叙事医学在临床实习中的应用及效果评价研究：以胸外科为例

朱炬; 陈焕文

doi:10.3760/cma.j.cn116021-20220821-01385

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叙事医学在临床实习中的应用及效果评价研究：以胸外科为例

临床教学 | 更新时间：2023-09-01

- 叙事医学在临床实习中的应用及效果评价研究：以胸外科为例
- Application and effectiveness of narrative medicine in clinical internship: with department of thoracic surgery as an example
- 中华医学教育探索杂志 2023年22卷第8期页码：1201-1205
- 作者机构：
  
  重庆医科大学附属第一医院胸心外科，重庆　400016
- 作者简介：
  
  陈焕文，Email：coolstarchw9527@163.com
- 基金信息：
- DOI：10.3760/cma.j.cn116021-20220821-01385
  中图分类号： R-05
- 纸质出版日期：2023-08-20，
  
  收稿日期：2022-08-21，
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朱炬, 陈焕文. 叙事医学在临床实习中的应用及效果评价研究：以胸外科为例[J]. 中华医学教育探索杂志, 2023, 22(8): 1201-1205.

Zhu Ju, Chen Huanwen. Application and effectiveness of narrative medicine in clinical internship: with department of thoracic surgery as an example[J]. Chinese Journal of Medical Education Research, 2023,22(8):1201-1205.
朱炬, 陈焕文. 叙事医学在临床实习中的应用及效果评价研究：以胸外科为例[J]. 中华医学教育探索杂志, 2023, 22(8): 1201-1205. DOI： 10.3760/cma.j.cn116021-20220821-01385.

Zhu Ju, Chen Huanwen. Application and effectiveness of narrative medicine in clinical internship: with department of thoracic surgery as an example[J]. Chinese Journal of Medical Education Research, 2023,22(8):1201-1205. DOI： 10.3760/cma.j.cn116021-20220821-01385.

摘要

目的

探讨叙事医学教学干预对胸外科临床实习学生的学习成绩和共情能力中的影响。

方法

将重庆医科大学临床医学“5+3”一体化专业74名在胸外科实习学生分为观察组（37人）和对照组（37人）。对照组采用传统教学，观察组在传统教学基础上增加叙事医学教学。比较两组学生的出科考核成绩、人文关怀水平、共情水平、医患关系处理能力、教学满意度、学科兴趣和毕业工作意向。采用SPSS 21.0进行

检验和卡方检验。

结果

在专业理论成绩[观察组（85.16±10.04），对照组（79.73±8.27）]、操作技能成绩[观察组（85.32±8.77），对照组（79.70±7.56）]、人文关怀水平[观察组（3.78±0.95），对照组（3.24±1.04）]、共情水平量表评分[观察组（104.89±12.90），对照组（96.57±11.00）]、医患沟通技能和职业实践信心、医生患者定位的问卷[观察组（52.59±10.15），对照组（72.59±5.86）]、教学满意度（观察组89.2%，对照组64.8%）、学科兴趣[观察组（3.86±1.08），对照组（3.05±1.12）]和毕业工作意向（观察组29.7%，对照组8.1%）上，观察组均优于对照组，差异有统计学意义。

结论

在临床实习带教中引入叙事医学，可以提高教学效果、学生的共情能力和教学满意度。

Abstract

Objective

To investigate the effect of narrative medicine teaching on the academic performance and empathy ability of clinical interns in department of thoracic surgery.

Methods

A total of 74 interns in the department of thoracic surgery

with the "5+3" integration major of clinical medicine in Chongqing Medical University

were divided into observation group and control group

with 37 interns in each group. The interns in the control group received traditional teaching

and those in the observation group received narrative medicine teaching in addition to traditional teaching. The two groups were compared in terms of department examination score

level of humanistic concern

empathy level

ability to handle doctor-patient relationship

degree of satisfaction with teaching

discipline interest

and job intention after graduation. SPSS 21.0 was used to perform the

-test and chi-square test.

Results

Compared with the control group

the observation group had significantly better theoretical score [(85.16±10.04) vs. (79.73±8.27)]

operational skill score [(85.32±8.77) vs. (79.70±7.56)]

level of humanistic concern [(3.78±0.95) vs. (3.24±1.04)]

empathy scale score [(104.89±12.90) vs. (96.57±11.00)]

results of the questionnaire on doctor-patient communication skills

confidence in professional practice

and doctor-patient orientation [(52.59±10.15) vs. (72.59±5.86)]

degree of satisfaction with teaching (89.2% vs. 64.8% in the control group)

discipline interest [(3.86±1.08) vs. (3.05±1.12)]

and job intention after graduation (29.7% vs. 8.1%).

Conclusion

Narrative medicine introduced into clinical practice teaching can improve the effectiveness of teaching

the empathy ability of students

and the degree of satisfaction with teaching.

关键词

叙事医学胸外科临床实习医学人文教育

Keywords

Narrative medicineThoracic surgeryClinical internshipMedical humanistic education

references

杨琼，张新华，黄祁平，等. 叙事医学对我国医学人文教育的启示[J]. 中华医学教育探索杂志， 2016， 15（9）： 943-946. DOI: 10.3760/cma.j.issn.2095-1485.2016.09.019http://dx.doi.org/10.3760/cma.j.issn.2095-1485.2016.09.019.

