Le Annie, Miller Kara, McMullin Juliet
Annie Le, MPH, is a second-year medical student at the University of California, Riverside School of Medicine.
Kara Miller, MA, is a PhD candidate in the Department of Anthropology at the University of California, Riverside.
AMA J Ethics. 2017 Mar 1;19(3):304-311. doi: 10.1001/journalofethics.2017.19.3.msoc1-1703.
This paper examines how illness narratives are used in medical education and their implications for clinicians' thinking and care of patients. Ideally, collecting and reading illness narratives can enhance clinicians' sensitivity and contextual thinking. And yet these narratives have become part of institutionalizing cultural competency requirements in ways that tend to favor standardization. Stereotyping and reductionistic thinking can result from these pedagogic approaches and obscure structural inequities. We end by asking how we might best teach and read illness narratives to fulfill the ethical obligations of listening and asking more informative clinical interview questions that can better meet the needs of patients and the community.
本文探讨了疾病叙事在医学教育中的应用方式及其对临床医生思维和患者护理的影响。理想情况下，收集和阅读疾病叙事可以提高临床医生的敏感性和情境思维能力。然而，这些叙事已成为将文化能力要求制度化的一部分，其方式往往倾向于标准化。这些教学方法可能导致刻板印象和简化思维，并掩盖结构性不平等。我们最后提出疑问，即如何才能最好地教授和阅读疾病叙事，以履行倾听和提出更具信息性的临床访谈问题的伦理义务，从而更好地满足患者和社区的需求。
