Egnew Thomas R, Lewis Peter R, Meyers Kimberly R, Phillips William R
Tacoma Family Medicine, Tacoma, WA.
Department of Family and Community Medicine, Pennsylvania State University.
Fam Med. 2018 Apr;50(4):296-299. doi: 10.22454/FamMed.2018.116755.
The purpose of this study was to explore medical student perceptions of their medical school teaching and learning about human suffering and their recommendations for teaching about suffering. During data collection, students also shared their percerptions of personal suffering which they attributed to their medical education.
In April through May 2015, we conducted focus groups involving a total of 51 students representing all four classes at two US medical schools.
Some students in all groups reported suffering that they attributed to the experience of medical school and the culture of medical education. Sources of suffering included isolation, stoicism, confusion about personal/professional identity and role as medical students, and witnessing suffering in patients, families, and colleagues. Students described emotional distress, dehumanization, powerlessness, and disillusionment as negative consequences of their suffering. Reported means of adaptation to their suffering included distraction, emotional suppression, compartmentalization, and reframing. Students also identified activities that promoted well-being: small-group discussions, protected opportunities for venting, and guidance for sharing their experiences. They recommended integration of these strategies longitudinally throughout medical training.
Students reported suffering related to their medical education. They identified common causes of suffering, harmful consequences, and adaptive and supportive approaches to limit and/or ameliorate suffering. Understanding student suffering can complement efforts to reduce medical student distress and support well-being.
本研究旨在探讨医学生对其医学院校关于人类苦难的教学的看法，以及他们对苦难教学的建议。在数据收集过程中，学生们还分享了他们将其归因于医学教育的个人苦难感受。
2015年4月至5月，我们开展了焦点小组访谈，共有来自美国两所医学院四个班级的51名学生参与。
所有小组中的一些学生报告了他们归因于医学院经历和医学教育文化的苦难。苦难来源包括孤立、坚忍克己、对作为医学生的个人/职业身份和角色感到困惑，以及目睹患者、家属和同事的苦难。学生们将情绪困扰、人性丧失、无力感和幻灭感描述为他们苦难的负面后果。报告的适应苦难的方式包括分散注意力、情绪抑制、区分对待和重新构建认知。学生们还确定了促进幸福感的活动：小组讨论、有保障的发泄机会以及分享经历的指导。他们建议在整个医学培训过程中纵向整合这些策略。
学生们报告了与医学教育相关的苦难。他们确定了苦难的常见原因、有害后果以及限制和/或减轻苦难的适应及支持方法。了解学生的苦难可以补充减少医学生困扰和支持幸福感的努力。
