本科医学生的同理心:对课程开始阶段和接近结束阶段学生的多中心横断面比较。

Empathy among undergraduate medical students: A multi-centre cross-sectional comparison of students beginning and approaching the end of their course.

作者信息

Quince Thelma A, Kinnersley Paul, Hales Jonathan, da Silva Ana, Moriarty Helen, Thiemann Pia, Hyde Sarah, Brimicombe James, Wood Diana, Barclay Matthew, Benson John

机构信息

Primary Care Unit, Department of Public Health, Primary Care University of Cambridge, IPH, Robinson Way, Cambridge, CB2 0SR, UK.

Institute of Medical Education, Medical School, Cardiff University 2nd floor, Neuadd Meirionydd, Heath Park, Cardiff, CF14 4XN, UK.

出版信息

BMC Med Educ. 2016 Mar 15;16:92. doi: 10.1186/s12909-016-0603-7.

Abstract

BACKGROUND

Although a core element in patient care the trajectory of empathy during undergraduate medical education remains unclear. Empathy is generally regarded as comprising an affective capacity: the ability to be sensitive to and concerned for, another and a cognitive capacity: the ability to understand and appreciate the other person's perspective. The authors investigated whether final year undergraduate students recorded lower levels of empathy than their first year counterparts, and whether male and female students differed in this respect.

METHODS

Between September 2013 and June 2014 an online questionnaire survey was administered to 15 UK, and 2 international medical schools. Participating schools provided both 5-6 year standard courses and 4 year accelerated graduate entry courses. The survey incorporated the Jefferson Scale of Empathy-Student Version (JSE-S) and Davis's Interpersonal Reactivity Index (IRI), both widely used to measure medical student empathy. Participation was voluntary. Chi squared tests were used to test for differences in biographical characteristics of student groups. Multiple linear regression analyses, in which predictor variables were year of course (first/final); sex; type of course and broad socio-economic group were used to compare empathy scores.

RESULTS

Five medical schools (4 in the UK, 1 in New Zealand) achieved average response rates of 55 % (n = 652) among students starting their course and 48 % (n = 487) among final year students. These schools formed the High Response Rate Group. The remaining 12 medical schools recorded lower response rates of 24.0 % and 15.2 % among first and final year students respectively. These schools formed the Lower Response Rate Group. For both male and female students in both groups of schools no significant differences in any empathy scores were found between students starting and approaching the end of their course. Gender was found to significantly predict empathy scores, with females scoring higher than males.

CONCLUSIONS

Participant male and female medical students approaching the end of their undergraduate education, did not record lower levels of empathy, compared to those at the beginning of their course. Questions remain concerning the trajectory of empathy after qualification and how best to support it through the pressures of starting out in medical practice.

摘要

背景

尽管共情是患者护理的核心要素,但本科医学教育期间共情的发展轨迹仍不明确。共情通常被认为包括情感能力:对他人敏感并关心他人的能力,以及认知能力:理解和领会他人观点的能力。作者调查了本科最后一年的学生与第一年的学生相比共情水平是否较低,以及男女生在这方面是否存在差异。

方法

2013年9月至2014年6月,对英国的15所和国际的2所医学院校进行了在线问卷调查。参与调查的学校提供5 - 6年的标准课程和4年的加速研究生入学课程。该调查纳入了广泛用于测量医学生共情的杰斐逊共情量表 - 学生版(JSE - S)和戴维斯人际反应指数(IRI)。参与是自愿的。卡方检验用于检验学生群体传记特征的差异。多元线性回归分析中,预测变量为课程年份(第一年/最后一年)、性别、课程类型和广泛的社会经济群体,用于比较共情得分。

结果

五所医学院校(英国4所,新西兰1所)在开课学生中的平均回复率为55%(n = 652),在最后一年学生中的平均回复率为48%(n = 487)。这些学校组成了高回复率组。其余12所医学院校在第一年和最后一年学生中的回复率分别较低,为24.0%和15.2%。这些学校组成了低回复率组。在两组学校中,无论是男生还是女生,开课学生和临近课程结束的学生在任何共情得分上均未发现显著差异。发现性别显著预测共情得分,女生得分高于男生。

结论

与本科课程开始时相比,临近本科教育结束的参与调查的男女医学生并未表现出较低的共情水平。关于毕业后共情的发展轨迹以及如何在开始医疗实践的压力下最好地支持共情,仍存在问题。

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