When patient-centred and family-centred approaches clash: Taiwanese health professions students' patient autonomy dilemmas

The hidden hurdles of clinical clerkship: unraveling the types and distribution of professionalism dilemmas among South Korean medical students

BACKGROUND

To improve the medical professionalism of medical students, it is essential to understand the dilemmas they face in various situations. This study explored the types and distribution of dilemmas Korean medical students encounter during their clinical clerkships. It then compared these with previous dilemma frameworks and identified the types and distribution of "complexity dilemmas," wherein two dilemma themes emerge in a single clinical situation.

METHODS

The researchers organized and recorded a group discussion with 106 third-year medical students who had completed their clinical clerkships. These students participated in the discussion as part of an assignment, focusing on the dilemmas they encountered during their clerkships. For data analysis and visualization, the researchers employed the MAXQDA software program and utilized the template analysis method, a qualitative research methodology.

RESULTS

A total of seven dilemma themes and sixteen sub-themes were identified. The identity-related dilemma concerning student-doctors had the highest frequency. The themes "mismatch" and "Nun-chi" emerged as new additions not found in previous dilemma frameworks. The complexity dilemmas appeared in the sequence of "identity-dignity," "identity-abuse," and "identity-consent".

CONCLUSIONS

To navigate the unique dilemmas present within South Korea's clinical culture, several key issues need consideration: elevating the role of student-doctors, balancing the primary emphasis of educational hospitals on delivering medical services, and understanding interpersonal strategies, such as "Nun-chi".

Formality or Reality: Student Teachers' Experiences of Ethical Dilemmas and Emotions During the Practicum

The main purpose of the study was to explore Chinese student teachers’ experience during their practicum and what they reported as ethical dilemmas and how these experiences affected them in terms of professional development as well as emotional well-being. Through the analysis of qualitative data collected from forty-three participants’ interviews, this study identified six most commonly reported ethical dilemmas, including: formal curriculum versus informal and hidden curriculum; family agenda versus educational standards; loyalty to colleagues versus school norms; confidentiality versus school rules; conformism dilemmas and red-envelope dilemmas and found that dilemmas about formal curriculum versus informal and hidden curriculum were the dominant workplace ethical dilemma for student teachers. The results also showed that the majority of the student teachers reported experiencing negative emotions or painful memories, which may hinder their development of professional competencies and overall wellbeing. Thus, the study argues that student teachers’ frequent encounters with ethical dilemmas highlight the challenges faced by teacher educators in transferring knowledge between university and school environments, and student teachers should be equipped with essential emotional regulation strategies that could benefit them in their future work.

Patients!

In this editorial the Editor considers the roles and representations of patients in health professional education and their implications for educational scholarship in this field. She also considers the implications of patient presence and engagement for the social contract and the ways it is being placed under stress and strain.