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Preparing to prescribe: How do clerkship students learn in the midst of complexity?

机译:准备开处方:职员学生如何在复杂的环境中学习?

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Prescribing tasks, which involve pharmacological knowledge, clinical decision-making and practical skill, take place within unpredictable social environments and involve interactions within and between endlessly changing health care teams. Despite this, curriculum designers commonly assume them to be simple to learn and perform. This research used mixed methods to explore how undergraduate medical students learn to prescribe in the 'real world'. It was informed by cognitive psychology, sociocultural theory, and systems thinking. We found that learning to prescribe occurs as a dynamic series of socially negotiated interactions within and between individuals, communities and environments. As well as a thematic analysis, we developed a framework of three conceptual spaces in which learning opportunities for prescribing occur. This illustrates a complex systems view of prescribing education and defines three major system components: the "social space", where the environmental conditions influence or bring about a learning experience; the "process space", describing what happens during the learning experience; and the intra-personal "cognitive space", where the learner may develop aspects of prescribing expertise. This conceptualisation broadens the scope of inquiry of prescribing education research by highlighting the complex interplay between individual and social dimensions of learning. This perspective is also likely to be relevant to students' learning of other clinical competencies.
机译:处方任务涉及药理学知识,临床决策和实践技能,发生在无法预测的社会环境中,并且涉及不断变化的医疗团队内部和之间的相互作用。尽管如此,课程设计者通常认为它们易于学习和执行。这项研究使用混合方法来探索医学生如何在“现实世界”中学习开处方。它是通过认知心理学,社会文化理论和系统思维来获得的。我们发现,学习开处方是在个人,社区和环境内部以及之间,相互之间进行的一系列动态的社会协商互动而产生的。除了主题分析外,我们还开发了一个包含三个概念空间的框架,在其中可以进行处方学习。这说明了处方教育的复杂系统观点,并定义了三个主要系统组成部分:“社会空间”,其中环境条件影响或带来学习体验; “过程空间”,描述学习过程中发生的情况;以及个人内部的“认知空间”,学习者可以在其中发展处方专业知识的各个方面。通过突出学习的个人和社会维度之间的复杂相互作用,这种概念化拓宽了教育研究处方的研究范围。这种观点也可能与学生学习其他临床能力有关。

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