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Meaningful Learning Moments on a Family Medicine Clerkship: When Students Are Patient Centered

机译：家庭医学职员有意义的学习时刻：以学生为中心

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Background and Objectives: Reflection after patient encounters is an important aspect of clinical learning. After our medical school instituted a reflection paper assignment for all clerkships, we wanted to learn about the types of encounters that students found meaningful on a family medicine clerkship and how they impacted students’ learning.Methods: Family and Community Medicine Clerkship students completed a reflection paper after the clerkship, based on guidelines that were used for all clerkship reflection papers at our medical school. Two reviewers independently organized student responses into themes and then jointly prioritized common themes and negotiated any initial differences into other themes.Results: A total of 272 reflection papers describing an actual learning moment in patient care were submitted during the study period of January 2011–December 2012. In describing actions performed, students most frequently wrote about aspects of patient-centered care such as listening to the patient, carefully assessing the patient’s condition, or giving a detailed explanation to the patient. In describing effects of those actions, students wrote about what they learned about the patient-physician interaction, the trust that patients demonstrated in them, the approval they gained from their preceptors, and the benefits they saw from their actions.Conclusions: An important contribution of a family medicine clerkship is the opportunity for students to further their skills in patient-centered care and realize the outcomes of providing that type of care.(Fam Med 2016;48(4):294-9.)Reflection after patient encounters is an important aspect of clinical learning1 and contributes to the development of competent and humanistic physicians.2-5 The Society of Teachers of Family Medicine’s Family Medicine Clerkship Curriculum encourages reflection as one educational method to enhance student learning.6 Recent work describes the content of reflections on a psychiatry clerkship7 and the development of professional identity revealed in reflections written during a 15-month pre-clerkship curriculum.8 There have been reports of family medicine clerkship students’ reflections on their cross-cultural encounters,9 on their patient-physician interactions,10 and on how their encounters enabled them to realize five key characteristics of family physicians.11 However, there is still much to learn about types of meaningful encounters on a family medicine clerkship that encourage reflection.In January 2011, our medical school instituted a reflective writing assignment for students to complete after each clerkship. As we introduced this assignment on our family medicine clerkship, the following were our questions of interest:(1) What were the meaningful learning moments on this clerkship that students described in the reflection papers?(2) What student actions resulted in these learning moments?(3) What were the effects of these actions?Methods
机译：背景与目的：患者相遇后的反思是临床学习的重要方面。在我们的医学院为所有文职人员设立了反思论文作业之后，我们想了解学生在家庭医学文职工作中发现有意义的相遇类型及其对学生学习的影响。方法：家庭和社区医学文职学生完成了反思担任职员职务后的论文，基于我们医学院用于所有职员职务反思论文的指导原则。两名审稿人将学生的回答独立组织为主题，然后共同确定共同主题的优先级，并就其他主题达成初步共识。结果：在2011年1月至12月的研究期间，共提交了272篇反映患者护理实际学习时机的反思论文。 2012年。在描述所执行的动作时，学生最常写有关以患者为中心的护理方面的信息，例如听患者，仔细评估患者的状况或向患者提供详细的说明。在描述这些动作的效果时，学生写下了他们对医患互动的了解，病人对他们的信任，他们从他们的导师那里获得的认可以及从他们的动作中看到的好处。结论：重要的贡献家庭医学业务的发展为学生提供了机会，以提高他们在以患者为中心的护理中的技能并实现提供这种类型护理的结果。（Fam Med 2016; 48（4）：294-9。）临床学习的一个重要方面1，并有助于培养称职和人文主义的医师。2-5家庭医学教师协会的家庭医学文员课程鼓励将反思作为一种增强学生学习的教育方法。6最近的工作描述了反思的内容在15个月的书记员前课程期间所写的感言中揭示了精神病学书记7和职业身份的发展riculum.8的报道有家庭医学文员学生对他们的跨文化相遇的反思，9关于他们与医患的互动，10以及他们的相遇如何使他们认识到家庭医生的五个关键特征的报道。11但是关于家庭医学业务中有意义的相遇类型的更多信息值得学习，以鼓励反思。2011年1月，我们的医学院设立了反思性写作作业，让学生在完成每个业务后完成工作。当我们将这项作业介绍给我们的家庭医学文员时，以下是我们感兴趣的问题：（1）学生在反思论文中描述的关于该文员的有意义的学习时刻是什么？（2）在这些学习时刻中学生采取了什么行动（3）这些措施的作用是什么？

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