Green Michael J
M.J. Green is professor, Departments of Humanities and Medicine, Penn State College of Medicine, Hershey, Pennsylvania.
Acad Med. 2015 Jun;90(6):774-9. doi: 10.1097/ACM.0000000000000703.
Medical students experience transformative personal and professional changes during medical school. The medical education community has much to learn about how students perceive these changes, which can be dramatic and profound.
Over the past six years (2009-2014), the author has taught a course on medical graphic narratives (or comics) to fourth-year medical students. Comics synergistically combine words and images to tell stories and provide an effective vehicle for helping students reflect on and give voice to varied experiences. In this course, students critically read and discuss medically themed comics and create their own original comic depicting a formative experience from medical school.
To date, 58 students have taken the course, and each has produced an original comic. The author conducted a thematic analysis of their comics and identified the following themes: (1) how I found my niche, (2) the medical student as patient, (3) reflections on a transformative experience, (4) connecting with a patient, and (5) the triumphs and challenges of becoming a doctor. Pre/post course assessments indicate that students believe creating a comic can significantly improve a variety of doctoring skills and attitudes, including empathy, communication, clinical reasoning, writing, attention to nonverbal cues, and awareness of physician bias. Students' comics reveal the impact of formative events on their professional identity formation.
Medical educators should explore additional ways to effectively integrate comics into medical school curricula and develop robust tools for evaluating their short- and long-term impact.
医学生在医学院学习期间会经历个人和职业上的转变。医学教育界对于学生如何看待这些可能巨大且深刻的变化还有很多需要了解的地方。
在过去六年（2009 - 2014年）里，作者为四年级医学生开设了一门关于医学图文叙事（或漫画）的课程。漫画通过文字和图像的协同结合来讲述故事，并为帮助学生反思并表达各种经历提供了一种有效的方式。在这门课程中，学生批判性地阅读和讨论以医学为主题的漫画，并创作自己的原创漫画来描绘医学院的一段 formative experience（此处formative experience未明确，可译为“成长经历”之类，需结合上下文确定准确含义）。
到目前为止，已有58名学生参加了该课程，并且每人都创作了一部原创漫画。作者对他们的漫画进行了主题分析，确定了以下主题：（1）我如何找到自己的定位，（2）医学生作为患者，（3）对一次转变性经历的反思，（4）与患者建立联系，以及（5）成为医生的成功与挑战。课程前后评估表明，学生们认为创作漫画可以显著提高多种医疗技能和态度，包括同理心、沟通能力、临床推理、写作、对非语言线索的关注以及对医生偏见的认识。学生的漫画揭示了成长事件对他们职业身份形成的影响。
医学教育工作者应探索更多方法，以有效地将漫画融入医学院课程，并开发强大的工具来评估其短期和长期影响。
