Transformative learning through communal documentary viewing: a mixed methods study on kidney transplantation and organ donation in medical education

通过集体观看纪录片实现变革性学习:一项关于医学教育中肾移植和器官捐献的混合方法研究

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Abstract

OBJECTIVES: To explore how learner transformation manifests in a communal arts and humanities (AH) educational activity for medical students. DESIGN: Mixed methods explorative study. SETTING: UK-based medical school that follows a 5-year case-based learning curricular model. INTERVENTIONS: A group of 105 first-year medical students attended a group viewing of a TV documentary titled, 'Life on the List' as part of their core curriculum. The documentary explores the humanistic aspects of kidney disease, organ donation and transplantation by portraying the personal stories of transplant recipients, donors and healthcare professionals. Following the screening, attendees engaged in a question-and-answer session with an expert panel. MAIN OUTCOME MEASURES: Perceived transformation of learning was measured using a quantitative Likert-scale paired pre-screening and post-screening questionnaire. Additionally, the qualitative study used facilitated focus groups (FGs) to explore how learners may or may not have transformed their learning based on the AH educational activity. PARTICIPANTS: Inclusion criteria were: (a) first-year medical students and (b) those who attended the screening. Those not meeting these criteria were excluded. The quantitative questionnaire was completed by 94 participants, while 19 attended FG interviews. RESULTS: Paired t-tests were conducted to compare pre-screening and post-screening responses across five questions. All results demonstrated statistical significance (p<0.01), reflecting perceived transformation. Using a constructivist approach and drawing on aspects of 'Transformative Learning Theory,' we identified five key themes regarding how learning was transformed: (1) an absorbing experience; (2) confronting and challenging: different ways of seeing the world; (3) collective reflection: the power and safety of the crowd; (4) 'everything just came into perspective': accepting the world in a new way; and (5) willing to change the world: advocacy and agency. By this collective experience focusing on real patient stories and providing an opportunity for discussion and reflection, participants were offered a holistic view on kidney medicine and transplantation. Overwhelmingly, participants were inspired to strive for person-centred care, with many being motivated to explore kidney medicine and transplantation as career options. CONCLUSION: Couched in pedagogy, an AH educational activity for medical students can leverage learner transformation and promote person-centred care. With respect to kidney medicine, organ donation and transplantation, such activities can provide early career exposure to these fields. Students may be inspired to act as positive ambassadors for organ donation and transplantation and further explore these areas as future career options. Further research should investigate AH interventions in diverse groups from a longitudinal perspective to consider long-term effects in promoting holistic and empathetic patient care.

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