Abstract:Medical education follows the clinical drive toward patient-centered care and, therefore, puts strong emphasis on the development of empathy by medical students. It has, however, been found that there is a decline in empathy throughout a student’s education. Students’ participation in role-play as the doctor has been proved to improve patient care in a clinical capacity. Here, it is proposed that patient role-play can enhance patient care holistically, by enhancing key communication skills and student’s empath… Show more
“…It is crucial to bear in mind that "while students may understand the importance of empathy, there is currently no consensus on the appropriate method for teaching this quality" [71]. For instance, a widely used method of enhancing medical students' empathy is the role-play and "the participation in both sides of the doctor-patient partnership" [72]. At any rate, it is crucial to bear in mind that "the current empathy intervention literature is limited by a variety of methodological weaknesses" [60].…”
Section: The Role Of Empathy In Clinical Practicementioning
Aims and objectivesEmpathy is an important key driver of any therapeutic relationship. It is beneficial not only to the patients, but also to physicians. Enhancing physician’s empathy should be an important goal of medical education. As there is a literature gap regarding the topic of empathy among medical students in Greece, this study aims to contribute to filling this gap.MethodsA cross-sectional study was conducted. The (validated in Greece) Greek version of Toronto 52‐item empathy 6-point Likert-scale was administered to all the medical students in the Aristotle University of Thessaloniki, in Greece. In addition, participants were asked to provide information regarding their socio-demographics. A demographic comparison was conducted.ResultsThe preliminary validation of the Greek version of the Toronto Composite Empathy Scale (TCES) demonstrated acceptable validity and reliability among medical students and could be further tested in larger samples of medical students. The overall reliability analysis of the TCES questionnaire is high (Cronbach's α = 0.895, Sig. from Hotelling’s T-Squared Test < 0.000). The mean total score of empathy showed that students have a moderately high empathy. The 52‐item TCES, 26 for the personal (Per) setting and another 26 for professional (Pro) life, equally divided into cognitive (Cog) and emotional (Emo) empathy in each case. It was found that there is a statistically significant difference in means between the Per-Cog and Per-Emo settings (Sig < 0.001), the Pro-Cog and Pro-Emo (Sig < 0.001), the Per-Cog and Pro-Cog (Sig = 0.004), and the Per-Emo and Pro-Emo (Sig < 0.001). Females had significantly higher empathy scores (mean score 208.04) than males (mean score 192.5) on the Per-Cognitive, Per-Emo and Pro-Emo subscales. Furthermore, a positive correlation was found between empathy and factors such as love for animals, interest in medical ethics, belief in God, having an ill person in the family, class year or carrier intention.ConclusionsThe Toronto Composite Empathy Scale (TCES) is applicable to medical students. For the most part our findings were consistent with previous literature. However, we identified some nuances that might draw researchers’ attention.
“…It is crucial to bear in mind that "while students may understand the importance of empathy, there is currently no consensus on the appropriate method for teaching this quality" [71]. For instance, a widely used method of enhancing medical students' empathy is the role-play and "the participation in both sides of the doctor-patient partnership" [72]. At any rate, it is crucial to bear in mind that "the current empathy intervention literature is limited by a variety of methodological weaknesses" [60].…”
Section: The Role Of Empathy In Clinical Practicementioning
Aims and objectivesEmpathy is an important key driver of any therapeutic relationship. It is beneficial not only to the patients, but also to physicians. Enhancing physician’s empathy should be an important goal of medical education. As there is a literature gap regarding the topic of empathy among medical students in Greece, this study aims to contribute to filling this gap.MethodsA cross-sectional study was conducted. The (validated in Greece) Greek version of Toronto 52‐item empathy 6-point Likert-scale was administered to all the medical students in the Aristotle University of Thessaloniki, in Greece. In addition, participants were asked to provide information regarding their socio-demographics. A demographic comparison was conducted.ResultsThe preliminary validation of the Greek version of the Toronto Composite Empathy Scale (TCES) demonstrated acceptable validity and reliability among medical students and could be further tested in larger samples of medical students. The overall reliability analysis of the TCES questionnaire is high (Cronbach's α = 0.895, Sig. from Hotelling’s T-Squared Test < 0.000). The mean total score of empathy showed that students have a moderately high empathy. The 52‐item TCES, 26 for the personal (Per) setting and another 26 for professional (Pro) life, equally divided into cognitive (Cog) and emotional (Emo) empathy in each case. It was found that there is a statistically significant difference in means between the Per-Cog and Per-Emo settings (Sig < 0.001), the Pro-Cog and Pro-Emo (Sig < 0.001), the Per-Cog and Pro-Cog (Sig = 0.004), and the Per-Emo and Pro-Emo (Sig < 0.001). Females had significantly higher empathy scores (mean score 208.04) than males (mean score 192.5) on the Per-Cognitive, Per-Emo and Pro-Emo subscales. Furthermore, a positive correlation was found between empathy and factors such as love for animals, interest in medical ethics, belief in God, having an ill person in the family, class year or carrier intention.ConclusionsThe Toronto Composite Empathy Scale (TCES) is applicable to medical students. For the most part our findings were consistent with previous literature. However, we identified some nuances that might draw researchers’ attention.
