Winkel Abigail Ford
Assistant Professor, Department of Obstetrics and Gynecology, New York University School of Medicine.
MedEdPORTAL. 2016 Nov 3;12:10493. doi: 10.15766/mep_2374-8265.10493.
Reflection is a critical part of the learning cycle. Narrative medicine has been shown to help physicians-in-training develop both empathy and professional identity. A narrative medicine curriculum focused on the experience of the physician and challenging patient experiences creates opportunities in which to process complicated aspects of the experience of both patient and physician with other members of the training community.
Fifteen 1-hour small-group reflective writing workshops comprise a 2-year narrative medicine curriculum. Each workshop uses selected literature to focus a discussion and a prompt for written reflection and can be integrated into a didactic curriculum. Teacher guides have been created to help untrained preceptors lead small-group sessions. Feedback forms are distributed to participating residents.
Out of 29 total residents enrolled at one program, 23 residents completed feedback forms, and 16 (69%) reported that the reflective writing sessions were relevant to their work as obstetrician-gynecologists. Residents stated the best parts of the course were reading and writing ( = 6; 27%), sharing writings with colleagues ( = 5; 21%), and having positive experiences with members of their community ( = 6; 27%). Some residents reported difficulty sharing their private reflections ( = 4; 17%).
A narrative medicine curriculum is a powerful tool for promoting reflection about the challenging work of training in obstetrics and gynecology and other specialties. Reflective writing workshops have been found to be acceptable to obstetrics and gynecology residents, and the curriculum has been successfully implemented at several training programs.
反思是学习周期的关键部分。叙事医学已被证明有助于医学生培养同理心和职业认同感。以医生经历和具有挑战性的患者经历为重点的叙事医学课程,创造了与培训社区的其他成员一起处理患者和医生经历中复杂方面的机会。
15个1小时的小组反思写作工作坊构成了一个为期2年的叙事医学课程。每个工作坊使用选定的文献来聚焦讨论和提供书面反思的提示,并可融入教学课程。已创建教师指南,以帮助未经培训的带教老师主持小组会议。向参与的住院医师分发反馈表。
在一个项目招收的29名住院医师中,23名完成了反馈表,16名(69%)报告说反思写作环节与他们作为妇产科医生的工作相关。住院医师表示课程中最精彩的部分是阅读和写作(n = 6;27%)、与同事分享作品(n = 5;21%)以及与社区成员有积极的互动(n = 6;27%)。一些住院医师报告在分享个人反思时存在困难(n = 4;17%)。
叙事医学课程是促进对妇产科及其他专业培训中具有挑战性的工作进行反思的有力工具。反思写作工作坊已被妇产科住院医师所接受,并且该课程已在多个培训项目中成功实施。