Inevitably, reading is one of the requirements to be undergone. To improve the performance and quality, someone needs to have something new every day. It will suggest you to have more inspirations, then. However, the needs of inspirations will make you searching for some sources. Even from the other people experience, internet, and many books. Books and internet are the recommended media to help you improving your quality and performance.

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Medicine, rationality, and experience: an anthropological perspective.

Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor?

Context: Medical education is as much about the development of a professional identity as it is about knowledge learning. Professional identities are contested and accepted through the synergistic internal–external process of identification that is constituted in and through language and artefacts within specific institutional sites. The ways in which medical students develop their professional identity and subsequently conceptualise their multiple identities has important implications for their own well-being, as well as for the relationships they form with fellow workers and patients.

Objectives: This paper aims to provide an overview of some current thinking about identity and identification with the aim of highlighting some of the core underlying processes that have relevance for medical educationists and researchers. These processes include aspects that occur within embodied individuals (e.g. the development of multiple identities and how these are conceptualised), processes specifically to do with interactional aspects of identity (e.g. how identities are constructed and co-constructed through talk) and institutional processes of identity (e.g. the influence of patterns of behaviour within specific hierarchical settings).

Implications: Developing a systematic understanding into the processes through which medical students develop their identities will facilitate the development of educational strategies, placing medical students’ identification at the core of medical education.

Conclusions: Understanding the process through which we develop our identities has profound implications for medical education and entails that we adopt and develop new methods of collecting and analysing data. Embracing this challenge will provide better insights into how we might develop students’ learning experiences, facilitating their development of a doctor identity that is more in line with desired policy requirements.

Identity, identification and medical education: why should we care?

Review date: Review period January 1992–December 2001. Final analysis July 2004–January 2005.Background and review context: There has been no rigorous systematic review of the outcomes of early exp...

How can experience in clinical and community settings contribute to early medical education? A BEME systematic review.

Relationship-Centered Care acknowledges the central importance of relationships in medical care. In a similar fashion, relationships hold a central position in medical education, and are critical for achieving favorable learning outcomes. However, there is little empirical work in the medical literature that explores the development and meaning of relationships in medical education. In this essay, we explore the growing body of work on the culture of medical school, often termed the “hidden curriculum.” We suggest that relationships are a critical mediating factor in the hidden curriculum. We explore evidence from the educational literature with respect to the student-teacher relationship, and the relevance that these studies hold for medical education. We conclude with suggestions for future research on student-teacher relationships in medical education settings.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1525-1497.2006.00304.x

The Role of the Student-Teacher Relationship in the Formation of Physicians: The Hidden Curriculum as Process

Context Medical educators have emphasized the importance of teaching patient-centred care.

Objectives  To describe and quantify the attitudes of medical students towards patient-centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient-centred attitudes.

Methods  We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient–Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor–patient relationship. Total PPOS scores can range from patient-centred (egalitarian, whole person oriented) to disease- or doctor-centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate coursework, family medical background and specialty choice were collected from the fourth year class.

Results  A total of 510 students (76%) completed data collection. Female gender (P < 0·001) and earlier year of medical school (P = 0·03) were significantly associated with patient-centred attitudes. Among fourth year students (n = 89), characteristics associated with more patient-centred attitudes included female gender, European-American ethnicity, and primary-care career choice (P < 0·05 for each comparison).

Conclusion  Despite emphasis on the need for curricula that foster patient-centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor-centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient-centred care in the current medical environment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centred care.

Medical student attitudes toward the doctor-patient relationship

The physician–patient relationship is central to the delivery of high-quality medical care and has been shown to affect patient satisfaction and a variety of other biological, psychological, and social outcomes. Patient-centered care is one aspect of the physician–patient relationship that takes into account patients’ preferences, concerns, and emotions and has been proposed as a mechanism through which favorable patient outcomes are achieved. In recent years, medical educators have recognized the importance of patient-centered care by instituting a variety of curricula to teach communication skills, professional values, and patient-centered behaviors to medical students. Despite the presence of such curricula, we recently demonstrated that medical students have less patientcentered attitudes in later years of medical school. Our quantitative results augment a large body of qualitative and ethnographic data that suggest that the culture of medical education emphasizes biomedical issues at the expense of patients’ preferences, concerns, and emotions. However, few data exist regarding the clinical significance of students’ patient-centered attitudes. Understanding the clinical significance of students’ attitudes is critical in the present context of ongoing debate about the relative merits of teaching attitudes versus skills in order to promote greater patient-centered care and improve patients’ outcomes. In this study, we explored associations between students’ attitudes toward patient-centered care and standardized patients’ perceptions of humanism, a construct commonly included in patient-satisfaction outcome measures.

Medical students' attitudes toward patient-centered care and standardized patients' perceptions of humanism: a link between attitudes and outcomes.

Background and objectives Previous reports have defined the time that community preceptors spend teaching students, but much remains to be learned about the process and content of office-based teaching. Our objective was to understand better the teaching process and content by documenting how often preceptors used the microskills described in the Five-step "Microskills" Model of Clinical Teaching and how often they discussed tasks described in the Task-oriented Processes in Care (TOPIC) teaching model when working with their students. Methods Using a checklist combining these two models, two independent observers documented the teaching and learning that occurred between 12 preceptors and their students. Results Inter-rater concordance was 96.2%. Preceptors frequently used two of the teaching microskills, "probe for supporting evidence" and "teach general rules." Preceptors and students frequently discussed many information-processing and management tasks in the TOPIC model. Conclusions Despite the lack of training in using either model, preceptors frequently used some teaching microskills and discussed many TOPIC model tasks. This finding supports both models as relevant teaching models but further observational study of preceptors trained in using both models is needed. For the TOPIC model, preceptor development may help preceptors to more explicitly refer to TOPIC tasks when teaching clinical content to students.

Observations on the teaching and learning occurring in offices of community-based family and community medicine clerkship preceptors.

Performances on a clinical skills OSCE of first- and second-year students were compared to measure the success of a new interviewing and physical examination component of the first-year curriculum.

Can first-year students master clinical skills?

Background and Objectives: The TOPIC model conceptualizes the work of family physicians as five prototypical visits (new problem, checkup, chronic illness, psychosocial problem, and behavioral change) and four major processes (physician information processing, patient-physician relationship development, integration of information and relationship, and lifelong learning). This paper describes methods for teaching this model to clerkship students and reports 4 years of outcome data. Methods: The instruction included seminars at the beginning of the rotation, a laminated pocket card as a reminder in clinical sites, a clerkship “passport” with examples of TOPIC verbal presentations, and student selfstudy for the end-of-rotation Clinical Performance Examination (CPX). Evaluation outcomes include student perceptions of the seminars and student performance on the CPX. Results: Students rated the usefulness of the seminars favorably. The CPX scores showed that students performed most of the tasks expected for each prototypical visit. Conclusions: Students learned the tasks presented in the seminars and demonstrated them during the CPX. The model is robust since students learned the material despite some changes in teaching methods.

Joyce E Dains

Papers

Medical student attitudes toward the doctor-patient relationship

Medical students' attitudes toward patient-centered care and standardized patients' perceptions of humanism: a link between attitudes and outcomes.

Observations on the teaching and learning occurring in offices of community-based family and community medicine clerkship preceptors.

Can first-year students master clinical skills?

Task-oriented processes in care (TOPIC): a proven model for teaching ambulatory care.