“…Tıp öğrencilerinin meslek kimliği kazanmalarında, "öyküleştirme" ve "öykü incelemelerinin" önemli rolü olduğu sıklıkla bildirilmiştir (16,(21)(22)(23)(24). Eğitiminin ilk yıllarında, öğrencilerin yaşadıkları olumsuz deneyimlerini yazı yoluyla öyküleştirmelerinin, "doğru" mesleki kimlik kazanmaları için etkin bir yöntem olduğu, içgörü sağladığı ve davranış değişikliği oluşturduğu gösterilmiştir (21)(22)(23)24). Meslek kimliğinin edinilmesine ve öğrencinin içgörü kazanmasına katkıda bulunan "yansıtıcı-aydınlatıcı" (reflective) yazma uygulamaları, önemli mesleki gelişim tekniği olarak kabul görerek, gelişmiş ülkelerin tıp eğitimi programlarında uzun süre önce yerini almıştır (7,13,25,26).…”
Section: Eğitimde öYküleştirmeunclassified
“…Hastalık deneyiminin öznel, sezgisel ve anlatısal yönlerini değerlendiren hasta merkezli yaklaşımın en önemli araçları; duygudaşlık (empati) ve iletişimdir. Tıp öğrencilerinde eğitimin ilk yıllarında daha yoğun olan duygudaşlığın, süreç içinde zayıfladığını gösteren çok sayıda çalışma vardır (9,17,22,23,27). Ülkemizde tıp öğrencilerinde yapılan bir araştırmada; öğrencilerin empati puanlarının gelişmiş ülke öğrencilerinden düşük olduğu, kız öğrencilerin empati puanlarının daha yüksek olduğu, empati puanı düşük öğrencilerin başarı düzeyinin de düşük olduğu ve öğrencilerin mutlulukları ile yüksek empati puanları arasında pozitif ilişki olduğu bildirilmiştir (28).…”
Section: Eğitimde öYküleştirmeunclassified
“…Bu nedenle eğitim-öğretim hedefleri, başlangıçta en "sağlam" örüntüyü sağlayacak şekilde yapılandırılmalıdır. Tıp öğrencilerinin meslek kimliği kazanmalarında, "öyküleştirme" ve "öykü incelemelerinin" önemli rolü olduğu sıklıkla bildirilmiştir (16,(21)(22)(23)(24). Eğitiminin ilk yıllarında, öğrencilerin yaşadıkları olumsuz deneyimlerini yazı yoluyla öyküleştirmelerinin, "doğru" mesleki kimlik kazanmaları için etkin bir yöntem olduğu, içgörü sağladığı ve davranış değişikliği oluşturduğu gösterilmiştir (21)(22)(23)24).…”
ÖZ
Hastalık
öyküleri tıbbı olguları tanımlamakla kalmaz; özelde, bir insanın yaşam ve
ölümünün en “asıl” gerçekliğini de anlatır. Tıpta “öyküleştirme” ya da
“anlatısallık” (narrative medicine); bireyin kendini, hastalığını ve yaşamı
nasıl algıladığını anlayarak, yaşadığı acı veren deneyimle baş etmesini
kolaylaştırmak amacında olan bir yaklaşımdır. Hasta oluş ve çare aramanın
öyküleştirilmesi; hekim, hasta ve hasta yakınlarına karşılıklı anlamayı
güçlendiren önemli bir içgörü kazandırır. “Yapılandırılmış” öyküler, yaşanılan
olumsuz deneyimden uzaklaşarak farklı bir bakış açısıyla görmeyi sağlar. Hastalıkların
tanı ve sağaltımını yönlendiren, kanıtlanabilen ve sonuca götüren uygulamalar
tıbbın temelidir. Ancak bireyin “eşsiz”liği ve “öznel” unsurların anlaşılması
da tanı ve sağaltıma, göz ardı edilemeyecek denli katkı sağlamaktadır. Kanıta
dayalı tıbbın, “öyküye dayalı tıp” yaklaşımı ile bütünleştirilebilmesi için,
“hasta merkezli” modelin benimsenmesi gerekir. Hekim-hasta ilişkisinde hasta
merkezli yaklaşımın özünü öyküler oluşturur. Öyküler nedenselliği aydınlatan
araçlardır. “Olgu” öyküleri, patolojik durumların tanımlanmasının yanı sıra,
belli bir bireyde, bir hastalığın “nasıl” yaşandığını da gösterir. Hastalıkları,
