Han Jing L, Pappas Theodore N
Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
J Surg Educ. 2018 Jan-Feb;75(1):88-94. doi: 10.1016/j.jsurg.2017.06.035. Epub 2017 Jul 14.
There has been much discussion in the medical literature about the importance of empathy and physician communication style in medical practice. Empathy has been shown to have a very real positive effect on patient outcomes. Most of the existing literature speaks to its role in medical education, with relatively little empiric study about empathy in the surgical setting.
Review of empathy and its importance as it pertains to the surgeon-patient relationship and improving patient outcomes, and the need for increased education in empathy during surgical training.
The published, peer-reviewed literature on patient-physician and patient-surgeon communication, medical student and resident education in empathy, and empathy research was reviewed. PubMed was queried for MESH terms including "empathy," "training," "education," "surgery," "resident," and "communication."
There is evidence of a decline in empathy that begins during the clinical years of medical school, which continues throughout residency training. Surgeons are particularly susceptible to this decline as by-product of the nature of their work, and the current lack of formalised training in empathic patient communication poses a unique problem to surgical residents.
The literature suggests that empathy training is warranted and should be incorporated into surgical residencies through didactics, role-playing and simulations, and apprenticeship to empathic attending role models.
医学文献中对同理心和医生沟通方式在医疗实践中的重要性已有诸多讨论。研究表明,同理心对患者治疗结果具有切实的积极影响。现有文献大多探讨了其在医学教育中的作用,而关于外科环境中同理心的实证研究相对较少。
综述同理心及其与医患关系和改善患者治疗结果的相关性,以及外科培训中加强同理心教育的必要性。
对已发表的、经过同行评审的关于医患和医患沟通、医学生和住院医师同理心教育以及同理心研究的文献进行综述。在PubMed上查询包括“同理心”“培训”“教育”“外科手术”“住院医师”和“沟通”等医学主题词。
有证据表明,同理心在医学院临床阶段开始下降,并在住院医师培训期间持续。外科医生因其工作性质的副产品,尤其容易出现这种下降,而目前缺乏关于同理心患者沟通的正规培训给外科住院医师带来了独特的问题。
文献表明,同理心培训是必要的,应通过教学、角色扮演和模拟以及向有同理心的带教榜样学习等方式纳入外科住院医师培训。