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Providing a liminal space: Threshold concepts for learning in palliative medicine

机译：提供宽限性空间：在姑息医学中学习的阈值概念

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Introduction: Experience in palliative medicine provides a beneficial learning opportunity for doctors-in-training. There is, however, a gap in understanding which aspects of learning are most useful, which are problematic and how learning can best be facilitated. This study addresses that gap using the 'threshold concepts' framework. Threshold concepts are critical points of learning, often unique to a discipline. The learning occurs within a transitional or 'liminal' space and has specific characteristics including being 'troublesome' and 'transformative.' Methods: A qualitative, exploratory study was carried using the threshold concept framework. Semi-structured focus group interviews were held with doctors-in-training who had undertaken a 6-month palliative medicine attachment. Data were analysed using a content analysis approach with deductive and inductive phases, in order to identify threshold concepts. Results: Five threshold concepts were identified. Two of these, 'emotional engagement' and 'communication management,' displayed all the typical characteristics of threshold concepts. This learning was highly valued by participants, had not occurred elsewhere in training and continued to influence practice. Conclusions: Specific threshold concepts were identified for doctors undertaking a palliative medicine placement. These highlights where specific supports are required for learning and can be used to inform curriculum design.
机译：简介：姑息医学的经验为医生培训提供了有益的学习机会。然而，在理解哪个方面是最有用的，这是有问题的，并且如何最好地促进学习。本研究使用“阈值概念”框架来解决该差距。门槛概念是学习的关键点，通常是一个纪律的独特。学习发生在过渡或“纯粹”空间内，并且具有特定的特征，包括“麻烦”和“转型性”。方法：使用阈值概念框架进行定性，探索性研究。随着医生培训，半结构化重点小组访谈举办了一个6个月的姑息医学附件。使用具有演绎和归纳阶段的内容分析方法进行分析数据，以识别阈值概念。结果：确定了五个阈值概念。其中两个“情绪参与”和“通信管理”显示了阈值概念的所有典型特征。该学习受到参与者的高度重视，在培训的其他地方没有发生并继续影响实践。结论：确定特定的阈值概念为持姑娘医学展示的医生。这些亮点学习所需的特定支持，可用于告知课程设计。

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