De la compétence à l’empathie : évaluation de l’évolution de la perception qu’ont les étudiants en médecine des chirurgiens dans le cadre d’un programme associant le patient enseignant et la réflexion fondée sur les humanités

Auteurs-es

DOI :

https://doi.org/10.36834/cmej.76536

Résumé

Introduction : L’objectif de cette étude était de déterminer si l’introduction d’une nouvelle approche de l’évaluation associant la participation de patients enseignants (PE) à une réflexion fondée sur les humanités (RFH) dans un stage d’externat en chirurgie permettait de mieux percevoir les qualités humanistes chez les chirurgiens.

Méthodes : Un nouvel outil d’évaluation à question unique a été créé. Des étudiants en troisième année de médecine ont été invités à énumérer les cinq principaux attributs d’un chirurgien, par ordre d’importance perçue, avant et après leur stage d’externat en chirurgie et le programme PE/RFH. Les attributs identifiés par les étudiants ont été codés comme « humanistes » ou « non humanistes », puis analysés à l’aide de modèles de régression linéaire généralisée dans un cadre bayésien.

Résultats : Après leur participation au programme PE/RFH, la probabilité prédite moyenne que les étudiants classent un trait humaniste comme l’attribut le plus important d’un chirurgien a augmenté de 17 %, et la probabilité prédite que les étudiants classent un trait humaniste parmi les trois premiers attributs d’un chirurgien a augmenté de 21 %.

Conclusion : Cette méthode d’évaluation innovante suggère que le programme PE/RFH réussit en effet à favoriser une vision humaniste de la chirurgie. Cette approche peut être explorée pour évaluer d’autres activités éducatives axées sur l’humanisme.

Statistiques

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Bibliographies de l'auteur-e

Gurjot K Gill, University of Toronto

Resident doctor, Department of Obstetrics and Gynaecology, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada

Stella L Ng, University of Toronto

Director and Scientist, Centre for Interprofessional Education; Scientist, the Wilson Centre; and associate professor, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.

Emilia Kangasjarvi , University of Toronto

Research and Education Coordinator with Faculty of Medicine, Centre for Faculty Development, University of Toronto at St. Michael’s Hospital, Unity Health Toronto.

Jeff Crukley, University of Toronto

Adjunct lecturer, Department of Speech-Language Pathology, University of Toronto.

Jory S Simpson, University of Toronto

Division Head of General Surgery at St. Michael’s Hospital, Director of MD Program for the Department of Surgery and director for Humanism in Surgery curriculum, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.

Références

Kumagai AK, Richardson L, Khan S, Kuper A. Dialogues on the threshold: dialogical learning for humanism and justice. Acad Med. Dec 2018;93(12):1778-1783. https://doi.org/10.1097/ACM.0000000000002327

Brady-Amoon P. Humanism, feminism, and multiculturalism: essential elements of social justice in counseling, education, and advocacy. J Humanistic COUNSELING. 2011;50

Baker L, Shing LK, Wright S, Mylopoulos M, Kulasegaram K, Ng S. Aligning and applying the paradigms and practices of education. Acad Med. Jul 2019;94(7):1060. https://doi.org/10.1097/ACM.0000000000002693

Baker LR, Phelan S, Woods NN, Boyd VA, Rowland P, Ng SL. Re-envisioning paradigms of education: towards awareness, alignment, and pluralism. Adv Health Sci Educ Theory Pract. Mar 2021; https://doi.org/10.1007/s10459-021-10036-z

Kumagai AK. From competencies to human interests: ways of knowing and understanding in medical education. Acad Med. Jul 2014;89(7):978-83. https://doi.org/10.1097/ACM.0000000000000234

Dijk SW, Duijzer EJ, Wienold M. Role of active patient involvement in undergraduate medical education: a systematic review. BMJ Open. Jul 27 2020;10(7):e037217. https://doi.org/10.1136/bmjopen-2020-037217

Rowland P, Kumagai AK. Dilemmas of Representation: Patient Engagement in Health Professions Education. Acad Med. Jun 2018;93(6):869-873. https://doi.org/10.1097/ACM.0000000000001971

Towle A, Bainbridge L, Godolphin W, et al. Active patient involvement in the education of health professionals. Med Educ. Jan 2010;44(1):64-74. https://doi.org/10.1111/j.1365-2923.2009.03530.x

