臨床実習での学生の指導方法について　実習の学生と指導者の振り返りからの一考察

Abstract

実習の際には、実習地を訪問し、課題の進捗状況を指導者と学生から聞き取り、問題が生じていれば、その原因と解決方法を共に考え対処し、実習の課題到達を目指している。今回精神領域の評価実習の訪問時、学生は「指導者に迷惑をかけたくない」「実習の場でどのように行動したら良いかわからない」との訴え、課題の進捗状況の確認に時間を要した。「実習ではできない事を見つけそれを練習する事が大切」と事前に学びの姿勢を伝えていが、学生は指導者にどう思われているかを優先していた。　この原因を知りたく、実習生と指導者それぞれに実習の振り返りを実施した。振り返りは、実習生には困った事と受けた援助、指導者には実習生が困っていた事と実施した援助にカード化した。学生と指導者それぞれのグループでKJ法を用い概念化し、結果を共有した。　学生が困った事については、学生自身よりも指導者の方が具体的に把握し、学生は自身が困った事を言語化できていなかったことが示された。この言語化できていないことが自身の実習課題の達成よりも指導者からの評価に視点がむいた原因と考えられたThe present study involved students undergoing practical training and their supervisors, and focused on supervisors’ approaches to help students complete assignments. Students who have had problems and their supervisors at a training site are supposed to report the status of progress made in assignments and discuss the causes and solutions together. Reports submitted by students who had undergone training in psychiatry included: “They did not want to cause trouble for supervisors” and “They did not know what to do at the training site”, and it took time to confirm the status of progress. Although students had been informed of a recommended learning attitude: “In practical training, it is important to identify what you cannot do and practice it for improvement” in advance, they were more occupied with their supervisors’ evaluations.Both students and supervisors were asked to reflect on the training sessions to examine the causes; the students reflected on problems they experienced and support they received, and the supervisors reflected on those problems and the support they provided. The results of the reflections were described on cards. The descriptions obtained from the student and supervisor groups were conceptualized using the KJ method, so that they could share the results.The supervisors had understood problems experienced by the students more comprehensively than the students themselves. The students had difficulty verbalizing their problems, which is considered to be the reason for their attaching greater importance to evaluation by supervisors rather than the completion of assignments