process. Noting the emerging virtues-based approach to ethics and professionalism, we also reexamined the data using a taxonomy of virtues. Results The response rate to this survey item was 144 out of 499 eligible respondents (28.9%). All 144 responses were successfully coded under one or more themes in the original taxonomy of ethical and professional issues, resulting in a total of 173 coded responses. Professional duties was the most frequently coded theme (29.2%), followed by Communication (26.4%), Quality of care (18.8%), Student-specific issues of moral distress (16.7%), Decisions regarding treatment (16.0%), and Justice (13.2%). In the virtues taxonomy, 180 total responses were coded from the 144 original responses, and the most frequent virtue coded was Wisdom (23.6%), followed by Respectfulness (20.1%) and Compassion or Empathy (13.9%). Conclusions Originally developed from students’ clinical experiences in one institution, the Kaldjian taxonomy appears to serve as a useful analytical framework for categorizing a variety of clinical experiences faced by a national sample of medical students. This study also supports the development of virtue-based programs that focus on cultivating the virtue of wisdom in the practice of medicine.


2021 ◽  
Author(s):  
Kevin John Milligan ◽  
Robert Scott Daulton ◽  
Zachary Taylor St. Clair ◽  
Madison Veronica Epperson ◽  
Rachel Holloway ◽  
...  

BACKGROUND Podcasting has become a popular medium for medical education content. Educators and trainees at all levels are turning to podcasts for high quality asynchronous content. While numerous medical education podcasts have emerged in recent years, few exist which are student-run. Student-run podcasts are a novel approach to supporting medical students. Near-peer mentoring has been shown to promote medical student personal and professional identity formation. Student-run podcasts offer a new medium to deliver near-peer advice to medical students in an enduring and accessible way. OBJECTIVE This article describes the creation of the UnsCripted Medicine Podcast (UMP), a student-run medical education podcast at a large public medical school. METHODS Planning and preparatory phases spanned six months. Defining a target audience and establishing a podcast mission were key first steps. Efforts were then directed towards securing funding, obtaining necessary equipment, and navigating the technical considerations of recording, editing, and publishing a podcast. In order to ensure high professionalism standards, key partnerships were created with faculty in the College of Medicine (COM). RESULTS The UnsCripted Medicine Podcast has published 53 episodes in its first two years. The number of episodes released per month ranges from 0 to 5 with a mean of 2.0. The podcast has a Twitter account with 217 followers. The show has an average 4.8/5 rating on Apple Podcasts from 24 ratings. The podcast has hosted 70 unique guests including medical students, resident physicians, attending physicians, nurses, physicians’ family members, GME leadership, and educators. CONCLUSIONS Medical student-run podcasts are a novel way to support medical student community and foster professional identity formation. Podcasts are widely available and convenient for listeners. Additionally, podcast creators can publish content with low barriers of entry compared to other forms of publishing. Medical schools should consider supporting student podcast initiatives to augment community, facilitate professional identity formation, and prepare the rising physician taskforce for the technological frontier of medical education.


2020 ◽  
Author(s):  
Michael Hawking ◽  
Jenny Kim ◽  
Melody Jih ◽  
Chelsea Hu ◽  
John D. Yoon

Abstract Background: Efforts have begun to characterize the ethical and professional issues encountered by medical students in their clinical years. By applying previously identified taxonomies to a national sample of medical students, this study seeks to develop generalizable insights that can inform professional identity formation across various clerkships and medical institutions.Methods: In a national survey of medical students, participants answered an open-ended survey item that asked them to describe a clinical experience involving an ethical or professional issue. We conducted a content analysis with these responses using the Kaldjian taxonomy of ethical and professionalism themes in medical education through an iterative, consensus-building process. Noting the emerging virtues-based approach to ethics and professionalism, we also reexamined the data using a taxonomy of virtues.Results: The response rate to this survey item was 144 out of 499 eligible respondents (28.9%). All 144 responses were successfully coded under one or more themes in the original taxonomy of ethical and professional issues, resulting in a total of 173 coded responses. Professional Duties was the most frequently coded theme (29.2%), followed by Communication (26.4%), Quality of Care (18.8%), Student-specific Issues of Moral Distress (16.7%), Decisions Regarding Treatment (16.0%), and Justice (13.2%). In the virtues taxonomy, 180 total responses were coded from the 144 original responses, and the most frequent virtue coded was Wisdom (23.6%), followed by Respectfulness (20.1%) and Compassion or Empathy (13.9%).Conclusions: Originally developed from students’ clinical experiences in one institution, the Kaldjian taxonomy appears to serve as a useful analytical framework for categorizing a variety of clinical experiences faced by a national sample of medical students. This study also supports the development of virtue-based programs that focus on cultivating the virtue of wisdom in the practice of medicine.