Kumagai AK, Wear D. "Making strange": a role for the humanities in medical education. Acad Med. Jul 2014;89(7):973-7. https://doi.org/10.1097/ACM.0000000000000269

Moniz T, Golafshani M, Gaspar CM, et al. How are the arts and humanities used in medical education? results of a scoping review. Acad Med. Aug 01 2021;96(8):1213-1222. https://doi.org/10.1097/ACM.0000000000004118

Haidet P, Jarecke J, Adams NE, et al. A guiding framework to maximise the power of the arts in medical education: a systematic review and metasynthesis. Med Educ. Mar 2016;50(3):320-31. https://doi.org/10.1111/medu.12925

Kinsella EA, Bidinosti S. 'I now have a visual image in my mind and it is something I will never forget': an analysis of an arts-informed approach to health professions ethics education. Adv Health Sci Educ Theory Pract. May 2016;21(2):303-22. https://doi.org/10.1007/s10459-015-9628-7

de Groot E, Schönrock-Adema J, Zwart D, et al. Learning from patients about patient-centredness: A realist review: BEME Guide No. 60. Med Teach. Apr 2020;42(4):380-392. https://doi.org/10.1080/0142159X.2019.1695767

Charon R, Hermann N, Devlin MJ. Close reading and creative writing in clinical education: teaching attention, representation, and affiliation. Acad Med. Mar 2016;91(3):345-50. https://doi.org/10.1097/ACM.0000000000000827

George DR, Stuckey HL, Whitehead MM. An arts-based intervention at a nursing home to improve medical students' attitudes toward persons with dementia. Acad Med. Jun 2013;88(6):837-42. https://doi.org/10.1097/ACM.0b013e31828fa773

Timpani S, Sweet L, Sivertsen N. Storytelling: One arts-based learning strategy to reflect on clinical placement. an integrative review. Nurse Educ Pract. Mar 2021;52:103005. https://doi.org/10.1016/j.nepr.2021.103005

Lindsay R. Baker SP, Nicole N. et al. Re-envisioning paradigms of education: towards awareness, alignment, and pluralism. 2021;26:1045-1058. https://doi.org/10.1007/s10459-021-10036-z

Tremblay MC, Richard L, Brousselle A, Beaudet N. Learning reflexively from a health promotion professional development program in Canada. Health Promot Int. Sep 2014;29(3):538-48. https://doi.org/10.1093/heapro/dat062

Vogel BA LR, Helmes AW. Communication matters: the impact of communication and participation in decision making on breast cancer patients' depression and quality of life. Patient Educ Couns. 2009;77(3):391-397.

Menendez ME, Chen NC, Mudgal CS, Jupiter JB, Ring D. Physician empathy as a driver of hand surgery patient satisfaction. J Hand Surg Am. Sep 2015;40(9):1860-5.e2. https://doi.org/10.1016/j.jhsa.2015.06.105

O’Rorke EV, Mauch JT, Liu Y, Friedrich JB. Essential elements of surgeon communication impacting patient satisfaction: a systematic review. J Comm Healthc. 2022. p. 90-101.

Gehenne L, Lelorain S, Eveno C, et al. Associations between the severity of medical and surgical complications and perception of surgeon empathy in esophageal and gastric cancer patients. Support Care Cancer. Dec 2021;29(12):7551-7561. https://doi.org/10.1007/s00520-021-06257-y

Steinhausen S, Ommen O, Antoine SL, Koehler T, Pfaff H, Neugebauer E. Short- and long-term subjective medical treatment outcome of trauma surgery patients: the importance of physician empathy. Patient Prefer Adherence. 2014;8:1239-53. https://doi.org/10.2147/PPA.S62925

Patel P, Martimianakis MA, Zilbert NR, et al. Fake it 'til you make it: pressures to measure up in surgical training. Acad Med. May 2018;93(5):769-774. https://doi.org/10.1097/ACM.0000000000002113

Sadati L, Yazdani S, Heidarpoor P. Surgical residents' challenges with the acquisition of surgical skills in operating rooms: a qualitative study. J Adv Med Educ Prof. Jan 2021;9(1):34-43. https://doi.org/10.30476/jamp.2020.87464.1308

Khan S, Jung F, Kirubarajan A, Karim K, Scheer A, Simpson J. A systematic review of interventions to improve humanism in surgical practice. J Surg Educ. 2021;78(2):548-560. https://doi.org/10.1016/j.jsurg.2020.07.032

