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Leung KCY, Peisah C. A Mixed-Methods Systematic Review of Group Reflective Practice in Medical Students. Healthcare (Basel) 2023; 11:1798. [PMID: 37372916 DOI: 10.3390/healthcare11121798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/02/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Used primarily as a pedagogical evaluation tool for didactic teaching and skill development, reflective practice (RP) for its own merits is poorly understood. This study aimed to systematically review the literature regarding the role of group RP in fostering empathy, wellbeing, and professionalism in medical students. METHODS Electronic searches of empirical studies published between 1 January 2010 and 22 March 2022 from Medline, Embase, and PsychINFO databases were conducted. Empirical studies of any design (qualitative or quantitative) which included RP (1) involving medical students; (2) with a focus on fostering empathy, or professionalism, or personal wellbeing; and (3) provided in a group setting were included. Duplicates, non-English articles, grey literature and articles using RP to examine pedagogy and specific technical skills were excluded. Both authors screened articles independently to derive a final list of included studies, with any discrepancies resolved by discussion, until consensus reached. Articles were rated for methodological quality using the Attree and Milton checklist for qualitative studies; the Oxford Centre for Evidence-Based Medicine criteria, and the Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative studies. RESULTS Of 314 articles identified, 18 were included: 9 qualitative; 4 quantitative and 5 mixed methodology. Settings included United States (6), United Kingdom (3), Australia (3), France (2), Taiwan (2), Germany (1), and Ireland (1). Themes were (i) professionalism: bridging theoretical paradigms and practice; (ii) halting empathy decline; (iii) wellbeing: shared experience. Additional themes regarding the "successful" delivery of RP groups in facilitating these outcomes also emerged. CONCLUSIONS This first systematic review of group RP in medical students shows that RP may bring theory to life in clinical dilemmas, while fostering collegiality and mitigating against isolation amongst students, despite the absence of studies directly examining wellbeing. These findings support the value of RP integration focusing on emotive and humanitarian processes into contemporary medical education for medical students. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022322496.
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Affiliation(s)
- Kelvin C Y Leung
- Research and Education Network, Westmead Hospital, Sydney, NSW 2145, Australia
| | - Carmelle Peisah
- Research and Education Network, Westmead Hospital, Sydney, NSW 2145, Australia
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Knowledge, Attitude, and Practice regarding Narrative Medicine among Chinese Medical Personnel: An Online Cross-Sectional Survey. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3329360. [PMID: 36277023 PMCID: PMC9581662 DOI: 10.1155/2022/3329360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022]
Abstract
Background Narrative medicine has been applied as a model for humane medical practice in many countries. However, it was not introduced in China until 2011 and there has been no standardized assessment of Chinese medical personnel regarding their perception and application of narrative medicine-related theories. This study is aimed at investigating Chinese medical personnel's knowledge, attitude, and practice regarding narrative medicine and the factors that influence it. Methods An online questionnaire based on the knowledge, attitude, and practice model was distributed among Chinese medical personnel from December 2021 to March 2022. All in-service medical personnel across China who had access to the Internet were eligible. Two independent samples t-tests, one-way analysis of variance, Pearson's correlation analysis, and multivariate linear regression were conducted for data analyses. Results The participants' scoring rates for knowledge, attitude, and practice were 49.62%, 47.18%, and 41.43%, respectively. Significant influencing factors for knowledge were education level, religious belief, professional role, title, working years, and institution categories; those for attitude were education level, religious belief, professional role, and working years; and those for practice were professional title, religious belief, working years, and institution categories. Conclusions Chinese medical personnel have generally good knowledge of, attitudes towards, and practice of narrative medicine; however, there remain deficiencies in their understanding of certain important concepts, their attitude towards narrative medicine, and the application of narrative skills in their daily work. Thus, to improve narrative medicine practice in China, the application of strategies based on theoretical, educational, and institutional aspects is warranted.
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Prosser M, Stephenson T, Mathur J, Enayati H, Kadie A, Abdi MM, Handuleh JIM, Keynejad RC. Reflective practice and transcultural psychiatry peer e-learning between Somaliland and the UK: a qualitative evaluation. BMC MEDICAL EDUCATION 2021; 21:58. [PMID: 33451314 PMCID: PMC7811254 DOI: 10.1186/s12909-020-02465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Reflective practice is a key skill for healthcare professionals. E-learning programmes have the potential to develop reflective practice in remote settings and low- and middle-income countries (LMICs), where access to in-person reflective groups may be reduced. 'Aqoon' is a global mental health peer-to-peer e-learning programme between Somaliland and UK medical students. We aimed to explore participants' experiences of participating in the Aqoon programme, including their experiences of reflective practice. METHODS Thirty-three medical students (22 Somaliland, 11 UK) enrolled in Aqoon. We matched volunteer learners in trios, to meet online to discuss anonymised clinical cases relevant to chapters of the World Health Organization's mental health gap action programme (mhGAP) intervention guide. We conducted thematic analysis of learners' reflective writing and post-programme focus group transcripts. RESULTS Twenty-four students (73%) attended at least three online discussions (14 Somaliland, 10 UK). Somaliland and UK students described improved reflective skills and greater recognition of stigma towards mental ill-health. Themes included gaining memorable insights from peer discussions which would impact their medical education. UK students emphasised improved cultural understanding of common psychiatric presentations whilst Somaliland students reflected on increased clinical confidence. DISCUSSION Integrating reflective practice into Aqoon showed the potential for low-cost e-learning interventions to develop cross-cultural reflective practice among medical students in diverse settings.
