Ahrweiler Florian, Scheffer Christian, Roling Gudrun, Goldblatt Hadass, Hahn Eckhart G, Neumann Melanie
Witten/Herdecke University, Faculty of Health, School of Medicine, Institute for Integrative Medicine, Integrated Curriculum for Anthroposophic Medicine, Witten, Germany ; Augusta-Kranken-Anstalt, Medizinische Kliniken, Bochum, Germany.
Witten/Herdecke University, Faculty of Health, School of Medicine, Institute for Integrative Medicine, Integrated Curriculum for Anthroposophic Medicine, Witten, Germany ; Gemeinschaftskrankenhaus Herdecke, Department of Internal Medicine, Clinical Education Ward for Integrative Medicine, Herdecke, Germany.
GMS Z Med Ausbild. 2014 Nov 17;31(4):Doc46. doi: 10.3205/zma000938. eCollection 2014.
Physician empathy constitutes an outcome-relevant aim of medical education. Yet, the factors promoting and inhibiting physician empathy have not yet been extensively researched, especially in Germany. In this study, we explored German medical students' views of the factors promoting and inhibiting their empathy and how their experiences were related to their curricula.
A qualitative short survey was conducted at three medical schools: Bochum University, the University of Cologne and Witten/Herdecke University. Students were invited to complete an anonymous written questionnaire comprised of open-ended questions inquiring about the educational content of and situations during their medical education that positively or negatively impacted their empathy. Data were analyzed through qualitative content analysis according to the methods of Green and Thorogood.
A total of 115 students participated in the survey. Respondents reported that practice-based education involving patient contact and teaching with reference to clinical practice and the patient's perspective improved their empathy, while a lack of these inhibited it. Students' internal reactions to patients, such as liking or disliking a patient, prejudice and other attitudes, were also considered to influence their empathy. Although each of the three schools takes a different approach to teaching interpersonal skills, no relevant differences were found in their students' responses concerning the possible determinants of empathy.
Providing more training in practice and more contact with patients may be effective ways of promoting student empathy. Students need support in establishing therapeutic relationships with patients and in dealing with their own feelings and attitudes. Such support could be provided in the form of reflective practice training in order to promote self-awareness. More research is needed to evaluate these hypothetical conclusions.
医生的同理心是医学教育与结果相关的一个目标。然而，促进和抑制医生同理心的因素尚未得到广泛研究，尤其是在德国。在本研究中，我们探讨了德国医学生对促进和抑制其同理心的因素的看法，以及他们的经历与课程之间的关系。
在三所医学院校开展了一项定性简短调查，这三所院校分别是波鸿大学、科隆大学和维滕/黑尔德克大学。邀请学生填写一份匿名书面问卷，问卷包含开放式问题，询问其医学教育过程中对其同理心产生积极或消极影响的教育内容和情况。根据格林和索罗古德的方法，通过定性内容分析法对数据进行分析。
共有115名学生参与了调查。受访者表示，基于实践的教育，包括与患者接触以及结合临床实践和患者视角进行教学，提高了他们的同理心，而缺乏这些则会抑制同理心。学生对患者的内在反应，如喜欢或不喜欢某个患者、偏见及其他态度，也被认为会影响他们的同理心。尽管三所学校在人际技能教学方面采取了不同方法，但在学生对同理心可能的决定因素的回答中未发现相关差异。
提供更多实践培训以及增加与患者的接触可能是促进学生同理心的有效方法。学生在与患者建立治疗关系以及处理自身感受和态度方面需要支持。这种支持可以通过反思性实践培训的形式提供，以促进自我认知。需要更多研究来评估这些假设性结论。
