构建:在医学院期间引入黄金人文主义荣誉协会(GHHS)被认为是人文取向和行为的指标。各种态度和人际关系取向,包括移情和以患者为中心,已被认为可以转化为构成人文关怀的行为。
背景:据我们所知,从来没有纵向,与GHHS成员身份相关的态度和人际关系取向的多机构实证研究。
方法:我们使用美国医学会学习环境研究(LES)数据集来探索与学生的态度相关关系,这些学生的行为被同龄人认为是非常人性化的。具体来说,我们检查了同理心,以病人为中心,容忍歧义,应对方式,对学习环境的看法与GHHS会员身份相关。我们进一步考虑了GHHS成员在多大程度上与这些态度相关,以及与非GHHS同行相比,GHHS成员之间的变化和发展有多大差异。在2011年至2015年之间,来自13所北美医学院的GHHS分会的585名学生参加了LES,一项纵向队列研究,使用一系列经过验证的心理测量,包括杰斐逊移情量表,患者-从业人员导向量表和歧义容忍度问卷。在最终的调查管理中,学生自我认定为GHHS入选者或非GHHS入选者(非GHHS)。T测试,效果大小,纵向广义混合效应模型研究了GHHS与非GHHS学生之间的差异。
结果:参加GHHS的学生在4年内的临床同理心平均得分明显高于非GHHS的学生,以病人为中心的信念,和对模棱两可的容忍度。GHHS学生在医学院入学时报告了更高水平的同理心和以患者为中心。这种差异在医学院的第四年以及控制时间时仍然存在,种族,性别,和学校。
结论:GHHS入选者进入医学院的态度和信念与非GHHS同学不同。虽然在学生的四年中,人文态度和信仰随着时间的推移而变化,两组之间的差距保持不变。医学院可能需要考虑在录取期间选择特定的人文特质,并通过课程干预促进人文主义的发展。
Construct: Induction into the Gold Humanism Honor Society (GHHS) during medical school is recognized as an indicator of humanistic orientation and behavior. Various attitudes and interpersonal orientations including empathy and patient-centeredness have been posited to translate into behaviors constituting humanistic care.
BACKGROUND: To our knowledge there has never been a longitudinal, multi-institutional empirical study of the attitudinal and interpersonal orientations correlated with GHHS membership status.
METHODS: We used the American Medical Association Learning Environment Study (LES) data set to explore attitudinal correlates associated with students whose behaviors are recognized by their peers as being exceptionally humanistic. Specifically, we examined whether empathy, patient-centeredness, tolerance of ambiguity, coping style, and perceptions of the learning environment are associated with GHHS membership status. We further considered to what extent GHHS members arrive in medical school with these attitudinal correlates and to what extent they change and evolve differentially among GHHS members compared to their non-GHHS peers. Between 2011 and 2015, 585 students from 13 North American medical schools with GHHS chapters participated in the LES, a longitudinal cohort study using a battery of validated psychometric measures including the Jefferson Scale of Empathy, Patient-Practitioner Orientation Scale and Tolerance of Ambiguity Questionnaire. In the final survey administration, students self-identified as GHHS inductees or not (non-GHHS). T tests, effect sizes, and longitudinal generalized mixed-effects models examined the differences between GHHS and non-GHHS students.
RESULTS: Students inducted into GHHS scored significantly higher on average over 4 years than non-GHHS inductees on clinical empathy, patient-centered beliefs, and tolerance of ambiguity. GHHS students reported higher levels of empathy and patient-centeredness at medical school matriculation. This difference persists in the 4th year of medical school and when controlling for time, race, gender, and school.
CONCLUSIONS: GHHS inductees enter medical school with different attitudes and beliefs than their non-GHHS classmates. Although humanistic attitudes and beliefs vary over time during students\' 4 years, the gap between the two groups remains constant. Medical schools may want to consider selecting for specific humanistic traits during admissions as well as fostering the development of humanism through curricular interventions.