Janssen Anna L, Macleod Roderick D, Walker Simon T
Faculty Education Unit, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Palliat Support Care. 2008 Dec;6(4):389-95. doi: 10.1017/S1478951508000618.
Medical education can be described as a socialization process that has a tendency to produce doctors who struggle to convey to patients that they care. Yet, for people who are suffering, to enjoy the quality of life they are entitled to, it is important that they feel cared for as people, rather than simply attended to as patients.
This article addresses how we teach medical students the art of caring for the person rather than simply treating the disease--a question particularly relevant to end-of-life care where, in addition to the physical needs, attention to the psychosocial, emotional, and spiritual needs of the patient is paramount. Following an overview of what it is to care and why it is important that patients feel cared for, we investigate how we learn to care and develop caring human relationships, describing the development and display of empathy in adulthood and the developmental impact of human interaction.
We outline evidence of situational barriers to effective education about care in medicine including role models, ward culture, and the socialization process.
We then propose a model for medical education based on patient contact, reflection, self-care, role model development, and feedback that will see students learn the art of human care as well as the science of disease management.
医学教育可被描述为一个社会化过程，这个过程往往培养出难以向患者传达关怀之情的医生。然而，对于正在遭受病痛折磨的人来说，要想享有他们应得的生活质量，重要的是他们作为人能感受到关怀，而不仅仅是作为患者得到治疗。
本文探讨了我们如何教导医学生关怀人的艺术，而不仅仅是治疗疾病——这个问题在临终关怀中尤为相关，在临终关怀中，除了身体需求外，关注患者的心理社会、情感和精神需求至关重要。在概述了关怀的本质以及患者感受到关怀为何重要之后，我们研究了我们如何学会关怀并建立关怀性的人际关系，描述了成年期同理心的发展与表现以及人际互动的发展影响。
我们概述了医学中有效关怀教育存在的情境障碍的证据，包括榜样、病房文化和社会化过程。
然后，我们基于患者接触、反思、自我关怀、榜样培养和反馈提出了一个医学教育模型，该模型将使学生学会人文关怀的艺术以及疾病管理的科学。
