Abstract:
CONTEXT:An important part of a doctor's identity is the social position he or she adopts relative to patients. Dialogic theory predicts that medical school discourses influence the positions students incorporate into their professional identities. As this may affect how students later exercise power in doctor-patient relationships, we set out to examine how medical teachers position doctors in relation to patients. METHODS:Informed by Holland's Figured Worlds theory, which draws important assumptions from Bakhtin, we chose dialogic research methodology to examine how educators' language positions doctors and may influence students' identity formation. We recruited a maximum variation sample of 10 teaching staff and used open prompts in individual semi-structured interviews to elicit discourses of doctors' social position. We used Sullivan's dialogic methodology reflexively to identify informative speech acts (utterances) and to examine how the language used in these constructed doctors' positions. RESULTS:Dominant discourses of Social Superiority, Technical Effectiveness, and Benevolence elevated doctors' positions based on their social status, applied knowledge and trustworthiness, respectively. These positions were defended by predicating medical care on doctors' mastery of treatments and their superior knowledge. A non-dominant discourse of Distributed Power and Responsibility narrowed the positional gap by constructing doctors as empowering patients. CONCLUSIONS:Whereas three conservative discourses upheld doctors' elevated social position, a non-dominant, transformative discourse distributed power. We suggest that doctors will form the best relationships with patients when they are aware of these discourses and know how to navigate them. In pursuit of effective and compassionate patient care, we commend critical pedagogy as a means of articulating non-dominant discourses and increasing students', educators' and doctors' awareness of how they learn the positions of doctors.
journal_name
Med Educjournal_title
Medical educationauthors
Dornan T,Roy Bentley S,Kelly Mdoi
10.1111/medu.14074subject
Has Abstractpub_date
2020-07-01 00:00:00pages
628-636issue
7eissn
0308-0110issn
1365-2923journal_volume
54pub_type
杂志文章abstract:CONTEXT:Adequate medical education has 3 interrelated aspects: theoretical knowledge, practical skills and the personal attitude of the doctor. The current emphasis on medical science diverts attention from the importance of the attitude aspect of medical education. We argue that the integration of palliative care into...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.2003.01635.x
更新日期:2003-10-01 00:00:00
abstract:INTRODUCTION:The Clinical Teaching Effectiveness Instrument (CTEI) was developed to evaluate the quality of the clinical teaching of educators. Its authors reported evidence supporting content and criterion validity and found favourable reliability findings. We tested the validity and reliability of this instrument in ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2929.2005.02245.x
更新日期:2005-09-01 00:00:00
abstract::Over the past decade, on-line databases have become increasingly popular among health care professionals. As a group, these 'end-users' report utilizing databases to keep abreast of medical progress, to conduct research and to address specific patient care issues. Throughout the literature, medical professionals ('con...