Charon R. Narrative medicine: form, function, and ethics [J]. Ann Intern Med, 2001, 134(1): 83-87. DOI: 10.7326/0003-4819-134-1-200101020-00024http://dx.doi.org/10.7326/0003-4819-134-1-200101020-00024.

Tonini MC, Chesi P. Narrative medicine, an innovative approach to migraine management [J]. Neurol Sci, 2018, 39(Suppl 1): 137-138. DOI: 10.1007/s10072-018-3377-3http://dx.doi.org/10.1007/s10072-018-3377-3.

Lampl C, Sacco S, Martelletti P. Narrative-based medicine in headache disorders [J]. J Headache Pain, 2022, 23(1): 66. DOI: 10.1186/s10194-022-01437-5http://dx.doi.org/10.1186/s10194-022-01437-5.

Scott-Conner CEH, Agarwal D. Applications of narrative medicine to surgical education [J]. Am Surg, 2022, 88(12): 2851-2856. DOI: 10.1177/00031348211029851http://dx.doi.org/10.1177/00031348211029851.

王喜术，宦宏波，吴黎雳，等. 临床医学专业学位硕士研究生开展叙事医学课程的初步研究[J]. 中华医学教育探索杂志， 2019， 18（1）： 22-26. DOI: 10.3760/cma.j.issn.2095-1485.2019.01.005http://dx.doi.org/10.3760/cma.j.issn.2095-1485.2019.01.005.

陈红，范罗丹，杨雁涵，等. 基于叙事医学视角的《护理心理学》教学探讨[J]. 中华医学教育探索杂志， 2022（2）： 223-227. DOI: 10.3760/cma.j.cn116021-20200914-00771http://dx.doi.org/10.3760/cma.j.cn116021-20200914-00771.

杨柠溪，李小燕，燕虹，等. 叙事医学教育对临床医学专业学生共情能力和学业成绩的影响：一项随机对照试验[J]. 中国临床心理学杂志， 2018， 26（3）： 557-560， 556. DOI: 10.16128/j.cnki.1005-3611.2018.03.029http://dx.doi.org/10.16128/j.cnki.1005-3611.2018.03.029.

许彬东，黄国忠，陈豪，等. 胸心外科临床实习教学的现状与解决方法探讨[J]. 安徽医药， 2018， 22（7）： 1427-1430. DOI: 10.3969/j.issn.1009-6469.2018.07.055http://dx.doi.org/10.3969/j.issn.1009-6469.2018.07.055.

Bertran S, Boby H, Bertrand PM, et al. Comparison of video-based learning and lecture-based learning for training of ultrasound-guidedcentral venous catheterization: a randomized controlled trial [J]. Br J Anaesth, 2017, 118(4): 628-630. DOI: 10.1093/bja/aex059http://dx.doi.org/10.1093/bja/aex059.

赵斌. 解读《叙事医学》的３个要素[J]. 中华急诊医学杂志， 2022， 31（3）： 272. DOI: 10.3760/cma.j.issn.1671-0282.2022.03.035http://dx.doi.org/10.3760/cma.j.issn.1671-0282.2022.03.035.

史丽丽，魏镜，姜忆南，等. 规培住院医师与八年制医学生医患沟通能力的比较研究：以北京协和医学院为例[J]. 中华医学教育探索杂志， 2018， 17（2）： 196-200. DOI: 10.3760/cma.j.issn.2095-1485.2018.02.022http://dx.doi.org/10.3760/cma.j.issn.2095-1485.2018.02.022.

乔亚军，黄河清，陈康宁，等. 临床实习中医学生人文精神的培养[J]. 中华医学教育探索杂志， 2012， 11（1）： 93-95. DOI: 10.3760/cma.j.issn.2095-1485.2012.01.028http://dx.doi.org/10.3760/cma.j.issn.2095-1485.2012.01.028

Milota MM, van Thiel GJMW, van Delden JJM. Narrative medicine as a medical education tool: a systematic review [J]. Med Teach, 2019, 41(7): 802-810. DOI: 10.1080/0142159x.2019.1584274http://dx.doi.org/10.1080/0142159x.2019.1584274.

Chretien KC, Swenson R, Yoon B, et al. Tell me your story: a pilot narrative medicine curriculum during the medicine clerkship [J]. J Gen Intern Med, 2015, 30(7): 1025-1028. DOI: 10.1007/s11606-015-3211-zhttp://dx.doi.org/10.1007/s11606-015-3211-z.

Yu M. When I say … narrative competence [J]. Med Educ, 2017, 51(12): 1203-1205. DOI: 10.1111/medu.13374http://dx.doi.org/10.1111/medu.13374.

Huang CD, Jenq CC, Liao KC, et al. How does narrative medicine impact medical trainees' learning of professionalism? A qualitative study [J]. BMC Med Educ, 2021, 21(1): 391. DOI: 10.1186/s12909-021-02823-4http://dx.doi.org/10.1186/s12909-021-02823-4.

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