摘要
目的 评估叙事医学教育对住院医师规范化培训的医师叙事能力的影响,并探讨其在临床实践中的应用价值。方法 随机选取2021年10月—2024年6月在河北医科大学第四医院参加住培的23名妇产科住培医师,接受融合叙事医学教育的住培培训3个月,包括叙事理论学习、文本细读、反思性写作和情景模拟案例分析等,问卷调查分析住培医师的个人情况、接受叙事医学教育前后其叙事能力情况,以及教学满意度。结果 问卷调查结果显示,经过叙事医学教育的住培医师在叙事能力评估量表上的得分高于培训前,包括在生命健康叙事意识维度、职业叙事思维维度、职业发展叙事行为维度、同行交流叙事行为维度以及医患互动叙事行为维度的叙事能力均有所提升(P<0.05);但在生命健康叙事行为维度、家庭连接叙事行为维度的差异无统计学意义(P>0.05)。同时,住培医师的主动学习兴趣、临床思维能力、医患沟通能力以及对教学方式的满意度也有所提升(P<0.05)。结论 叙事医学教育能有效提升住培医师的叙事能力,可弥补目前医学教育中人文素养和伦理教育的不足,对改善医患关系、提高医疗服务质量意义重大,建议将叙事医学教育纳入住培医师的常规培训课程中。
Objective:To evaluate the impact of narrative medicine education on the narrative ability of resident physicians undergoing standardized residency training,and to explore its application value in clinical practice.Methods:A total of 23 obstetricians and gynecologists who participated in residency training at the Fourth Hospital of Hebei Medical University from October 2021 to June 2024 were randomly selected to receive a 3-month residency training program integrated with narrative medicine education,including narrative theory learning,text reading,reflective writing,and scenario-based case analysis.A questionnaire survey was conducted to analyze the personal situation of resident physicians,their narrative ability before and after receiving narrative medicine education,and their satisfaction with teaching.Results:The results of the questionnaire survey showed that resident physicians who had received narrative medicine education scored higher on the narrative ability assessment scale than before training,including improved narrative abilities in the dimensions of life and health narrative awareness,professional narrative thinking,professional development narrative behavior,peer communication narrative behavior,and doctor-patient interaction narrative behavior(P<0.05).However,there were no statistically significant differences in the dimensions of life and health narrative behavior and family connection narrative behavior(P>0.05).Meanwhile,resident physicians’interest in active learning,clinical thinking ability,doctor-patient communication ability,and satisfaction with teaching methods have also been improved(P<0.05).Conclusion:Narrative medicine education can effectively enhance the narrative ability of resident physicians and make up for the current deficiencies in humanistic literacy and ethical education in current medical education.It is of great significance for improving doctor-patient relationships and the quality of medical services.Therefore,it is recommended to integrate narrative medicine education into the regular training curriculum for resident physicians.
作者
杜丽佳
郑芮
那佳
朱潇雄
杨志芬
DU Lijia;ZHENG Rui;NA Jia;ZHU Xiaoxiong;YANG Zhifen(Obstetrical Department,East Campus,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Research Center for Medical Education Collaboration and Medical Education,Hebei Medical University,Shijiazhuang 050011,China)
出处
《中国医学伦理学》
北大核心
2025年第6期695-703,共9页
Chinese Medical Ethics
基金
2024年河北医科大学2024年度研究生精品教材建设项目“产科情景模拟教学案例集”(YJPJC202403)
2024年省级研究生示范课程“以叙事医学为纲的产科学示范课程”(KCJSX2024040)
2021年教育部首批新文科研究与改革实践项目“‘5+3’医学人才培养模式下医学人文课程设置的序贯性研究”(2021070026)。
关键词
医学叙事能力
叙事医学教育
产科
住院医师规范化培训
医学人文
medical narrative ability
narrative medicine education
obstetrics
standardized residency training
medical humanities
