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以人为本:在三年级医学生中培养同理心。

Humanism at heart: preserving empathy in third-year medical students.

机构信息

Meridian Health, Neptune, New Jersey, USA.

出版信息

Acad Med. 2011 Mar;86(3):350-8. doi: 10.1097/ACM.0b013e318209897f.

Abstract

PURPOSE

Research suggests that medical student empathy erodes during undergraduate medical education. The authors evaluated the Jefferson Scale of Physician Empathy Medical Student Version (JSPE-MS) scores of two consecutive medical school classes to assess the impact of an educational intervention on the preservation of empathy.

METHOD

The authors conducted a before-and-after study of 209 Robert Wood Johnson Medical School (RWJMS) students enrolled in the classes of 2009 and 2010. Students' clerkships included a mandatory, longitudinal "Humanism and Professionalism" (H&P) component, which included blogging about clerkship experiences, debriefing after significant events, and discussing journal articles, fiction, and film. Students completed the JSPE-MS during their first and last clerkships.

RESULTS

The results showed that (1) contrary to previous studies' findings, third-year students did not show significant decline in empathy as measured by the JSPE-MS (these students, from two consecutive RWJMS classes, experienced the H&P intervention), (2) students selected for the Gold Humanism Honor Society (GHHS) were significantly different from their peers in empathy scores as measured by JSPE-MS, and (3) knowledge of selection for the GHHS seems to positively influence students' JSPE-MS scores.

CONCLUSIONS

Maintaining empathy during the third year of medical school is possible through educational intervention. A curriculum that includes safe, protected time for third-year students to discuss their reactions to patient care situations during clerkships may have contributed to the preservation of empathy. Programs designed to validate humanism in medicine (such as the GHHS) may reverse the decline in empathy as measured by the JSPE-MS.

摘要

目的

研究表明,医学生的同理心会在本科医学教育中逐渐减弱。作者评估了连续两届医学院学生的杰斐逊医生同理心量表医学学生版(JSPE-MS)得分,以评估教育干预对同理心保护的影响。

方法

作者对 2009 年和 2010 年入学的 209 名罗伯特伍德约翰逊医学院(RWJMS)学生进行了一项前后对照研究。学生的实习包括一个强制性的、纵向的“人文主义和专业精神”(H&P)组成部分,其中包括写关于实习经历的博客、在重大事件后进行反思、以及讨论期刊文章、小说和电影。学生在第一次和最后一次实习期间完成了 JSPE-MS。

结果

结果表明:(1)与之前研究的发现相反,三年级学生的同理心并没有像 JSPE-MS 所测量的那样显著下降(这两届 RWJMS 的学生都经历了 H&P 干预);(2)入选金人文主义荣誉学会(GHHS)的学生在 JSPE-MS 测量的同理心得分上与同龄人有显著差异;(3)对入选 GHHS 的了解似乎会对学生的 JSPE-MS 分数产生积极影响。

结论

通过教育干预,在医学院的第三年保持同理心是可能的。一个包括为三年级学生提供安全、受保护的时间,让他们在实习期间讨论对患者护理情况的反应的课程,可能有助于保护同理心。旨在验证医学中的人文主义(如 GHHS)的项目可能会逆转 JSPE-MS 测量的同理心下降。

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