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首页> 外文期刊>Advances in health sciences education: theory and practice >Making sense of how physician preceptors interact with medical students: Discourses of dialogue, good medical practice, and relationship trajectories
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Making sense of how physician preceptors interact with medical students: Discourses of dialogue, good medical practice, and relationship trajectories

机译：理解医师的感受器如何与医学生互动：对话的话语，良好的医学实践和关系轨迹

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Work based learning and teaching in health care settings are complex and dynamic. Sociocultural theory addresses this complexity by focusing on interaction between learners, teachers, and their environment as learners develop their professional identity. Although social interaction between doctors and students plays a crucial role in this developmental process, socio-cultural research from the perspective of doctors is scarce. We performed discourse analysis on seven general practitioners' audio diaries during a 10-week general practice clerkship to study how they gave shape to their interaction with their students. Examination of 61 diary-entries revealed trajectories of developing relationships. These trajectories were initiated by the way respondents established a point of departure, based on their first impression of the students. It continued through the development of dialogue with their student and through conceptualizations of good medical practice. Such conceptualizations about what was normal in medical and educational practice enabled respondents to recognize qualities in the student and to indirectly determine students' desired learning trajectory. Towards the end, discursive turns in respondents' narratives signaled development within the relationship. This became evident in division of roles and positions in the context of daily practice. Although respondents held power in the relationships, we found that their actions depended strongly on what the students afforded them socially. Our findings address a gap in literature and could further inform theory and practice, for example by finding out how to foster constructive dialogue between doctors and students, or by exploring different discourses among learners and teachers in other contexts.
机译：在医疗机构中基于工作的学习和教学是复杂而动态的。社会文化理论通过关注学习者，教师及其环境之间的相互作用来解决这种复杂性，因为学习者发展了他们的职业身份。尽管在这一发展过程中，医患之间的社会互动起着至关重要的作用，但从医者的角度进行社会文化研究却很少。在为期10周的全科实习期间，我们对7名全科医生的音频日记进行了语篇分析，以研究他们如何形成与学生的互动。对61个日记条目的检查揭示了发展中的关系的轨迹。这些轨迹是由受访者根据对学生的第一印象建立出发点的方式发起的。通过与学生的对话的发展以及对良好医疗实践的概念化，这一过程得以继续。这种关于医学和教育实践中正常现象的概念化使受访者能够认识到学生的素质并间接确定学生期望的学习轨迹。最终，受访者叙述中的话语转向标志着双方关系的发展。在日常实践中，角色和职位的划分变得很明显。尽管受访者在这段关系中拥有力量，但我们发现他们的行为在很大程度上取决于学生在社会上为他们提供的东西。我们的发现解决了文学领域的空白，并可能进一步为理论和实践提供信息，例如，通过发现如何促进医患之间的建设性对话，或在其他情况下探索学习者和教师之间的不同话语。

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