Lemogne Cédric, Buffel du Vaure Céline, Hoertel Nicolas, Catu-Pinault Annie, Limosin Frédéric, Ghasarossian Christian, Le Jeunne Claire, Jaury Philippe
Université de Paris, Faculté de Santé, UFR de Médecine, 15 rue de l'Ecole-de-Médecine, 75006, Paris, France.
AP-HP.Centre-Université de Paris, Hôpital Hôtel-Dieu, Service de Psychiatrie de l'adulte, 1 place du parvis Notre-Dame, 75004, Paris, France.
BMC Med Educ. 2020 Nov 9;20(1):412. doi: 10.1186/s12909-020-02316-w.
The perceived importance of clinical empathy may decline among students during medical training. Several interventions have been shown to be effective in promoting or preserving medical students' empathic abilities, such as empathy skills training or Balint groups. Although narrative medicine training shares some features with these interventions, no randomized study to date examined the efficacy of narrative medicine training. This study aimed to assess the effects of Balint groups and narrative medicine training on clinical empathy measured by the self-rated Jefferson's School Empathy Scale - Medical Student (JSPE-MS©) among fourth-year medical students.
Students who gave their consent to participate were randomly allocated in equal proportion to Balint groups, narrative medicine training or to the control group. Participants in the intervention groups received either seven sessions of 1.5-h Balint groups or a 2-h lecture and five sessions of 1.5-h narrative medicine training from October 2015 to December 2015. The main outcome was the change in JSPE-MS© score from baseline to one week after the last session.
Data from 362 out of 392 participants were analyzed: 117 in the control group, 125 in the Balint group and 120 in the narrative medicine group. The change in JSPE-MS© score from baseline to follow-up was significantly higher in the Balint group than in the control group [mean (SD): 0.27 (8.00) vs. -2,36 (11.41), t = 2.086, P = 0.038]. The change in JSPE-MS© score in the narrative medicine group [mean (SD): - 0.57 (8.76)] did not significantly differ from the changes in the control group (t = 1.355, P = 0.18) or the Balint group (t = 0.784, P = 0.43). Adjusting for participants' characteristics at baseline, Balint groups remained associated with better outcomes compared to the control group (β = 2.673, P = 0.030).
Balint groups may promote clinical empathy to some extent among medical students, at least in the short run.
在医学培训期间，学生对临床同理心的认知重要性可能会下降。已证明几种干预措施在促进或保持医学生的共情能力方面是有效的，例如共情技能培训或巴林特小组。尽管叙事医学培训与这些干预措施有一些共同特征，但迄今为止尚无随机研究检验叙事医学培训的效果。本研究旨在评估巴林特小组和叙事医学培训对四年级医学生通过自评的杰斐逊医学院校共情量表 - 医学生版（JSPE - MS©）测量的临床同理心的影响。
同意参与的学生被等比例随机分配到巴林特小组、叙事医学培训组或对照组。干预组的参与者在2015年10月至2015年12月期间接受了七次每次1.5小时的巴林特小组活动，或一次2小时的讲座以及五次每次1.5小时的叙事医学培训。主要结局是从基线到最后一次活动后一周JSPE - MS©评分的变化。
分析了392名参与者中362人的数据：对照组117人，巴林特小组125人，叙事医学组120人。巴林特小组从基线到随访时JSPE - MS©评分的变化显著高于对照组[均值（标准差）：0.27（8.00）对 -2.36（11.41），t = 2.086，P = 0.038]。叙事医学组JSPE - MS©评分的变化[均值（标准差）： -0.57（8.76）]与对照组（t = 1.355，P = 0.18）或巴林特小组（t = 0.784，P = 0.43）的变化无显著差异。在对参与者基线特征进行调整后，与对照组相比，巴林特小组仍与更好的结局相关（β = 2.673，P = 0.030）。
巴林特小组可能在一定程度上促进医学生的临床同理心，至少在短期内如此。
