Ronan Lara K, Czerwiec M K
Dartmouth College Geisel School of Medicine, Lebanona, NH, USA.
Northwestern University School of Medicine, Chicago, IL, USA.
J Med Humanit. 2020 Dec;41(4):573-578. doi: 10.1007/s10912-020-09654-2.
Curricular design that addresses residency physician competencies in communication skills and professionalism remains a challenge. Graphic Medicine (GM) uses comics, a medium combining text and images, to communicate healthcare concepts. Narrative Medicine, in undergraduate medical education, has limited reported usage in Graduate Medical Education (GME). Given the time constraints and intensity of GME, we hypothesized that comics as a form of narrative medicine would be an efficient medium to engage residents.The authors created a novel curriculum to promote effective communication and professionalism, focusing on empathy, compassion and cultural competency. A four-week curriculum was delivered in a neurology residency program. Excerpts from non-fiction graphic memoirs about neurological conditions were read, discussed, and paired with prompt-driven drawing exercises. Qualitative surveys were used to assess acceptability of comics, usefulness of comics to convey patient illness experience, and perception of patient needs for physician-patient communication.Ninety-seven percent of residents reported the sessions were a good use of their time. Residents identified new symptoms of neurologic disorders, articulated patient communication needs, and expressed increased empathy after participation. Residents participated in drawing exercises, but these were not formally analyzed. Graphic medicine is a well received format that may build communication skills and increase empathy.
针对住院医师沟通技能和职业素养能力的课程设计仍然是一项挑战。图文医学（GM）利用漫画这种文字与图像相结合的媒介来传达医疗保健概念。叙事医学在本科医学教育中已有应用，但在毕业后医学教育（GME）中的报道使用情况有限。考虑到GME的时间限制和强度，我们推测漫画作为叙事医学的一种形式将是吸引住院医师的有效媒介。作者创建了一个新颖的课程，以促进有效的沟通和职业素养，重点关注同理心、同情心和文化能力。在一个神经科住院医师项目中开展了为期四周的课程。阅读、讨论了关于神经系统疾病的非虚构图文回忆录节选，并与基于提示的绘画练习相结合。使用定性调查来评估漫画的可接受性、漫画在传达患者疾病经历方面的有用性以及对医患沟通中患者需求的认知。97%的住院医师报告称这些课程很好地利用了他们的时间。住院医师识别出了神经系统疾病的新症状，阐明了患者的沟通需求，并在参与后表达了更强的同理心。住院医师参与了绘画练习，但未对其进行正式分析。图文医学是一种广受好评的形式，可能有助于培养沟通技能并增强同理心。
