ABSTRACT
We attempted to identify whether and how the gender of the patient influences interpretations of an illness narrative. We investigated how medical and psychology undergraduates' (n = 313) views change according to the patient's gender, students' gender, and field of study. A short story about a female patient was chosen as stimulus material, and a gender-modified version with a male protagonist was created for comparison. Responses were content analyzed by qualitative and quantitative methods. The female patient elicited more detailed descriptions and somatizing attributions. The gender of students had a stronger impact on responses than their field of study.
Subject(s)
Attitude to Health , Gender Identity , Psychology/education , Students, Medical/psychology , Students/psychology , Adult , Age Factors , Attitude of Health Personnel , Female , Humans , Male , Middle Aged , Patient Education as Topic , Physician-Patient Relations , Socialization , Somatoform Disorders/diagnosis , Somatoform Disorders/psychology , Stereotyping , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: Development of therapeutic relational skills is a relatively neglected area of medical education. Conventional teaching techniques are mostly unsuitable for the realization of experience-based learning. AIMS: To develop a training method which enables lived self-experiences of the therapeutic relationship in class. To help students understand that illness and the doctor-patient relationship are integrated in the network of life histories and other relationships. METHODS: Our Integrated Performative Action Method is based on the elaboration of a short story of an illness in a student group. Through the 5 phases of the process, students write their own version of the story, build up characters, scenarios and enact the play. We have tested the method with 6 groups of students (n = 70) in a 10-week course. Video-recordings and minutes of sessions were analysed by two independent observers. RESULTS: Through elaborating the characters and playing the roles, students could speak about their own problems and act out feelings in the name of the characters. All groups had strong involvement throughout the process. CONCLUSIONS: The method helps to experience the ways in which therapeutic relationships and professional identities are constructed, reflected upon and communicated in a group of medical students.
Subject(s)
Drama , Interpersonal Relations , Students, Medical , Humans , Physician-Patient Relations , Problem-Based Learning , Professional Competence , Video RecordingABSTRACT
Systematic observations regarding techniques of medical career-socialization has hardly ever appeared in Hungarian technical literature yet. Focusing on the need for practical medical training the author elaborated a career-socialization program consisting of a three-level, three-branch training technique. This consisted of a Junior Bálint-group, an imaginative visualization technique, and an expressive, drama-pedagogical working method completed with a projective technique. This career-socialization program focuses on the physician's personality, capability-expansion in relationship management, and practicing a set of professional behavior-roles. During the empirical observations connected to the work the author examined medical students' patient-representation, their relation to the patients, and the development of the physician's professional character. Within the frames of this three-level, three-branch training technique program it enables us to observe which training technique is able to reveal all those psychological qualities that can contribute to the conformation of the representations, thus to the process of career-socialization in the most effective way. The content-analyses of the cases of Junior Bálint-groups (n = 60) revealed that the most frequent problems are fear of intimacy, of bodily contact, communication with patients in a chronic or terminal state, and the fear of medical practice. The content-analyses of imaginary patient-images (n = 62) with Rorschach-signs confirmed that the psychological burdens mentioned above are the most serious problems for medical students. The process-, and content-analyses of drama-games, the integrative healing contact training groups (n = 74) showed that group work primarily intensifies the relationship responsiveness, the ability to adopt the other's (the patient's) viewpoints, and enables an involuntary and distressless identification with the patient and the physician, both agents in the healing relationship. It is the drama-game that gives significant support to experience the physician- patient relationship in a high quality level. In the next phase the author tested the short story used for the drama-game and its projective contents on a sample of medical and psychology students (n = 313). For the statistical analysis the SPSS and the LEM program-packets were applied. Statistical methods included variance analysis, chi-square test and log-linear analysis. The vast similarity of the projective contents appearing in the survey questionnaire and in the drama-group verified that the chosen short story as a projective surface is suitable for recalling the students' typical stereotypes and representations related to diseases, patients, healing experts and therapeutic situations. The drama-group focused on the realization of these stereotypical representations, and also on experiencing and forming the students' emotional relations to them.
