A Dialogic Approach to Teaching Person-Centered Care in Graduate Medical Education.
Journal
Journal of graduate medical education
ISSN: 1949-8357
Titre abrégé: J Grad Med Educ
Pays: United States
ID NLM: 101521733
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
29
01
2019
revised:
15
04
2019
accepted:
23
04
2019
entrez:
24
8
2019
pubmed:
24
8
2019
medline:
29
1
2020
Statut:
ppublish
Résumé
Training future physicians to provide compassionate, equitable, person-centered care remains a challenge for medical educators. Dialogues offer an opportunity to extend person-centered education into clinical care. In contrast to discussions, dialogues encourage the sharing of authority, expertise, and perspectives to promote new ways of understanding oneself and the world. The best methods for implementing dialogic teaching in graduate medical education have not been identified. We developed and implemented a co-constructed faculty development program to promote dialogic teaching and learning in graduate medical education. Beginning in April 2017, we co-constructed, with a pilot working group (PWG) of physician teachers, ways to prepare for and implement dialogic teaching in clinical settings. We kept detailed implementation notes and interviewed PWG members. Data were iteratively co-analyzed using a qualitative description approach within a constructivist paradigm. Ongoing analysis informed iterative changes to the faculty development program and dialogic education model. Patient and learner advisers provided practical guidance. The concepts and practice of dialogic teaching resonated with PWG members. However, they indicated that dialogic teaching was easier to learn about than to implement, citing insufficient time, lack of space, and other structural issues as barriers. Patient and learner advisers provided insights that deepened design, implementation, and eventual evaluation of the education model by sharing experiences related to person-centered care. While PWG members found that the faculty development program supported the implementation of dialogic teaching, successfully enabling this approach requires expertise, willingness, and support to teach knowledge and skills not traditionally included in medical curricula.
Sections du résumé
BACKGROUND
BACKGROUND
Training future physicians to provide compassionate, equitable, person-centered care remains a challenge for medical educators. Dialogues offer an opportunity to extend person-centered education into clinical care. In contrast to discussions, dialogues encourage the sharing of authority, expertise, and perspectives to promote new ways of understanding oneself and the world. The best methods for implementing dialogic teaching in graduate medical education have not been identified.
OBJECTIVE
OBJECTIVE
We developed and implemented a co-constructed faculty development program to promote dialogic teaching and learning in graduate medical education.
METHODS
METHODS
Beginning in April 2017, we co-constructed, with a pilot working group (PWG) of physician teachers, ways to prepare for and implement dialogic teaching in clinical settings. We kept detailed implementation notes and interviewed PWG members. Data were iteratively co-analyzed using a qualitative description approach within a constructivist paradigm. Ongoing analysis informed iterative changes to the faculty development program and dialogic education model. Patient and learner advisers provided practical guidance.
RESULTS
RESULTS
The concepts and practice of dialogic teaching resonated with PWG members. However, they indicated that dialogic teaching was easier to learn about than to implement, citing insufficient time, lack of space, and other structural issues as barriers. Patient and learner advisers provided insights that deepened design, implementation, and eventual evaluation of the education model by sharing experiences related to person-centered care.
CONCLUSIONS
CONCLUSIONS
While PWG members found that the faculty development program supported the implementation of dialogic teaching, successfully enabling this approach requires expertise, willingness, and support to teach knowledge and skills not traditionally included in medical curricula.
Identifiants
pubmed: 31440342
doi: 10.4300/JGME-D-19-00085.1
pii: Customer: JGME-D-19-00085R1
pmc: PMC6699535
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
460-467Déclaration de conflit d'intérêts
Conflict of interest: The authors declare they have no competing interests.
Références
Res Nurs Health. 2000 Aug;23(4):334-40
pubmed: 10940958
Qual Health Res. 2005 Sep;15(7):964-74
pubmed: 16093373
BMJ. 2008 Aug 07;337:a288
pubmed: 18687727
Acad Med. 2009 Jun;84(6):782-7
pubmed: 19474560
Res Nurs Health. 2010 Feb;33(1):77-84
pubmed: 20014004
Soc Sci Med. 2010 May;70(10):1518-26
pubmed: 20207061
N Z Nurs J. 1990 Dec-1991 Jan;83(11):18-9
pubmed: 2267106
Acad Med. 2015 Mar;90(3):283-8
pubmed: 25426737
Acad Med. 2015 Mar;90(3):289-93
pubmed: 25426738
Med Educ. 2017 Feb;51(2):158-173
pubmed: 27862175
Perspect Med Educ. 2017 Feb;6(1):12-20
pubmed: 28050879
Acad Med. 2018 Jun;93(6):869-873
pubmed: 29068822
Acad Med. 2018 Dec;93(12):1778-1783
pubmed: 29901659
Acad Med. 2019 Aug;94(8):1122-1128
pubmed: 30920447
Int J Qual Health Care. 1996 Oct;8(5):491-7
pubmed: 9117203