2020 ◽  
Author(s):  
Michael Hawking ◽  
Jenny Kim ◽  
Melody Jih ◽  
Chelsea Hu ◽  
John D. Yoon

Abstract Background Efforts have begun to characterize the ethical and professional issues encountered by medical students in their clinical years. By applying previously identified taxonomies to a national sample of medical students, this study seeks to develop generalizable insights that can inform professional identity formation across various clerkships and medical institutions. Methods In a national survey of medical students, participants answered an open-ended survey item that asked them to describe a clinical experience involving an ethical or professional issue. We coded these responses using the Kaldjian taxonomy of ethical and professionalism themes in medical education through an iterative, consensus-building process. Noting the emerging virtues-based approach to ethics and professionalism, we also reexamined the data using a taxonomy of virtues. Results The response rate to this survey item was 144 out of 499 eligible respondents (28.9%). All 144 responses were successfully coded under one or more themes in the original taxonomy of ethical and professional issues, resulting in a total of 173 coded responses. Professional Duties was the most frequently coded theme (29.2%), followed by Communication (26.4%), Quality of Care (18.8%), Student-specific Issues of Moral Distress (16.7%), Decisions Regarding Treatment (16.0%), and Justice (13.2%). In the virtues taxonomy, 180 total responses were coded from the 144 original responses, and the most frequent virtue coded was Wisdom (23.6%), followed by Respectfulness (20.1%) and Compassion or Empathy (13.9%). Conclusions Originally developed from students’ clinical experiences in one institution, the Kaldjian taxonomy appears to serve as a useful analytical framework for categorizing a variety of clinical experiences faced by a national sample of medical students. This study also supports the development of virtue-based programs that focus on cultivating the virtue of wisdom in the practice of medicine.


Author(s):  
Shiva Sarraf-Yazdi ◽  
Yao Neng Teo ◽  
Ashley Ern Hui How ◽  
Yao Hao Teo ◽  
Sherill Goh ◽  
...  

Abstract Background Professional identity formation (PIF) in medical students is a multifactorial phenomenon, shaped by ways that clinical and non-clinical experiences, expectations and environmental factors merge with individual values, beliefs and obligations. The relationship between students’ evolving professional identity and self-identity or personhood remains ill-defined, making it challenging for medical schools to support PIF systematically and strategically. Primarily, to capture prevailing literature on PIF in medical school education, and secondarily, to ascertain how PIF influences on medical students may be viewed through the lens of the ring theory of personhood (RToP) and to identify ways that medical schools support PIF. Methods A systematic scoping review was conducted using the systematic evidence-based approach. Articles published between 1 January 2000 and 1 July 2020 related to PIF in medical students were searched using PubMed, Embase, PsycINFO, ERIC and Scopus. Articles of all study designs (quantitative and qualitative), published or translated into English, were included. Concurrent thematic and directed content analyses were used to evaluate the data. Results A total of 10443 abstracts were identified, 272 full-text articles evaluated, and 76 articles included. Thematic and directed content analyses revealed similar themes and categories as follows: characteristics of PIF in relation to professionalism, role of socialization in PIF, PIF enablers and barriers, and medical school approaches to supporting PIF. Discussion PIF involves iterative construction, deconstruction and inculcation of professional beliefs, values and behaviours into a pre-existent identity. Through the lens of RToP, factors were elucidated that promote or hinder students’ identity development on individual, relational or societal levels. If inadequately or inappropriately supported, enabling factors become barriers to PIF. Medical schools employ an all-encompassing approach to support PIF, illuminating the need for distinct and deliberate longitudinal monitoring and mentoring to foster students’ balanced integration of personal and professional identities over time.