yalnız biyolojik ve patolojik nedenlerle açıklayan biyomedikal yaklaşımın, süreç
içinde evrildiği “biyo-psiko-sosyal” model, hastalıkların ruhsal ve sosyal unsurlar
da içerdiği gerçeğiyle, “hastalık yok, hasta var” bilincini geliştirmiştir. Biliminin
kanıta dayalı olması gerektiği gerçeği, tıbbın öznel yanının yok sayılmasını
gerektirmemektedir. Çünkü öznellik, tanısal durumlarda karar vermeyi
kolaylaştıran ve sağaltımı, “o” birey için yapılandırabilen bir unsurdur. “Hastayı
dinlerseniz size tanısını söyler” öğretisi ve “hümanizma”, tıbbı uygulamada
giderek yok olmaktadır. Bu
çalışmanın amacı; öyküleştirmenin tıp eğitimi ve uygulamalarında neden ve nasıl
var olması gerektiğini incelemektir.
“…Of particular interest is whether student portrayal of patients’ roles leads to greater learning related to empathy for patients’ perspectives. 12 16 27 This outcome has been proposed as a unique benefit of peer simulation above other SBE approaches. 28 It is also unclear whether the familiarity that exists between the simulated patient and simulated practitioner in peer simulation is a barrier, an enabler, or irrelevant with respect to the value of the exercise.…”
IntroductionSimulation-based education (SBE) benefits learners, but multiple barriers limit curriculum integration. Peer simulation, where students are formally educated to portray patient roles in simulated interactions with their peers, might maintain the educational benefits of SBE, be cost-effective, and enable additional learning. Our research question was: ‘What are the perspectives and experiences of physiotherapy students who participated in peer simulation?’.MethodsSecond-year physiotherapy students (n=16) participated in a blended peer simulation programme that included preparation for patient role portrayal and simulated clinical interactions with peers. Using an interpretivist approach, students’ experiences and perspectives were explored in two focus groups. Inductive thematic analysis was completed by two researchers.ResultsThree primary themes were identified that characterised the experiences and perspectives of physiotherapy students: peer simulation is a valuable learning experience, specific design features enable effective peer simulation, and portraying a patient provides unique insight. Peer simulation was unexpectedly realistic, revealed knowledge and skill deficits, and improved their clinical skills. Specific design features included consistent engagement, repetitive, individualised practice, multiple forms of feedback, and detailed role preparation. Being the patient in peer simulation gave students unique and valuable insight into patients’ experiences of and feelings about health issues and healthcare interactions.ConclusionPhysiotherapy students acquire new insights during peer simulation that may enrich their capabilities for practice through understanding healthcare interactions from patients’ perspectives. Physiotherapy students’ learning in peer simulation appears to align with the powerful learning experiences of health professional students in other immersive simulation modalities.
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