Simpson JS, Ng S, Kangasjarvi E, et al. Humanistic education in surgery: a "patient as teacher" program for surgical clerkship. Can J Surg. May 13 2020;63(3):E257-E260. https://doi.org/10.1503/cjs.005319

Kangasjarvi E, Ng SL, Friesen F, Simpson JS. Patients as teachers and arts-based reflection in surgical clerkship: A preliminary exploration. Med Teach. 12 2020;42(12):1362-1368. https://doi.org/10.1080/0142159X.2020.1807482

Kruschke JK, Liddell TM. The Bayesian New Statistics: hypothesis testing, estimation, meta-analysis, and power analysis from a Bayesian perspective. Psychon Bull Rev. 02 2018;25(1):178-206. https://doi.org/10.3758/s13423-016-1221-4

Osman M, Eacott B, Willson S. Arts-based interventions in healthcare education. Med Humanit. Mar 2018;44(1):28-33. https://doi.org/10.1136/medhum-2017-011233

Buck E, Holden M, Szauter K. A methodological review of the assessment of humanism in medical students. Acad Med. Nov 2015;90(11 Suppl):S14-23. https://doi.org/10.1097/ACM.0000000000000910

Logghe HJ, Rouse T, Beekley A, Aggarwal R. The evolving surgeon image. AMA J Ethics. May 1 2018;20(5):492-500. https://doi.org/10.1001/journalofethics.2018.20.5.mhst1-1805

Braun HJ, Dusch MN, Park SH, et al. Medical students' perceptions of surgeons: implications for teaching and Recruitment. J Surg Educ. Nov-Dec 2015;72(6):1195-9. https://doi.org/10.1016/j.jsurg.2015.05.014

Kumagai AK. A conceptual framework for the use of illness narratives in medical education. Acad Med. Jul 2008;83(7):653-8. https://doi.org/10.1097/ACM.0b013e3181782e17

Charise A. Site, sector, scope: mapping the epistemological landscape of health humanities. J Med Humanit. Dec 2017;38(4):431-444. https://doi.org/10.1007/s10912-017-9445-5

Kumagai AK. Beyond "dr. feel-good": a role for the humanities in medical education. Acad Med. Dec 2017;92(12):1659-1660. https://doi.org/10.1097/ACM.0000000000001957

Rosenthal S, Howard B, Schlussel YR, et al. Humanism at heart: preserving empathy in third-year medical students. Acad Med. Mar 2011;86(3):350-8. https://doi.org/10.1097/ACM.0b013e318209897f

Yang KT, Yang JH. A study of the effect of a visual arts-based program on the scores of Jefferson Scale for physician empathy. BMC Med Educ. Oct 2013;13:142. https://doi.org/10.1186/1472-6920-13-142

Leppink J, O'Sullivan P, Winston K. Evidence against vs. in favour of a null hypothesis. Perspect Med Educ. Apr 2017;6(2):115-118. https://doi.org/10.1007/s40037-017-0332-6

Young M, Varpio L, Uijtdehaage S, Paradis E. The spectrum of inductive and deductive research approaches using quantitative and qualitative data. Acad Med. Jul 2020;95(7):1122. https://doi.org/10.1097/ACM.0000000000003101

Cochran A, Paukert JL, Neumayer LA. Does a general surgery clerkship influence student perceptions of surgeons and surgical careers? Surgery. Aug 2003;134(2):153-7. https://doi.org/10.1067/msy.2003.216

Batt-Rawden SA, Chisolm MS, Anton B, Flickinger TE. Teaching empathy to medical students: an updated, systematic review. Acad Med. Aug 2013;88(8):1171-7. https://doi.org/10.1097/ACM.0b013e318299f3e3

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2023-08-01

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1.
Gill GK, Ng SL, Kangasjarvi E, Crukley J, Simpson JS. De la compétence à l’empathie : évaluation de l’évolution de la perception qu’ont les étudiants en médecine des chirurgiens dans le cadre d’un programme associant le patient enseignant et la réflexion fondée sur les humanités. Can. Med. Ed. J [Internet]. 1 août 2023 [cité 23 nov. 2024];. Disponible à: https://dev.journalhosting.ucalgary.ca/index.php/cmej/article/view/76536

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