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- Andersson, Jenny, et al.
(författare)
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Using patients' narratives to reveal gender stereotypes among medical students
- 2013
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Ingår i: Academic Medicine. - 1040-2446 .- 1938-808X. ; 88:7, s. 1015-1021
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Gender bias exists in patient treatment, and, like most people, health care providers harbor gender stereotypes. In this study, the authors examined the gender stereotypes that medical students hold about patients. Method: In 2005, in Umeå, Sweden, the authors collected 81 narratives written by patients who had undergone cancer treatment; all information that might reveal the patients’ gender was removed from the texts. Eighty-seven medical students read 40 or 41 narratives each, guessed the patient’s gender, and explained their guess. The authors analyzed the students’ explanations qualitatively and quantitatively to reveal the students’ gender stereotypes and to determine whether those stereotypes had any predictive value for correctly guessing a patient’s gender. Results: The students’ explanations contained 21 categories of justifications, 12 of which were significantly associated with the students guessing one gender or the other. Only three categories successfully predicted a correct identification of gender; two categories were more often associated with incorrect guesses. Conclusions: Medical students enter their training program with culturally shared stereotypes about male and female patients that could cause bias during their future careers as physicians. To prevent this, medical curricula must address gender stereotypes and their possible consequences. The impact of implicit stereotypes must be included in discussions about gender bias in health care.
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| 4. |
- Englander, Robert, et al.
(författare)
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Coproducing health professions education : A prerequisite to coproducing health care services?
- 2020
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Ingår i: Academic Medicine. - : Wolters Kluwer. - 1040-2446 .- 1938-808X. ; 95:7, s. 1006-1016
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Tidskriftsartikel (refereegranskat)abstract
- In 2016, Batalden et al proposed a coproduction model for health care services. Starting from the argument that health care services should demonstrate service-dominant rather than goods-dominant logic, they argued that health care outcomes are the result of the intricate interaction of the provider and patient in concert with the system, community, and, ultimately, society. The key notion is that the patient is as much an expert in determining outcomes as the provider, but with different expertise. Patients come to the table with expertise in their lived experiences and the context of their lives.The authors posit that education, like health care services, should follow a service-dominant logic. Like the relationship between patients and providers, the relationship between learner and teacher requires the integrated expertise of each nested in the context of their system, community, and society to optimize outcomes. The authors then argue that health professions learners cannot be educated in a traditional, paternalistic model of education and then expected to practice in a manner that prioritizes coproductive partnerships with colleagues, patients, and families. They stress the necessity of adapting the health care services coproduction model to health professions education. Instead of asking whether the coproduction model is possible in the current system, they argue that the current system is not sustainable and not producing the desired kind of clinicians.A current example from a longitudinal integrated clerkship highlights some possibilities with coproduced education. Finally, the authors offer some practical ways to begin changing from the traditional model. They thus provide a conceptual framework and ideas for practical implementation to move the educational model closer to the coproduction health care services model that many strive for and, through that alignment, to set the stage for improved health outcomes for all.
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| 5. |
- Hagelin, Joakim, et al.
(författare)
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Undergraduate University Students' Views on the Use of Animals in Biomedical Research
- 1999
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Ingår i: Academic Medicine. - : Ovid Technologies (Wolters Kluwer Health). - 1040-2446 .- 1938-808X. ; 74:10, s. 1135-1137
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To investigate the influences of gender, discipline, and level onundergraduate students' views of the use of animals, in research. Method. In 1998, 888 university undergraduate students from six different programs were surveyed at Uppsala University for their views of animal use in biomedical research. Statistical analysis involved chi-square tests. Results. Most students found animal use morally acceptable and believed it plays a significant role in the treatment of human diseases. Engineering, law, and medicalstudents were the most supportive, whereas preschool-teaching students were the least supportive. Men were more supportive than were women. Sixth-term medical and nursingstudents had a more positive view than did their inexperienced first-term peers. Conclusion. The results of this study show that university students, who will be tomorrow's decision makers, are likely to continue supporting the use of animals in biomedicalresearch and teaching.
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| 6. |
- Headrick, L. A., et al.
