核心自我评价和生活满意度对澳门中学生学业倦怠的影响

采用问卷调查法,以336名澳门中学生为被试,探讨澳门中学生的核心自我评价、生活满意度与学业倦怠的关系。结果发现,(1)澳门中学生的核心自我评价、生活满意度对学业倦怠有负向影响作用。(2)生活满意度在核心自我评价与学业倦怠间起调节作用:高生活满意度的个体,核心自我评价越高,学业倦怠程度越低;低生活满意度个体,无论核心自我评价的高低,学业倦怠程度都较高。     

Reflective Writing about Near-Peer Blogs: A Novel Method for Introducing the Medical Humanities in Premedical Education

Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors conducted qualitative analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes (empathic conflict, bias in healthcare, and the humanity of medicine) and one overarching theme (near-peer affinities). The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine.

     

First Year Medical Students’ Perceptions Towards Integration of Medical Law in the Medical Curriculum: a Pilot Study

Medical law is not new in medical literature and can constitute an imperative component in medical education. Some medical schools include medical law as a compulsory component of the curriculum. In line with curriculum re-structuring at the University of Malaya, medical law was integrated in the medical curriculum and the feasibility of this integration into the Year 1 undergraduate curriculum was evaluated. Following implementation of a 4-week medical law module, an evaluation of the suitability of early integration of this module was conducted using a ten-item, 4-point Likert scale (1?=?strongly disagree to 4?=?strongly agree) questionnaire. Two open-ended questions were also included to gauge insights of the integration. All items were scored 3 points or more from the students’ responses (n?=?129). Using the open-ended questions, recommendations for future directions as well as constraints and issues related to the integration of medical law into teaching and learning was revealed. Overall, findings of the study indicated that integrating medical law into medical curriculum at an early stage was beneficial for the medical students.     

The impact of empathy on burnout in medical students: new findings

Introduction: Research on medical students has shown they are at a higher risk for burnout and that this burnout may become more prevalent as they advance in medical school. The literature, thus far, has not explored the construct of ,emotional empathy and whether this can impact burnout in medical students. Objective: To understand the relationship between empathy (Empathic Concern [EC] and Personal Distress [PD]) and burnout in medical students. Method: Five successive classes of medical students enrolled at a new medical school were given the Maslach Burnout Inventory and Davis’ Interpersonal Reactivity Index over the course of three successive years (n = 353). Two dimensions of empathy were evaluated to determine if they have an impact on three dimensions of burnout (Emotional Exhaustion/EE, Depersonalization/DP, Personal Accomplishment/PA). Results: data was analyzed using a linear mixed model for each of the three components of burnout based on gender, age, year in medical school, and two types of empathy: EC, and PD. Conclusion: It was discovered that students with high levels of EC had statistically lower scores of burnout over time while students with high levels of PD empathy showed statistically higher scores of burnout over three years. Implications for these findings are discussed.     

Academic Guidance in Medical Student Research: How Well Do Supervisors and Students Understand the Ethics of Human Research?

Research is increasingly recognised as a key component of medical curricula, offering a range of benefits including development of skills in evidence-based medicine. The literature indicates that experienced academic supervision or mentoring is important in any research activity and positively influences research output. The aim of this project was to investigate the human research ethics experiences and knowledge of three groups: medical students, and university academic staff and clinicians eligible to supervise medical student research projects; at two Australian universities. Training in research ethics was low amongst academic staff and clinicians eligible to supervise medical student research. Only two-thirds of academic staff (67.9 %) and students (65.7 %) and less than half of clinicians surveyed (47.1 %; p?=?0.014) indicated that specific patient consent was required for a doctor to include patient medical records within a research publication. There was limited awareness of requirements for participant information and consent forms amongst all groups. In the case of clinical trials, fewer clinicians (88.4 %) and students (83.3 %) than academics (100 %) indicated there was a requirement to obtain consent (p?=?0.009). Awareness of the ethics committee focus on respect was low across all groups. This project has identified significant gaps in human research ethics understanding among medical students, and university academic staff and clinicians. The incorporation of research within medical curricula provides the impetus for medical schools and their institutions to ensure that academic staff and clinicians who are eligible and qualified to supervise students’ research projects are appropriately trained in human research ethics.     

Medicine and the arts

Three years' experience in teaching a course in Literature and Medicine is reviewed. Examples of the ‘Laboratory’ or ‘in vitro’ functions of art are given, as they relate to and benefit both medical students and practitioners. The usefulness of literature (especially) in the medical setting is underscored, together with the need for medical personnel to be more aware of their heritage in this area. Examples of well-known physicians who have excelled in the arts (literature, music, painting/sculpture) are given and their major contributions discussed. There are some surprises.     