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Affiliation(s)
| | - Thomas Stephenson
- South London and Maudsley NHS Foundation Trust Maudsley Hospital, Denmark Hill, London, Greater London, SE5 8AZ, UK
| | - Jai Mathur
- St George's, University of London, London, UK
| | | | - Abdirasak Kadie
- Buhoodle District Hospital, IOM Mida Finnsom Health Project, Bohotle, Somaliland
| | - Manal Mohamed Abdi
- College of Medicine and Health Science, University of Hargeisa, Hargeisa, Somalia
| | - Jibril I M Handuleh
- College of Health Sciences, Amoud University, Borama, Somaliland.
- Department of Psychiatry, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
| | - Roxanne C Keynejad
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
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Chengappa N, Rajkumar Honest PC, David K, Pricilla RA, Rahman SM, Rebecca G. Effect of BATHE interview technique on patient satisfaction in an ambulatory family medicine centre in South India. Fam Med Community Health 2020; 8:fmch-2020-000327. [PMID: 33060126 PMCID: PMC7566425 DOI: 10.1136/fmch-2020-000327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The objective of the study is to determine the effect of background, affect, trouble, handling and empathy (BATHE) versus usual interview technique on patient satisfaction during regular consultation with family physicians in ambulatory care. DESIGN The research design was a prospective, randomised control trial. SETTING The trial took place in a family practice unit in South India, which was one of the clinical service units of the academic Department of Family Medicine of a tertiary hospital. PARTICIPANT The eligible participants were adults above the age of 18 years, who did not have any acute presenting illness. The participants should have given consent and also not have any cognitive disability. A total of 138 participants took part in the trial, 70 in BATHE group and 68 in the non-BATHE group. All participants entering the trial completed the questionnaire. RESULT The BATHE group had a significantly higher mean score for questions grouped under professional satisfaction. This included questions on whether the patient felt that the physician treated them as a person and also whether they felt the appropriate clinical examination was communicated to them. The questionnaire used for scoring satisfaction had 18 questions with a maximum possible score of 90. When taking a cut-off of 75% (68) from the total possible score of 90, 72.9% (51) of the participants for whom the BATHE consultation technique was used were satisfied as compared with only 55.9% (30) for whom the routine consultation was carried out. This was statistically significant (χ2=11.15, p value=0.0006) CONCLUSION: The study suggests that using BATHE in this family practice centre is beneficial in improving the perception of person centeredness in the consultation. However, further studies ruling out all possible bias are needed in our setting before the range of probable benefits of the BATHE technique can be fully gauged.
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Affiliation(s)
- Navnee Chengappa
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Kirubah David
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Sajitha Mf Rahman
- Department of Family Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Grace Rebecca
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
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Hung H, Kueh LL, Roan JN, Tsai JJ. Fostering 2 nd-year medical students' reflective capacity: A biopsychosocial model course. Tzu Chi Med J 2020; 32:291-297. [PMID: 32955525 PMCID: PMC7485666 DOI: 10.4103/tcmj.tcmj_65_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/17/2019] [Accepted: 07/09/2019] [Indexed: 11/04/2022] Open
Abstract
Objective: The biopsychosocial (BPS) model has been proposed to take into account the interaction of psychological and social factors in medical practice. Although some studies have explored its application in medical education, little has been evaluated about students’ reflection in such courses. This study introduced a BPS model course and aimed to assess changes in students’ reflective capacity resulting from this course. Materials and Methods: Eighty-seven written reflections before and after the course were segmented, coded, and rated using the Reflection Evaluation for Learners’ Enhanced Competencies Tool rubric, which contains six factors of reflective capacity, namely description of disease experience, presence, attending to emotions, description of conflict or disorienting dilemma, meaning making, and action. Results: After the BPS model course, the overall reflective capacity, as well as the “Presence” and “Meaning making” scores, increased, while scores for “Attending to emotion” decreased significantly. “Description of disease experience,” “Description of conflict or disorienting dilemma,” and “Action” showed no significant change. Conclusion: Pedagogical suggestions are discussed for a BPS model course with reflective training for young medical students.
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Affiliation(s)
- Hsuan Hung
- Institute of Education, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Ling Kueh
- Institute of Education, National Cheng Kung University, Tainan, Taiwan
| | - Jun-Neng Roan
- Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital and College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jing-Jane Tsai
- Institute of Education, National Cheng Kung University, Tainan, Taiwan
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Chu SY, Lin CW, Lin MJ, Wen CC. Correction to: Psychosocial issues discovered through reflective group dialogue between medical students. BMC MEDICAL EDUCATION 2018; 18:83. [PMID: 29712553 PMCID: PMC5925827 DOI: 10.1186/s12909-018-1185-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 06/08/2023]
Abstract
Following publication of the original article [1], the authors reported that they had had mistakenly put the wrong IRB number in the last paragraph of the Methods section (as IRB NO.: IRB101-80 instead of IRB102-20 as given in the Ethics approval and consent to participate in Declarations). The corrected last paragraph on the Method section should read as follows.
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Affiliation(s)
- Shao-Yin Chu
- Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chi-Wei Lin
- Department of Counseling and Clinical Psychology, National Dong Hwa University, Hualien, Taiwan.
- Department of Counseling and Clinical Psychology, National Dong Hwa University, Hualien, 97401, Taiwan, Republic of China.
| | - Meei-Ju Lin
- Department of Counseling and Clinical Psychology, National Dong Hwa University, Hualien, Taiwan
| | - Chin-Chen Wen
- Department of Human Development and Psychology, Tzu Chi University, Hualien, Taiwan
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