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首页> 外文期刊>Advances in health sciences education: theory and practice >At the precipice: a prospective exploration of medical students' expectations of the pre-clerkship to clerkship transition
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At the precipice: a prospective exploration of medical students' expectations of the pre-clerkship to clerkship transition

机译：在悬崖上：对医学生对从文员到文员过渡的期望的前瞻性探索

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Medical learners face many challenging transitions. We prospectively explored students' perceptions of their upcoming transition to clerkship and their future professional selves. In 2013, 160/165 end-of-second-year medical students wrote narrative reflections and 79/165 completed a questionnaire on their perceptions of their upcoming transition to clerkship. Narratives were separately analyzed by four authors and then discussed to identify a final thematic framework using parsimonious category construction. We identified two overarching themes: (1) "Looking back": experiences which had helped students feel prepared for clerkship with subthemes focused on of patient care, shadowing, classroom teaching and the pre-clerkship years as foundational knowledge, (2) "Looking forward": anticipating the clerkship experience and the journey of becoming a physician with subthemes focused on death and dying, hierarchy, work-life balance, interactions with patients, concerns about competency and career choice. Questionnaire data revealed incongruities around expectations of minimal exposure to death and dying, little need for independent study and limited direct patient responsibility. We confirmed that internal transformations are happening in contemplative time even before clerkship. By prospectively exploring pre-clerkship students' perceptions of the transition to clerkship training we identified expectations and misconceptions that could be addressed with future curricular interventions. While students are aware of and anticipating their learning needs it is not as clear that they realise how much their future learning will depend on their own inner resources. We suggest that more attention be paid to professional identity formation and the development of the physician as a person during these critical transitions.
机译：医学学习者面临许多挑战。我们前瞻性地探讨了学生对他们即将过渡到文职和未来的职业自我的看法。 2013年，有160/165名二年级医学专业的学生写了叙事感言，而79/165名学生则完成了关于他们对即将过渡为文员的看法的问卷调查。四位作者分别对叙事进行了分析，然后进行了讨论，以使用简约的类别构建来确定最终的主题框架。我们确定了两个总体主题：（1）“回头看”：那些帮助学生为参加文职工作做好准备的体验，其子主题着重于患者护理，阴影，课堂教学和入职前的年限等基础知识，（2）前进”：预测其工作经历和成为医师的历程，其子主题关注死亡和垂死，等级，工作与生活的平衡，与患者的互动，对能力和职业选择的关注。问卷调查数据显示，人们对死亡和垂死的几率极小，对独立研究的需求很少以及对患者的直接责任有限，因此他们的期望不一致。我们证实，内部变革是在深思熟虑的时期发生的，甚至在担任文职人员之前。通过前瞻性地研究入职前学生对入职培训的看法，我们确定了可以通过将来的课程干预解决的期望和误解。尽管学生意识到并预期了他们的学习需求，但还不清楚他们是否意识到自己未来的学习将在很大程度上取决于他们自己的内部资源。我们建议在这些关键的过渡过程中，应更加注意专业身份的形成和医师作为一个人的发展。

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