"We might be put into situations we are uncomfortable with, but not exactly told how to deal with them": Health professional students' experiences questioning low-value care practices during work-integrated learning

“我们可能会被置于令我们感到不适的境地,但却没有人明确告诉我们该如何应对”:卫生专业学生在工作实践学习期间质疑低价值医疗服务实践的经历

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Abstract

Health professions students often observe and practice alongside supervising health professionals during work-integrated learning (WIL) to develop essential capabilities. While students may encounter practices they interpret as low-value care during WIL, many hesitate to question or challenge these practices. This study aimed to (1) explore students' perceptions of low-value care and their experiences discussing it during WIL and (2) identify training priorities for education programs to support students and educators in navigating these conversations. A descriptive qualitative study was conducted with health professions students who had completed at least one clinical placement and participated in online interviews. A team-based framework approach was used to identify themes from the data. Thirty-six students from 10 health professions (average age 26 years) were interviewed. Three themes were identified: (1) student conceptualizations of low-value care are multi-faceted, (2) students need safety to initiate conversations about perceived low-value care on clinical placement, and (3) students seek practical training and clear guidance to handle complex conversations during placement. This study highlights the nuanced ways students perceive low-value care, encompassing respect, compassion, and trust, in addition to clinical guidelines. It underscores the importance of pre-placement training and the need to co-design education programs involving students, educators, and healthcare consumers to improve communication skills around low-value care. These findings offer actionable insights for developing supportive teaching and learning interventions.

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