Weissmann Peter F, Branch William T, Gracey Catherine F, Haidet Paul, Frankel Richard M
Department of Medicine, Hennepin County Medical Center, University of Minnesota Medical School--Twin Cities, Minneapolis, Minnesota 55415, USA.
Acad Med. 2006 Jul;81(7):661-7. doi: 10.1097/01.ACM.0000232423.81299.fe.
Humanistic care is regarded as important by patients and professional accrediting agencies, but little is known about how attitudes and behaviors in this domain are taught in clinical settings. To answer this question, the authors studied how excellent clinical teachers impart the behaviors and attitudes consistent with humanistic care to their learners.
Using an observational, qualitative methodology, the authors studied 12 clinical faculty identified by the medical residents enrolled from 2003 to 2004 as excellent teachers of humanistic care on the inpatient medical services at four medical universities in the United States (University of Minnesota Medical School, Emory University, University of Rochester School of Medicine, and Baylor College of Medicine). Observations were conducted by the authors using standardized field notes. After each encounter, the authors debriefed patients, learners (residents and medical students), and the teaching physicians in semistructured interviews.
Clinical teachers taught primarily by role modeling. Although they were highly aware of their significance as role models, they did not typically address the human dimensions of care overtly. Despite the common themes of role modeling identified, each clinical teacher exhibited unique teaching strategies. These clinical teachers identified self-reflection as the primary method by which they developed and refined their teaching strategies.
Role modeling is the primary method by which excellent clinical teachers try to teach medical residents humanistic aspects of medical care. Although clinical teachers develop unique teaching styles and strategies, common themes are shared and could be used for the future development of clinical faculty.
人文关怀受到患者和专业认证机构的重视，但对于在临床环境中如何传授该领域的态度和行为却知之甚少。为回答这个问题，作者研究了优秀的临床教师如何向学习者传授与人文关怀相一致的行为和态度。
作者采用观察性定性研究方法，研究了2003年至2004年在美国四所医学院（明尼苏达大学医学院、埃默里大学、罗切斯特大学医学院和贝勒医学院）住院医疗服务中被住院医师认定为人文关怀优秀教师的12名临床教员。作者使用标准化的现场记录进行观察。每次接触后，作者通过半结构化访谈对患者、学习者（住院医师和医学生）以及带教医生进行汇报总结。
临床教师主要通过榜样示范进行教学。尽管他们高度意识到自己作为榜样的重要性，但通常不会公开提及关怀的人文层面。尽管确定了榜样示范的共同主题，但每位临床教师都展示出独特的教学策略。这些临床教师将自我反思视为他们制定和完善教学策略的主要方法。
榜样示范是优秀临床教师试图向住院医师传授医疗护理人文方面的主要方法。尽管临床教师会形成独特的教学风格和策略，但也有共同的主题，可用于临床教员的未来发展。