journal_title:Medical education
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2923.1998.00229.x
更新日期:1998-05-01 00:00:00
abstract:CONTEXT:Some medical courses in the UK have many more applicants than places and almost all applicants have the highest possible previous and predicted examination grades. The BioMedical Admissions Test (BMAT) was designed to assist in the student selection process specifically for a number of 'traditional' medical cou...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.2009.03367.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:Multi-source feedback (MSF) enables performance data to be provided to doctors from patients, co-workers and medical colleagues. This study examined the evidence for the validity of MSF instruments for general practice, investigated changes in performance for doctors who participated twice, 5 years apart, an...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.2008.03127.x
更新日期:2008-10-01 00:00:00
abstract:CONTEXT:Prior studies suggest that clinicians can categorise patients in an emergency room as 'sick' or 'not sick' using rapid visual assessment. The rapid nature of these decisions suggests clinicians are relying on pattern recognition or System 1 processing; however, this has not been studied experimentally. In this ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/medu.13396
更新日期:2017-11-01 00:00:00
abstract::This paper describes the development and structure of an Electronic Study Guide for Oncology (LETSGO) for undergraduate medical students. LETSGO is aimed at clinical students learning about cancer. The subject of the guide is breast cancer and learning objectives cover structure and function, behavioural science, publ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1995.tb02860.x
更新日期:1995-11-01 00:00:00
abstract::This study set out to determine the long-term benefits of teaching psychiatric interview skills. Nine established general practitioners, eight of whom were also trainers, took part some 18 months after attending a problem-based interviewing course. Interview skills were assessed by rating behaviour during 10-minute vi...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1992.tb00125.x
更新日期:1992-01-01 00:00:00
abstract::An improved teaching package is described which aims to help general practice trainees manage somatized presentations of psychological distress. The package comprises a training videotape in which a reattribution model is demonstrated, with material for role-play of new skills and small-group video feedback of consult...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1992.tb00139.x
更新日期:1992-03-01 00:00:00
abstract:CONTEXT:The responsibility to determine just who is competent to practice medicine, and at what standard, is great. Whilst there is still a period available for potential remediation, examinations at the completion of year three of the four-year Graduate Entry Medical Programme (GEMP) at Flinders University of South Au...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.2000.00690.x
更新日期:2000-05-01 00:00:00
abstract::Quantitative methods of evaluating the outcomes of medical education may not always deliver the information which course organizers and teachers most need in order to improve their courses. Qualitative methods of research could provide such information. However, the use of qualitative methods has been limited by the d...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1989.tb01575.x
更新日期:1989-11-01 00:00:00
abstract::In achieving a more effective use of resources in the National Health Service (NHS), the medical profession has a role to play by improving cost efficiency in clinical practice. This role implies that doctors should have some knowledge of medical costs. In order to determine the extent of this knowledge, sixty-seven h...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1985.tb01150.x
更新日期:1985-03-01 00:00:00
abstract::In October 1994 a project was initiated by the General Practice Continuing Medical Education Tutors in the Department of General Practice at Sheffield University. The project sought to evaluate the efficiency (effort expended) and effectiveness (distance travelled) of a model of continuing professional development for...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1997.tb00038.x
更新日期:1997-01-01 00:00:00
abstract:CONTEXT:As a contribution to this special issue commemorating the journal's 50th volume, this paper seeks to explore directions for national licensing examinations (NLEs) in medicine. Increases in the numbers of new medical schools and the mobility of doctors across national borders mean that NLEs are becoming even mor...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/medu.12810
更新日期:2016-01-01 00:00:00
abstract:CONTEXT:The Faculty of Medicine and Medical Sciences at the University of Aberdeen viewed the use of Computer Assisted Leaning (CAL) and other IT based learning resources as a possible way of coping with an increase in student numbers whilst maintaining or increasing the quality of medical teaching. OBJECTIVES:Our pri...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.1999.00270.x
更新日期:1999-04-01 00:00:00
abstract::A postal survey about opinions of quality assurance and the methods used to teach this subject was sent to all family practice course organizers in England, Wales and Scotland, and to all family practice residency directors in the USA. Opinions of quality assurance were more positive from the American responders. A wi...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1990.tb00010.x
更新日期:1990-05-01 00:00:00
abstract::There is evidence that nurses fulfil the requirements of objective judgement better than doctors. Simulation of Initial Medical Problem-Solving (SIMP), a paper-and-pencil test for the assessment of medical problem-solving, consists of case histories, followed by an open-ended question. The scoring of open-ended questi...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1989.tb01564.x
更新日期:1989-07-01 00:00:00
abstract::As the importance of psycho-social factors in medicine is increasingly stressed, it is believed that attitudes towards psycho-social issues in medicine should be taken into account in the selection of medical students. The first step of a longitudinal study concerning the impact of medical studies on the students of a...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1980.tb02271.x
更新日期:1980-07-01 00:00:00
abstract::This paper describes a method of teaching communication skills to pre-clinical medical students in the setting of general practice. By focusing on the nature of the patient's problem this teaching tries to place interviewing and diagnostic procedures in their proper context in the doctor-patient relationship. ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1979.tb00926.x
更新日期:1979-03-01 00:00:00
abstract:OBJECTIVES:The lack of published studies into effective skills teaching in clinical skills centres inspired this study of student views of the teaching behaviours of skills teachers. METHODS:We organised focus group discussions with students from Years 1-3 of a 6-year undergraduate medical curriculum. A total of 30 ra...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.2008.03283.x
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVES:Since their introduction, workplace-based assessments (WBAs) have proliferated throughout postgraduate medical education. Previous reviews have identified mixed findings regarding WBAs' effectiveness, but have not considered the importance of user-tool-context interactions. The present review was conducted t...