2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Vasiliki Nataly Rahimzadeh ◽  
David Lessard ◽  
Peter Nugus

Objective—This article provides a reflection on medical teaching opportunities for whole person care based on our experiences mentoring 2nd-year medical students through an Ethnography Practicum at a Canadian university.                                                                  Background—The Ethnography Practicum is a new addition to the Family Medicine Transition to Clinical Practice (TCP) curriculum introduced in the second year of medical school at McGill University. It involves 30 hours of instruction (6 hours in lectures with an instructor, and 24 hours in small-group tutorials with the authors), and 9 hours of fieldwork observations in various community health settings across Montreal, QC. The primary aims of the Practicum converge with those of the TCP generally in two important ways: to inculcate in students the concepts of patient centered care, and to promote family medicine as both an academic discipline and career option.                    Results and Discussion— Our experiences illustrate two tensions that shape students’ expectations and experiences throughout their involvement in the Practicum and, in turn, highlight the implications for teaching whole-person care. First, ethnography as a combination of different methods has itself been the locus of tensions between positivist and critical traditions in the three last decades. Second, the Practicum is situated precisely at the crossroads of key moments on the professional identity formation continuum for our students. Such a crossroads is disruptive to the status quo of medical traineeship characteristic of the first two years in medical school, and thus reorients professional identity formation. The above tensions reveal how ethnography is not only a revered research tradition in the humanities, but can also be a conduit to whole person care-inspired clinical practice.Conclusion—As instructors and mentors involved in this Ethnography Practicum, we are continually forging a new relevance for organizational ethnography in medical training, where medical students can reflect and act on competencies beyond clinical ones. The Practicum provides a space for students to wrestle with alternative epistemologies to understanding the social world in which medicine is embedded. We lastly provide pragmatic ways to better address these tensions in an effort to support students as they proceed through the (multifaceted) development of their professional identities as future physicians.


2017 ◽  
Vol 6 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Kimera Joseph ◽  
Karlen Bader ◽  
Sara Wilson ◽  
Melissa Walker ◽  
Mark Stephens ◽  
...  

2019 ◽  
Vol 43 (5) ◽  
pp. 521-527 ◽  
Author(s):  
Latha Chandran ◽  
Richard J. Iuli ◽  
Lisa Strano-Paul ◽  
Stephen G. Post

2018 ◽  
Vol 42 (1) ◽  
pp. 84-93 ◽  
Author(s):  
Marcelo Schweller ◽  
Diego L. Ribeiro ◽  
Sílvia R. Passeri ◽  
Jamiro S. Wanderley ◽  
Marco Antonio Carvalho-Filho

ABSTRACT In general, students have few opportunities to address their emotions under the guidance of an experienced physician, which can undermine their self-confidence to deal with real patients in stressful situations. Emotional detachment and cynicism are defense mechanisms, which can emerge as a consequence. The consolidation of a professional identity committed to patients’ interests can become a challenge when medical students are not comfortable in their role as caregivers. In general, we consider that the undergraduate medical curriculum has been insufficient in providing appropriate environments for students to reflect on professional identity formation and on the future challenges of their profession. Objective: To develop an in-depth debriefing to address students’ emotions and professional identity formation in the context of a simulation activity with simulated patients at a medical school in Brazil. Methods: The authors conducted a simulated medical consultation activity using standardized patients (SPs) with an in-depth debriefing based on the feelings of the patient and the student. During each encounter the formation and consolidation of professional identity was discussed. Fourth- and sixth-year medical students (n=551) participated and answered a questionnaire about the activity and the learning outcome. Results: The students felt comfortable during the activity, due to "openness to dialogue", "proximity with colleagues and teachers" and the "judgment-free environment". More than 90% reported that what they had learned would be useful in their professional and personal lives, providing a greater "understanding of emotions", "empathy", "ability to listen" and "ability to deal with conflicts". More than half of them were motivated to study, especially "doctor-patient relationship", "treatment", "common diseases" and "medicine in general". Students considered the activity important for retrieving the initial reasons that had led them to embarking on the medical profession in the first place. Conclusions: Reflecting on disease and its impact on patients’ daily life may motivate learning in medicine, allowing for the recovery of the personal and social meaning of its practice. In-depth debriefing was important to nurture professional identity committed to empathy and patients’ interests. Activities planned to discuss the influence and importance of emotions in medical practice can help students to reconcile personal and professional identities.


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