Professor of Psychiatry, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida.
Associate Professor of Psychiatry, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida.
Psychodyn Psychiatry. 2020 Winter;48(4):477-497. doi: 10.1521/pdps.2020.48.4.477.
Professionalism is a fundamental expectation of practicing medicine and a core competency in medical education, yet the methods of how to teach and evaluate it are still experimental. Professionalism involves self-reflection, a psychodynamic understanding of the patient's and the doctor's predicament, and conflict resolution, so psychiatrists are uniquely qualified to teach it. This article describes an innovative course that utilizes psychodynamic principles to teach professionalism to medical students. The authors present a novel 2-year curriculum for teaching professionalism to first- and second-year medical students utilizing psychodynamic principles to help develop awareness of others' feelings and motivations, self-reflection, compassion, empathy, and skills in ethical conflict resolution by means of written and oral narrative exercises. Outcomes are evaluated by the student ratings about the course and the faculty, and by using the test for emotional intelligence (EI), administered as a baseline and then at the end of each year. Each subsequent year the students demonstrated a statistically significant increase in EI scores, student evaluations of the course ranked among the highest in the medical school, clerkship supervisors and residency training directors noted the high degree of professionalism of the students, and the number of student applicants to psychiatry residency were consistently higher than the national average. In addition, this course was awarded the 2018 Alpha Omega Alpha Honor Medical Society's Edward B. Harris Medical Professionalism Award for the best professionalism course of U.S. medical schools. Psychodynamic principles are fundamental for teaching medical professionalism at a medical-student level. Professionalism also serves as a way to introduce students to psychiatry early in the curriculum, and psychiatrists and other mental health professionals are uniquely qualified to teach medical professionalism.
专业精神是行医的基本期望，也是医学教育的核心能力，但教授和评估它的方法仍在探索中。专业精神涉及自我反思、对患者和医生困境的心理动力学理解以及冲突解决，因此精神科医生最有资格教授它。本文介绍了一种利用心理动力学原理教授医学生专业精神的创新课程。作者提出了一种新颖的为期 2 年的课程，利用心理动力学原理教授医学生专业精神，帮助他们发展对他人感受和动机的意识、自我反思、同情心、同理心以及通过书面和口头叙述练习解决伦理冲突的技能。通过学生对课程和教师的评价以及情商测试（EI）的结果来评估结果，该测试作为基线进行，并在每年年底进行一次。随后的每一年，学生的 EI 分数都有显著提高，学生对课程的评价在医学院中名列前茅，实习主管和住院医师培训主任注意到学生的专业精神程度很高，申请精神科住院医师的学生人数始终高于全国平均水平。此外，该课程获得了 2018 年阿尔法欧米茄阿尔法荣誉医学协会爱德华 B.哈里斯医学专业精神奖，是美国医学院最佳专业精神课程。心理动力学原则是在医学生层面教授医学专业精神的基础。专业精神也可以作为在课程早期向学生介绍精神病学的一种方式，精神科医生和其他心理健康专业人员最有资格教授医学专业精神。
