Role modeling humanistic behaviour: Learning bedside manner from the experts

被引:167
作者
Weissmann, Peter F.
Branch, William T.
Gracey, Catherine F.
Haidet, Paul
Frankel, Richard M.
机构
[1] Univ Minnesota, Dept Med, Hennepin Cty Med Ctr, Sch Med, Minneapolis, MN 55415 USA
[2] Emory Univ, Sch Med, Div Gen Internal Med, Atlanta, GA USA
[3] Univ Rochester, Med Ctr, Sch Med & Dent, Rochester, NY 14642 USA
[4] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA
[5] Indiana Univ, Sch Med, Regenstrief Inst Hlth Care, Indianapolis, IN 46202 USA
[6] Richard L Roudebush Vet Affairs Med Ctr, Ctr Implementing Evidence Based Practice, Indianapolis, IN 46202 USA
关键词
D O I
10.1097/01.ACM.0000232423.81299.fe
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
Purpose Humanistic care is regarded as important by patients and professional accrediting agencies, but little is known about how attitudes and behaviors in this domain are taught in clinical settings. To answer this question, the authors studied how excellent clinical teachers impart the behaviors and attitudes consistent with humanistic care to their learners. Method Using an observational, qualitative methodology, the authors studied 12 clinical faculty identified by the medical residents enrolled from 2003 to 2004 as excellent teachers of humanistic care on the inpatient medical services at four medical universities in the United States (University of Minnesota Medical School, Emory University, University of Rochester School of Medicine, and Baylor College of Medicine). Observations were conducted by the authors using standardized field notes. After each encounter, the authors debriefed patients, learners (residents and medical students), and the teaching physicians in semistructured interviews. Results Clinical teachers taught primarily by role modeling. Although they were highly aware of their significance as role models, they did not typically address the human dimensions of care overtly. Despite the common themes of role modeling identified, each clinical teacher exhibited unique teaching strategies. These clinical teachers identified self-reflection as the primary method by which they developed and refined their teaching strategies. Conclusions Role modeling is the primary method by which excellent clinical teachers try to teach medical residents humanistic aspects of medical care. Although clinical teachers develop unique teaching styles and strategies, common themes are shared and could be used for the future development of clinical faculty.
引用
收藏
页码:661 / 667
页数:7
相关论文
共 43 条
[1]   Following medical school graduates into practice: Residency directors' assessments after the first year of residency [J].
Alexander, GL ;
Davis, WK ;
Yan, AC ;
Fantone, JC .
ACADEMIC MEDICINE, 2000, 75 (10) :S15-S17
[2]  
BANDURA A, 1986, SOCIAL FDN THOUGHT A
[3]  
BIRNBAUM G, 1997, MED ENCOUNTER, V13, P11
[4]   Iterative method for learning skills as an efficient outpatient teacher [J].
Brady, D ;
Schultz, L ;
Spell, N ;
Branch, WT .
AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 2002, 323 (03) :124-129
[5]   Feedback and reflection: Teaching methods for clinical settings [J].
Branch, WT ;
Paranjape, A .
ACADEMIC MEDICINE, 2002, 77 (12) :1185-1188
[6]   Teaching the human dimensions of care in clinical settings [J].
Branch, WT ;
Kern, D ;
Haidet, P ;
Weissmann, P ;
Gracey, CF ;
Mitchell, G ;
Inui, T .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 286 (09) :1067-1074
[7]   Teaching compassion and respect - Attending physicians' responses to problematic behaviors [J].
Burack, JH ;
Irby, DM ;
Carline, JD ;
Root, RK ;
Larson, EB .
JOURNAL OF GENERAL INTERNAL MEDICINE, 1999, 14 (01) :49-55
[8]   The evolution of courses in professional skills and perspectives for medical students [J].
Curry, RH ;
Makoul, G .
ACADEMIC MEDICINE, 1998, 73 (01) :10-13
[9]   EFFECTS OF COMMUNICATION-SKILLS TRAINING ON STUDENTS DIAGNOSTIC EFFICIENCY [J].
EVANS, BJ ;
STANLEY, RO ;
MESTROVIC, R ;
ROSE, L .
MEDICAL EDUCATION, 1991, 25 (06) :517-526
[10]   Precepting humanism: Strategies for fostering the human dimensions of care in ambulatory settings [J].
Gracey, CF ;
Haidet, P ;
Branch, WT ;
Weissmann, P ;
Kern, DE ;
Mitchell, G ;
Frankel, R ;
Inui, T .
ACADEMIC MEDICINE, 2005, 80 (01) :21-28