Exploring the meaning of respect in medical student education: An analysis of student Narratives

Orit Karnieli-Miller, Amanda C. Taylor, Ann H. Cottingham, Thomas Inui, Toan Vu, Richard Frankel

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

BACKGROUND: Respect for others is recognized in the medical literature and society as an essential attribute of the good medical professional. However, the specific meaning of respect varies widely and is underexplored as a lived experience of physicians-in-training. OBJECTIVE: To describe third-year medical students' narratives of respect and disrespect [(dis)respect] during their internal medicine clerkship. DESIGN: Qualitative thematic analysis of 152 third-year student narratives that 'taught them something about professionalism,' focusing on (dis)respect. APPROACH: Immersion/crystallization narrative analysis. RESULTS: We reviewed 595 professionalism narratives and found that one in four narratives involved (dis)respect. We then found that 2/3 of these narratives were negative (describing instances of disrespect rather than respect). In the other coded categories, the proportion of negative narratives was significantly lower. In order to better understand these results, we analyzed the content of the (dis)respect narratives and identified six primary themes: (1) content and manner of communication (including, appreciating or belittling, being sensitive or blunt and respecting privacy); (2) conduct: behaviors expressing (dis)respect; (3) patient centeredness: honoring others' preferences, decisions and needs; (4) treating others as equals; (5) valuing the other and their experience and/or problem; and (6) nurturing students' learning. CONCLUSIONS: Focusing on the lived experience of (dis)respect on wards broadens the concept of respect beyond any one type of act, behavior or attitude. Students perceive respect as a way of being that applies in all settings (private and public), with all participants (patients, family members, nurses, colleagues and students) and under all circumstances (valuing others' time, needs, preferences, choices, opinions and privacy). Respect seems to entail responding to a need, while disrespect involves ignoring the need or bluntly violating it.

Original languageEnglish
Pages (from-to)1309-1314
Number of pages6
JournalJournal of General Internal Medicine
Volume25
Issue number12
DOIs
StatePublished - Dec 2010

Fingerprint

Medical Education
Medical Students
Students
Privacy
Medical Societies
Immersion
Internal Medicine
Crystallization
Nurses
Communication
Learning
Physicians
Professionalism

Keywords

  • medical education
  • medical professional
  • respect

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Exploring the meaning of respect in medical student education : An analysis of student Narratives. / Karnieli-Miller, Orit; Taylor, Amanda C.; Cottingham, Ann H.; Inui, Thomas; Vu, Toan; Frankel, Richard.

In: Journal of General Internal Medicine, Vol. 25, No. 12, 12.2010, p. 1309-1314.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Respect for others is recognized in the medical literature and society as an essential attribute of the good medical professional. However, the specific meaning of respect varies widely and is underexplored as a lived experience of physicians-in-training. OBJECTIVE: To describe third-year medical students' narratives of respect and disrespect [(dis)respect] during their internal medicine clerkship. DESIGN: Qualitative thematic analysis of 152 third-year student narratives that 'taught them something about professionalism,' focusing on (dis)respect. APPROACH: Immersion/crystallization narrative analysis. RESULTS: We reviewed 595 professionalism narratives and found that one in four narratives involved (dis)respect. We then found that 2/3 of these narratives were negative (describing instances of disrespect rather than respect). In the other coded categories, the proportion of negative narratives was significantly lower. In order to better understand these results, we analyzed the content of the (dis)respect narratives and identified six primary themes: (1) content and manner of communication (including, appreciating or belittling, being sensitive or blunt and respecting privacy); (2) conduct: behaviors expressing (dis)respect; (3) patient centeredness: honoring others' preferences, decisions and needs; (4) treating others as equals; (5) valuing the other and their experience and/or problem; and (6) nurturing students' learning. CONCLUSIONS: Focusing on the lived experience of (dis)respect on wards broadens the concept of respect beyond any one type of act, behavior or attitude. Students perceive respect as a way of being that applies in all settings (private and public), with all participants (patients, family members, nurses, colleagues and students) and under all circumstances (valuing others' time, needs, preferences, choices, opinions and privacy). Respect seems to entail responding to a need, while disrespect involves ignoring the need or bluntly violating it.",
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