Guidelines for Writing Letters to Patients

Patient letters provide a permanent record of the genetic counseling that was provided and are unique in medical care; rarely do other health care providers send summaries written specifically to their patients and families. We surveyed genetic counseling training program directors and found that while the acquisition of patient letter-writing skills was considered important, there were no specific guidelines made available to students. To develop letter-writing guidelines, we evaluated patient letters, reviewed references on professional correspondence, surveyed the medical literature, and worked with a writing consultant. The guidelines we subsequently developed and present here include a format for writing patient letters, suggestions on presenting medical information in understandable terms, and wording considerations. These patient letter-writing guidelines are intended to serve as a guide for teaching students this important skill and as a resource for practicing health care professionals.     

Medical Student Burnout: Interdisciplinary Exploration and Analysis

Burnout—a stress-related syndrome characterized by exhaustion, depersonalization, and a diminished sense of accomplishment—is a common phenomenon among medical students with significant potential consequences for student health, professionalism, and patient care. This essay proposes that the epidemic of medical student burnout can be attributed to a technocratic paradigm that fails to value medical students as persons with human needs and limitations. After briefly reviewing the literature on medical student burnout, the author uses two theories to elucidate potential causes: unsatisfactory aspects of the learning environment and a feeling one’s efforts are meaningless or irrelevant. Cultural factors also facilitate burnout in medical students immersed in a clinical environment that cultivates excessive detachment from patient and self, impairing self-care, damaging a sense of self, and impeding the development of a mature, well-integrated professional identity. The ethical implications of medical student burnout are also addressed. Finally, this paper suggests possible preventive and remediative strategies such as optimizing the learning environment as well as narrative approaches that promise enhancement of both individual and institutional well-being.     

Healing as Constitutive of Jesus’ Mission Handed to the Church

After a basic statement of the Catholic doctrine on healing ministry, this article adopts the understanding of the World Council of Churches’ document Healing and Wholeness: The Churches’ Role in Health, adopted in 1990 by the central committee. The document views health, healing, and wholeness not just as medical issues, but as embracing the political, social, economic, cultural, and spiritual dimensions. Building on the above, this article proposes an integral approach to sacramental healing for the African Catholic Church, arguing that alongside healing of physical ailments and deliverance from evil and malignant forces, healing must include working for social justice and peace for the people.     

“I don’t want to let myself down or the charity down”: men’s accounts of using various interventions to reduce smoking and alcohol consumption

Men are less likely to seek medical help than women and are more likely to adopt unhealthy practices. This study investigated men’s constructions of alcohol and tobacco cessation interventions in relation to dominant masculine identities. Focus groups and interviews with 12 male university students were analysed using an eclectic approach informed by discursive psychology and Foucauldian discourse analysis. Findings suggested that interventions encouraging competition among friends were constructed as favourable, and autonomy and control were central to men’s accounts. While men presented their behaviour change as intentional, their accounts revealed a tendency to conceal this from others, suggesting a negative influence of peer pressure. However, participants who had raised money for charity whilst abstaining described this process as rewarding and acting as a “buffer” to legitimise their healthy behaviour when socializing with other men. Implications for health providers and policy makers are discussed.     

Keeping Up with the Joneses: Friends’ Perfectionism and Students’ Orientation Toward Extrinsic Aspirations

Kasser and Ryan (1993,1996) have contrasted two types of life values: intrinsic aspirations, which include community contribution, building close relationships, and self‐growth, and extrinsic aspirations, which include fame, wealth, and physical beauty. Prioritization of extrinsic relative to intrinsic aspirations has been related cross‐sectionally to decreased well‐being (Kasser, 2002). However, the influence of close others in the etiology of young adults' prioritization of extrinsic aspirations, and the prospective effects of aspirations on well‐being, are not well understood. In a multiple‐informant prospective study of 341 university students (mean age = 19.4; 64% Caucasian; 74% female), we examined the influence of friends’ and family members’ perfectionism on participants’ aspirations, and the outcomes of prioritization of extrinsic aspirations. Having friends high in other‐oriented perfectionism was significantly positively related to prioritization of extrinsic over intrinsic aspirations. Furthermore, living with friends amplified the effect. Last, prioritization of extrinsic aspirations at T1 was related to decreased subjective well‐being and self‐concordance for goals 3 months later. The study provides preliminary evidence for a relationship between friends’ other‐oriented perfectionism and students’ orientation toward extrinsic aspirations, as well as negative prospective consequences of students’ orientation to extrinsic aspirations.     

