a Julius Center for Health Sciences and Primary Care , University Medical Center Utrecht , Utrecht , The Netherlands.
Med Teach. 2019 Jul;41(7):802-810. doi: 10.1080/0142159X.2019.1584274. Epub 2019 Apr 14.
Narrative medicine has been promoted as an innovative and effective means of stimulating medical students' professional development by teaching them to approach their patients' experiences of illness with more understanding and compassion. This systematic literature review aims to answer the following question: what evidence of effect is available in the literature about models for teaching narrative medicine? We conducted a narrative review of 36 articles and used the Best Evidence in Medical Education (BEME) Global Scale and Kirkpatrick Scale for strength and importance of evidence to categorize reported assessment strategies and to evaluate the effectiveness of their narrative medicine programs. We found evidence that narrative medicine is an effective pedagogic tool with a clear and replicable structure and methodology. We also determined that a positive impact could be measured when pertaining to participation and modification of attitudes, knowledge, and skills. However, unequivocal evidence of the effect of narrative medicine on students' behavior or ongoing interaction with colleagues and patients is still lacking. While many recent publications describe the goals and virtues of a narrative-based approach, more research is needed to determine whether or not there is an ideological consensus undergirding this approach. In addition, it is still unclear whether the long-term impact of narrative medicine classroom interventions are felt by patients, or whether such interventions positively impact patient care.
叙事医学被提倡为一种创新且有效的方法,可以通过教导医学生更深入地理解和同情患者的疾病经历,从而促进他们的专业发展。本系统文献综述旨在回答以下问题:关于叙事医学教学模式,文献中有哪些效果证据?我们对 36 篇文章进行了叙述性综述,并使用医学教育最佳证据(BEME)全球量表和柯克帕特里克量表来对报告的评估策略进行分类,并评估其叙事医学课程的有效性。我们发现有证据表明叙事医学是一种有效的教学工具,具有明确且可复制的结构和方法。我们还确定,当涉及到参与和改变态度、知识和技能时,可以衡量出积极的影响。然而,叙事医学对学生行为或与同事和患者持续互动的影响的明确证据仍然缺乏。虽然最近有许多出版物描述了基于叙事的方法的目标和优点,但仍需要更多的研究来确定这种方法是否有一个潜在的共识。此外,叙事医学课堂干预对患者的长期影响,或者这种干预是否对患者护理有积极影响,仍不清楚。