[A Reappraisal of Pain Using a Nurses' Professional Study Circle].

BACKGROUND: Pain relates to the highly personal and subjective experience of feelings and emotions. Patients are often misunderstood because of language-related limitations and the conditions of their disease. PURPOSE: In this research, a professional study circle was held to help nurses reconstruct their understanding of patient pain to enhance their awareness / empathy for differences in pain perception between others and themselves and to improve their ability to provide professional, individualized care. METHODS: Nine nurses were invited from the urology department to join the developed professional study circle. We spent one year and a half reading "Listening to Pain: Finding Words, Compassion, and Relief" and held a sharing and discussion roundtable meeting every month. The study circle included: (1) assigned reading and the appointment of a leader on rotation to direct the sharing and discussion, (2) presentation of clinical cases related to the reading, (3) discussions of how to apply what they had learned in clinical practice, and (4) an interview of study circle members and a full analysis of their reflections and changes of view regarding pain perceptions. RESULTS: After a close reading and guided discussions, these nine nurses began to change their perceptions of pain and, in general, passed through three stages, including: (1) cast doubt on the authenticity of patient expressions of pain because of stereotyped biases; (2) develop a new empathy based on careful listening; (3) providing individualized care and experiencing professional growth. After successfully transiting through these stages, the nurses held a more profound understanding of their patients, practiced a more sensitive use of language, and reflected an enhanced professional ability to assess pain. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This professional study circle successfully helped the nurses internalize a more empathetic understanding of pain and exhibit greater skill in designing individualized care for their patients.

Learning medical professionalism - the application of appreciative inquiry and social media.

BACKGROUND: Medical professionalism is often considered difficult to be clearly observed and learned. However, although most medical students or residents affirm the necessity of medical professionalism courses, few agree that those currently offered are adequate for a medical career. OBJECTIVE: To develop a curriculum for teaching professionalism by enabling students to share positive examples of professionalism in social media that reflects the authentic experience in clinical environment. DESIGN: Between October 2015 and June 2017, the authors developed a clerkship program to teach professionalism with the support of social media and appreciative inquiry. Medical students were required to write posts on the positive behaviors they observed during clinical practice in the Facebook group. Other students and course instructors commented or responded to the posted content. The content on Facebook analyzed by course instructors and was based on the definition of medical professionalism according to the 18 attributes proposed by Cruess et al. Results: In total, 103 medical students in their first clinical year participated and posted 435 records of role model learning in the Facebook group. The majority of students learned the most when the clinical instructors were passionate about their teaching and guidance in medical expertise; this accounted for 23.0% of all role model behaviors. Other attributes of professionalism that students appreciated most were being caring and compassionate (17.2%), competence (9.6%), openness (8.8%), and presence (7.7%). More than 90% of the students reported enjoying this type of course and would like to integrate their learning experiences into future behavior. CONCLUSIONS: This innovative training program was well accepted in the formal curriculum and the predesigned social media environment. Appreciative inquiry for medical professionalism should be integrated into the organizational culture and the culture of social media interaction.