Abstract
BackgroundThe biopsychosocial model is a comprehensive approach emphasizing holistic medical care. However, medical curricula that incorporate narrative reflective writing and group dynamic discussion of psychosocial issues among patients and their family members in reflective dialogue groups are currently underutilized. The aim of this study was to determine psychosocial issues among patients and their family members through medical students’ reflective dialogue groups.MethodsThis study was completed as part of a pediatric clerkship. Fifty medical students were rotated to the department of Pediatrics. They completed a narrative writing assignment concerning patients’ psychosocial issues and participated in a reflective group discussion during the rotation. The recordings of the six reflective group sessions were transcribed for thematic analysis. A six-step theme generation process was conducted in the first reading stage of all transcripts by four researchers. Subsequently, initial codes were generated and potential themes sought before possible themes were reviewed and thematic maps generated. Names for each theme were defined and a scholarly report of the analysis was presented through a consensus-based approach.ResultsA total of 108 psychosocial issues were coded and categorized as the following six main themes: medical communication, the intricate medical ecological system, role and function of a family, development of medical professionalism, ethical dilemmas, and various patient perspectives from diverse cultural backgrounds. All these themes underlie the complexity of clinical encounters.ConclusionsClinical care is an extremely complex interactive ecological network involving human behavior, family, and public health care systems. The discovery of psychosocial problems by medical students as narrators in this study illustrates that medical care should focus not only on illnesses but also patients’ psychosocial narratives.
Highlights
The biopsychosocial model is a comprehensive approach emphasizing holistic medical care
Building on the biopsychosocial (BPS) model, this study used thematic analysis to identify psychosocial issues disclosed by medical students during a small group discussion
Given that reflective writing represents a valuable approach to developing narrative competency, medical students can benefit greatly from reflecting on and recounting their encounters with patients and family members [6,7,8]
Summary
The biopsychosocial model is a comprehensive approach emphasizing holistic medical care. The aim of this study was to determine psychosocial issues among patients and their family members through medical students’ reflective dialogue groups. Chu et al BMC Medical Education (2018) 18:12 patients with opportunities to address their concerns as a means of understanding their expectations and issuing health-related information. This relationship-centered model guides clinical conditions toward a dialogic model that enables a more holistic and humanistic response [3]. Given that reflective writing represents a valuable approach to developing narrative competency, medical students can benefit greatly from reflecting on and recounting their encounters with patients and family members [6,7,8]. The medical students in this study were encouraged to listen to patients’ stories to form biological diagnoses and develop psychosocial perspectives on specific problems that were observed and addressed
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