公共物品困境中自我权力和他人权力对初中生合作行为的影响

本研究分别操纵被试稳定的权力（实验1）和不稳定的权力（实验2）,并与不同权力个体进行公共物品困境任务,以考察了自我权力和他人权力对初中生合作行为的交互作用及其权力稳定性在其中的作用。结果发现,在权力稳定情境下,高权力的初中生合作水平低于低权力组和控制组,而在权力不稳定的情境下,高权力的初中生合作水平高于低权力组。无论权力稳定与否,与低权力同伴合作时,低权力者的合作水平均显著高于与高权力同伴合作时。     

公共物品困境中自我权力和他人权力对初中生合作行为的影响

本研究分别操纵被试稳定的权力（实验1）和不稳定的权力（实验2）,并与不同权力个体进行公共物品困境任务,以考察了自我权力和他人权力对初中生合作行为的交互作用及其权力稳定性在其中的作用。结果发现,在权力稳定情境下,高权力的初中生合作水平低于低权力组和控制组,而在权力不稳定的情境下,高权力的初中生合作水平高于低权力组。无论权力稳定与否,与低权力同伴合作时,低权力者的合作水平均显著高于与高权力同伴合作时。     

Obstetric Autonomy and Informed Consent

I argue that public officials and health workers ought to respect and protect women’s rights to make risky choices during childbirth. Women’s rights to make treatment decisions ought to be respected even if their decisions expose their unborn children to unnecessary risks, and even if it is wrong to put unborn children at risk. I first defend a presumption of medical autonomy in the context of childbirth. I then draw on women’s birth stories to show that women’s medical autonomy is often ignored during labor. Medical interventions are performed during childbirth without women’s consent. Childbirth is risky and some coercive medical interventions may be understood as attempts to protect children and to prevent mothers from acting impermissibly. However, even if it is wrong to make risky choices during childbirth, women have rights to do wrong in these cases. Therefore, coercive medical interventions are impermissible during childbirth and institutions should adopt specific protections for obstetric autonomy.     

初中生人际交往能力、学业成绩及其发展背景系统间的关系

摘 要 采用问卷法调查586名初中生,探讨其人际交往能力、学业水平及发展背景系统的互动关系模式。研究发现初二学生的人际交往能力表现最为突出,女生更善于处理人际问题。高人际交往能力学生的学业成绩明显优于低人际交往能力学生。良好的父母教养方式能有效促进学生的人际交往能力,该能力有助于积极师生关系和同伴关系的发展。人际交往能力受家庭教养背景系统的直接影响,并作用于学校人际背景系统,两大系统以直接或间接的方式影响学业成绩。     

Political and religious group membership,value priorities and educational values

Value priorities and educational value patterns are explored in respect to university students’ active membership to religious and political groups. The sample was 117 students of the University of Athens, Greece, with 39 of them being active members of Christian Orthodox religious groups, 34 active members of political groups or unions, and 44 students acting as the ‘control’ group, since they were not members of such religious or political groups. Group membership—religious or political—was found to be associated with the systems of value priorities and educational values, with specific value combinations differentiating between religious group membership and political group membership.     

Further Validation of the Social and Emotional Health Survey for High School Students

The Social Emotional Health Survey (SEHS) was developed with the aim of assessing core cognitive dispositions associated with adolescents’ positive psychosocial development. Using a new sample, the present study sought to extend previous SEHS research by coadministering it with the Behavioral Emotional Screening System (BESS). The sample included 2,240 students in Grades 9-12 from two comprehensive high schools located in a major west coast USA city. A majority of the students were of Latino/a heritage (72 %) and had experienced disadvantaged economic circumstances (80 % at school 1 and 68 % at school 2). Confirmatory factor analyses supported the original SEHS factor structure composed of the first-order constructs of belief-in-self, belief-in-others, emotional competence, and engaged living, which parsimoniously mapped on to a second-order “covitality” factor. Complete factorial invariance was found across four groups formed by crossing gender (male, female) and age (ages 13–15, ages 16–18). Latent means analysis found several small to moderate effects size differences, primarily for the belief-in-self and belief-in-others first-order latent traits. A SEM analysis found that the SEHS measurement model, including covitality was a significant negative predictor of psychological distress as measured by the BESS and was positively associated with students’ end-of-semester grade point average. The discussion focuses on implications for conceptualizing the core psychological components of adolescents’ positive quality of life and how schools can use the SEHS as part of a whole-school procedure to screen for students’ complete mental health.     

Preparing our future counselling professionals: Gatekeeping and the implications for research

Social science research specific to the identification and prevalence of unsuitable students within counselling, psychology, and social work training programmes is briefly reviewed in this article. This area of enquiry relates to the gatekeeping responsibilities of professional educational programmes, to ensure that their graduates are competent to provide ethical and effective practice to the public. Key issues which impede the usefulness of this gatekeeping literature to counselling educators are raised. These include: methodological inconsistencies which limit the comparison of findings and hence the drawing of sound conclusions; the lack of definitional clarity relating to the construct of gatekeeping; and the confusing array of nomenclature used to represent students’ failure to meet acceptable professional standards. It is apparent from this overview that there are common factors irrespective of nomenclature that are associated with students at risk of not becoming competent entry‐level practitioners. This suggests that a structured approach to terminology is appropriate. There is also evidence to suggest that encountering such students is a regular occurrence for faculty, with students indicating higher numbers of impaired students than educators. A working definition of gatekeeping is provided and nomenclature suggested.