Rosenfield Paul J, Jones Lee
Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, NY 10032, USA.
Med Educ. 2004 Sep;38(9):927-33. doi: 10.1111/j.1365-2929.2004.01931.x.
Medical students face many challenges as they progress through training, some of which refer to learning how to manage the stresses and anxiety of confronting illness and suffering. In trying to relieve anxiety, they may develop maladaptive responses that lead to a decrease in their level of empathy for patients. Education should aim to teach students how to deal with their responses so that they can tolerate patients' distress and treat them effectively.
This paper will address central dilemmas in students' attitudes towards patients during clerkships and suggest positive developmental goals to strive for in this formative time. It may be used as a reference tool for medical student educators and medical students to elucidate the educational tensions in teaching and learning about how to provide empathetic care.
Students and teachers can benefit from an awareness of the tension between the poles of pathology and health, not knowing and too much knowing, vulnerability and denial and reaction and inaction. Medical students can learn adaptive methods of managing their anxiety about dealing with illness and death and strike a balance in their approach to patients.
医学生在整个培训过程中面临诸多挑战,其中一些挑战涉及学习如何应对面对疾病和痛苦时的压力与焦虑。在试图缓解焦虑时,他们可能会形成适应不良的反应,从而导致对患者的同理心水平下降。教育应旨在教导学生如何应对自身反应,以便他们能够容忍患者的痛苦并有效治疗患者。
本文将探讨学生在临床实习期间对患者态度的核心困境,并提出在此形成期应努力追求的积极发展目标。它可作为医学生教育工作者和医学生的参考工具,以阐明在教授和学习如何提供共情护理方面的教育张力。
学生和教师可以从认识病理学与健康、无知与过度了解、脆弱与否认以及反应与无为这些两极之间的张力中受益。医学生可以学习管理其对处理疾病和死亡的焦虑的适应性方法,并在对待患者的方式上取得平衡。