(författare)
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Exemplary Care and Learning Sites : A Model for Achieving Continual Improvement in Care and Learning in the Clinical Setting
- 2016
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Ingår i: Academic Medicine. - : Wolters Kluwer. - 1040-2446 .- 1938-808X. ; 91:3, s. 354-359
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Tidskriftsartikel (refereegranskat)abstract
- Problem Current models of health care quality improvement do not explicitly describe the role of health professions education. The authors propose the Exemplary Care and Learning Site (ECLS) model as an approach to achieving continual improvement in care and learning in the clinical setting.Approach From 2008-2012, an iterative, interactive process was used to develop the ECLS model and its core elements-patients and families informing process changes; trainees engaging both in care and the improvement of care; leaders knowing, valuing, and practicing improvement; data transforming into useful information; and health professionals competently engaging both in care improvement and teaching about care improvement. In 2012-2013, a three-part feasibility test of the model, including a site self-assessment, an independent review of each site's ratings, and implementation case stories, was conducted at six clinical teaching sites (in the United States and Sweden).Outcomes Site leaders reported the ECLS model provided a systematic approach toward improving patient (and population) outcomes, system performance, and professional development. Most sites found it challenging to incorporate the patients and families element. The trainee element was strong at four sites. The leadership and data elements were self-assessed as the most fully developed. The health professionals element exhibited the greatest variability across sites.Next Steps The next test of the model should be prospective, linked to clinical and educa tional outcomes, to evaluate whether it helps care delivery teams, educators, and patients and families take action to achieve better patient (and population) outcomes, system performance, and professional development.
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- Lie Ken Jie, Christopher, et al.
(författare)
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Mechanisms Driving Postgraduate Health and Social Science Students' Cultural Competence : An Integrated Systematic Review
- 2022
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Ingår i: Academic Medicine. - : Lippincott Williams & Wilkins. - 1040-2446 .- 1938-808X. ; 97:11, s. 1707-1721
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE: The COVID-19 pandemic revealed a global urgency to address health care provision disparities, which have largely been influenced by systematic racism in federal and state policies. The World Health Organization recommends educational institutions train clinicians in cultural competence (CC); however, the mechanisms and interacting social structures that influence individuals to achieve CC have received little attention. This review investigates how postgraduate health and social science education approaches CC and how it accomplishes (or not) its goals.METHOD: The authors used critical realism and Whittemore and Knafl's methods to conduct a systematic integrated review. Seven databases (MEDLINE, CINAHL, PsycINFO, Scopus, PubMed, Web of Science, and ERIC) were searched from 2000 to 2020 for original research studies. Inclusion criteria were: the use of the term "cultural competence" and/or any one of Campinha-Bacote's 5 CC factors, being about postgraduate health and/or social science students, and being about a postgraduate curriculum or a component of it. Thematic analysis was used to reveal the mechanisms and interacting social structures underlying CC.RESULTS: Thirty-two studies were included and 2 approaches to CC (themes) were identified. The first theme was professionalized pedagogy, which had 2 subthemes: othering and labeling. The second theme was becoming culturally competent, which had 2 subthemes: a safe CC teaching environment and social interactions that cultivate reflexivity.CONCLUSIONS: CC conceptualizations in postgraduate health and social science education tend to view cultural differences as a problem and CC skills as a way to mitigate differences to enhance patient care. However, this generates a focus on the other, rather than a focus on the self. Future research should explore the extent to which insight, cognitive flexibility, and reflexivity, taught in safe teaching environments, are associated with increasing students' cultural safety, cultural humility, and CC.
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| 10. |
- Salander, Pär, 1948-, et al.
(författare)
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Why 'spirituality' instead of 'the humanistic side of medicine'?
- 2014
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Ingår i: Academic Medicine. - : Association of American Medical Colleges. - 1040-2446 .- 1938-808X. ; 89:11, s. 1430-
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Tidskriftsartikel (refereegranskat)abstract
- To the Editor: In a recent commentary, Puchalski et al1 describe the developing field of "spirituality” and its expansion into health professions education. However, we question whether this promotion really reflects an improvement.1 Puchalski CM, Blatt B, Kogan M, Butler A. Spirituality and health: The development of a field. Acad Med. 2014;89:10–16.
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