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dc.contributor.authorFischer, Melissa A.
dc.contributor.authorHarrell, Heather E.
dc.contributor.authorHaley, Heather-Lyn
dc.contributor.authorCifu, Adam S.
dc.contributor.authorAlper, Eric J.
dc.contributor.authorJohnson, Krista M.
dc.contributor.authorHatem, David S.
dc.date2022-08-11T08:09:21.000
dc.date.accessioned2022-08-23T16:27:22Z
dc.date.available2022-08-23T16:27:22Z
dc.date.issued2008-07-01
dc.date.submitted2009-09-23
dc.identifier.citationJ Gen Intern Med. 2008 Jul;23(7):958-63. <a href="http://dx.doi.org/10.1007/s11606-008-0508-1">Link to article on publisher's website</a>
dc.identifier.issn1525-1497
dc.identifier.doi10.1007/s11606-008-0508-1
dc.identifier.pmid18612724
dc.identifier.pmid18612724
dc.identifier.urihttp://hdl.handle.net/20.500.14038/36767
dc.description.abstractBACKGROUND: Recent changes in healthcare system and training mandates have altered the clinical learning environment. We incorporated reflective writing into Internal Medicine clerkships (IMcs) in multiple institutions so students could consider the impact of clerkship experiences on their personal and professional development. We analyzed student reflections to inform curricula and support learning. METHODS: We qualitatively analyzed the reflections of students at 3 US medical schools during IMcs (N = 292) to identify themes, tone, and reflective quality using an iterative approach. Chi-square tests assessed differences between these factors and across institutions. FINDINGS: Students openly described powerful experiences. Major themes focused on 4 categories: personal issues (PI), professional development (PD), relational issues (RI), and medical care (MC). Each major theme was represented at each institution, although with significant variability between institutions in many of the subcategories including student role (PI), development-as-a-physician (PD), professionalism (PD) (p < 0.001). Students used positive tones to describe student role, development-as-a-physician and physician-patient relationship (PD) (p < 0.01-0.001), and negative tones for quality and safety (MC) (p < 0.05). Only 4% of writings coded as professionalism had a positive tone. Students employed a "reporting" voice in writing about clinical problem-solving, healthcare systems, and quality/safety (MC). DISCUSSION: Reflection is considered important to professional development. Our analysis suggests that students at 3 institutions reflect on similar experiences. Theme variability across institutions implies curricula should be tailored to local culture. Reflective quality analysis suggests students are better equipped to reflect on certain experiences over others, which may impact learning. Student reflections can function as a mirror for our organizations, offer institutional feedback for support and improvement, and inform curricula for learners and faculty.
dc.language.isoen_US
dc.publisherBlackwell Publishing
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=18612724&dopt=Abstract">Link to article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1007/s11606-008-0508-1
dc.subjectCareer Choice
dc.subjectClinical Clerkship
dc.subjectHumans
dc.subjectInternal Medicine
dc.subjectStudents, Medical
dc.subjectWriting
dc.subjectHealth Services Research
dc.subjectMedicine and Health Sciences
dc.titleBetween two worlds: a multi-institutional qualitative analysis of students' reflections on joining the medical profession.
dc.typeJournal Article
dc.source.journaltitleJournal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine
dc.source.volume23
dc.source.issue7
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/meyers_pp/13
dc.identifier.contextkey1013803
html.description.abstract<p>BACKGROUND: Recent changes in healthcare system and training mandates have altered the clinical learning environment. We incorporated reflective writing into Internal Medicine clerkships (IMcs) in multiple institutions so students could consider the impact of clerkship experiences on their personal and professional development. We analyzed student reflections to inform curricula and support learning.</p> <p>METHODS: We qualitatively analyzed the reflections of students at 3 US medical schools during IMcs (N = 292) to identify themes, tone, and reflective quality using an iterative approach. Chi-square tests assessed differences between these factors and across institutions.</p> <p>FINDINGS: Students openly described powerful experiences. Major themes focused on 4 categories: personal issues (PI), professional development (PD), relational issues (RI), and medical care (MC). Each major theme was represented at each institution, although with significant variability between institutions in many of the subcategories including student role (PI), development-as-a-physician (PD), professionalism (PD) (p < 0.001). Students used positive tones to describe student role, development-as-a-physician and physician-patient relationship (PD) (p < 0.01-0.001), and negative tones for quality and safety (MC) (p < 0.05). Only 4% of writings coded as professionalism had a positive tone. Students employed a "reporting" voice in writing about clinical problem-solving, healthcare systems, and quality/safety (MC).</p> <p>DISCUSSION: Reflection is considered important to professional development. Our analysis suggests that students at 3 institutions reflect on similar experiences. Theme variability across institutions implies curricula should be tailored to local culture. Reflective quality analysis suggests students are better equipped to reflect on certain experiences over others, which may impact learning. Student reflections can function as a mirror for our organizations, offer institutional feedback for support and improvement, and inform curricula for learners and faculty.</p>
dc.identifier.submissionpathmeyers_pp/13
dc.contributor.departmentDepartment of Medicine
dc.contributor.departmentDepartment of Family Medicine and Community Health
dc.contributor.departmentMeyers Primary Care Institute


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