journal_title:Medical education
pub_type: 杂志文章,评审
doi:10.1111/medu.14221
更新日期:2020-11-01 00:00:00
abstract::The GMC's publications The New Doctor (GMC 1997) outlines an approach for the education of Pre-registration House Officers using designated educational supervisors. In order to establish appropriate means of training consultants to undertake this role, the Centre for Postgraduate and Continuing Medical Education at th...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.1998.00209.x
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVES:The General Medical Council has recommended that medical students should gain more experience in general practice. The study set out to determine patients' reactions to consultations conducted by a medical student alone prior to seeing their GP. DESIGN:A random sample of patients attending general practice ...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.1999.00410.x
更新日期:1999-09-01 00:00:00
abstract::The University of Washington School of Medicine (UWSM) has initiated new efforts to build a regional minority applicant pool and to expand its educational programmes to accommodate students from disadvantaged backgrounds. Specific interventions include: establishment of medical career planner position to coordinate re...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1988.tb00760.x
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:To compare the teaching value of one session of computer-guided solo instruction in exposure therapy for phobias with that of one face-to-face small-group tutorial. DESIGN:Non-blind, randomized, controlled study. SETTING:King's College Hospital Medical School, London. PARTICIPANTS:Thirty-seven third-year m...
journal_title:Medical education
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2923.2002.01210.x
更新日期:2002-05-01 00:00:00
abstract::Musculoskeletal disease in the community is common, and much of it responds to early diagnosis and preventive care. At the same time, modern orthopaedics, like so many specialist subjects, has increased significantly in depth and detail pari passu with its advances. It therefore becomes all the more important in desig...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2923.1979.tb00914.x
更新日期:1979-01-01 00:00:00
abstract:OBJECTIVE:To follow the progress of young female adolescents, as risk-taking standardised patients (SPs), and to monitor for adverse affects that role-playing may have on the adolescents. METHODS:A prospective design was used in which 11 female adolescents, aged 13-15 years, were recruited from 2 schools. The adolesce...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2929.2005.02343.x
更新日期:2006-01-01 00:00:00
abstract::Since its first implementation in a medical programme at McMaster University, Canada, problem-based learning (PBL) has become a well-established means of teaching and learning medicine. Extensive research has been conducted and a number of strengths of the method are well supported. Several items, however, remain uncl...
journal_title:Medical education
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2923.1999.00289.x
更新日期:1999-02-01 00:00:00
abstract:PURPOSE:Understanding how students resolve professional conflict is essential to teaching and evaluating professionalism. The purpose of this study was to refine an existing coding structure of rationalizations of student behaviour, and to further our understanding of students' reasoning strategies in the face of perce...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1046/j.1365-2923.2003.01326.x
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To determine whether improvements gained in general practitioners' (GPs') self-perceived competency, attitudes and knowledge after an intervention in adolescent health care designed with evidence-based strategies in continuing medical education, are maintained longterm, 5 years post intervention. The interven...
journal_title:Medical education
pub_type: 杂志文章
doi:10.1111/j.1365-2929.2005.02172.x
更新日期:2005-06-01 00:00:00