Coulehan J
Med Humanit. 2007 Dec;33(2):106-9. doi: 10.1136/jmh.2005.000250.
After more than a generation of neglect in medical education, professionalism has now been restored to the classroom and clinic. However, the current emphasis on teaching and evaluating professionalism in clinical education risks failure because of the large gap between explicit professional ideals and today's culture of medical education. For professionalism curricula to be successful, they must be narrative-based, rather than rule-based. This requires substantial increases in appropriate role modeling, opportunities to develop self-awareness, development of narrative competence and investment in community service. Fictional and non-fictional written narratives can play an important supplemental role throughout medical training by introducing additional role model physicians and, more importantly, by promoting discussion and analysis of professional virtue in practice. Using "The Steel Windpipe", "Darkness", "Malingerers" and "The Good Doctor" as examples, the author illustrates the use of short stories to help medical students explore the meaning of professionalism from a narrative perspective.
在医学教育被忽视了一代人多的时间之后,专业精神如今已重回课堂和临床。然而,当前临床教育中对专业精神教学与评估的重视存在失败风险,因为明确的专业理想与当今医学教育文化之间存在巨大差距。要使专业精神课程取得成功,就必须基于叙事,而非基于规则。这需要大幅增加合适的榜样示范、培养自我意识的机会、叙事能力的发展以及对社区服务的投入。虚构和非虚构的书面叙事在整个医学培训过程中可以发挥重要的补充作用,通过引入更多榜样医生,更重要的是,通过促进对实践中专业美德的讨论和分析。作者以《钢铁气管》《黑暗》《装病者》和《好医生》为例,阐述了如何利用短篇小说帮助医学生从叙事角度探索专业精神的意义。